Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
109 Cards in this Set
- Front
- Back
- 3rd side (hint)
|
Causes of decreased cardiac output secondary to a heart rate >150 bpm
|
Pumping to fast to let the ventricles completely or correctly fill.
|
|
|
|
Definition of acute coronary syndrome (ACS)
|
The term used to describe and group of clinical symptoms consistent with acute myocardial ischemia, insufficient blood supply to the heart muscle.
|
|
|
|
Rx of SVT
|
Unstable perform immediate synchronized cardioversion (Biphasic is 50J-->75J-->120J, Mono 50,100, 300, than 360)
Stable attempt vagal maneuvers than move on to adenosine at 6mg than 2 more doses of 12mg may be given. If it does not convert consult MD. |
27.81
|
|
|
Classic signs of A-flutter on an EKG
|
Sawtooth
When a single irritable site in the atria initiates many electrical impulses at a rapid rate, characterized by the presence of regular atrial activity when a picket-fence or sawtooth pattern. 2:1 3:1 ect. depending on how many atrial flutter rhythms it takes till the gate keeper/AV node accepts to make ventricular response. |
|
|
|
Classic presentations of chronic bronchitis
|
Define as sputum production most days of the month for 3 or more months out of the year for more than 2 years. The hallmark of this disease is excessive mucous production in the bronchial tree, which is nearly always accompanied by a chronic or recurrent productive cough. Usually a heavy smoker, obese, and may have a bluish complexion. May also have a fever.
|
26.30
|
|
|
The definition of automaticity
|
The ability of the cardiac pacemaker cells to generate their own electrical impulses spontaneously without external (or nervous) stimulation. Location is SA node, AV junction, and purkinje network fibers. Function is electrical.
|
|
|
|
Common S/S of CHF
|
Left sided heat failure will have wheezes, crackles, JVD, edema. Often older pts, may have heart problems or HTN, recent weight gain, and dyspnea may worsen when they lay down (orthopnea).
Rt sided heart failure less dangerous and may only show as edema. |
27.35
|
|
|
What is the most common cause of right-sided heart failure
|
As a result of left-sided heart failure due to the increasingly harder work on the heat to pump blood into the engorged pulmonary vessels.
|
27.36
|
|
|
Mechanisms of medications used to treat wheezing
|
Relaxes bronchi by stimulating beta 2
|
|
|
|
Why a first degree heart block has a prolonged PRI
|
Typically, first degree block results from excessive conduction delay in the AV node.
|
|
|
|
Describe the layers of the heart
|
The heart has three layers; the epicardium, myocardium, and endocardium.
The epicardium is the smooth outer layer. The myocardium is the thick middle layer of the heart composed primarily of cardiac muscle cells and responsible for the heart's ability to contract. The thickest of the three layers. The endocardium is the innermost layer of the heart; composed of thin connective tissue. |
|
|
|
What neurotransmitter regulates sympathetic nerves?
|
Norepinephrine
|
|
|
|
When depolarization occurs
|
Electrical occurrence normally expected to result in myocardial contraction; involves the movement of ions across cardiac cell membranes, resulting in positive polarity inside the cell membrane.
POTASIUM OUT, SODIUM IN. |
|
|
|
Etiology of retractions and when they most commonly occur
|
Most common in peds due to their elastic cartilage
|
|
|
|
Parameters of second degree heart block
|
A partial or incomplete heart block characterized by the PRI continues to increase in length until such time as the impulse is not conductive or a QRS complex is "dropped." The ventricular rhythm is irregular, the the atrial rhythm remains regular.
|
|
|
|
What a P wave represents
|
Atrial contraction
|
|
|
|
What causes an inverted p-wave on a monitor screen/stip
|
Impulse by other than the SA node, often the AV node causes the electrical impulse (juctional).
|
|
|
|
Treatment considerations for the morbidly obese respiratory pts
|
Sit them up or on their side so that there fat is off their diaphragm.
|
|
|
|
Clinical signs of pneumonia in the COPD pt
|
Diminish lung sounds on one side, productive cough especially yellow green and brown mucus, fever, gradual onset 2 or so days, and rhochi.
|
|
|
|
Intubation considerations for the astmatic pt
|
Not a first line treatment
|
|
|
|
What Chronotropic medications affect
|
Heart rate
|
|
|
|
Considerations to prevent or stop artifact on the cardiac monitor
|
Turn off lights, check lead attachment, sit still
|
|
|
|
Normal duration of the PRI
|
0.12-0.20 seconds (three to five small squares).
|
|
|
|
JVD presentation in the CHF pt
|
Be sure to eval at least a 45 degree angle
JVD is rt sided failure |
|
|
|
Parameters of ventricular bigeminy
|
every other beat
Reg PVC Reg PVC Reg PVC.... |
|
|
|
Treatment considerations for bradycardia
|
Is the pt symptomatic?
|
|
|
|
Parameters of a run of V-Tach
|
3 or more PVCs in a row.
|
|
|
|
Complications associated with atrial fibrillation
|
clots causing strokes
|
|
|
|
What digital clubbing indicates
|
hyperventilation
|
|
|
|
Primary focus of sinus tachycardia treatment
|
Slow down heart rate
|
|
|
|
Pulmonary edema complications with left heart failure
|
Edema in lungs causes dyspnea
pathophys why |
|
|
|
Examples of drugs that beta blockers effect
|
They block bronchiodilators, epi, norepi, etc
|
|
|
|
Where it is easiest to lower elevated BP
|
Best in controlled conditions in a hospital.
|
27.40
|
|
|
S/S of ACS
|
Most common symptom is angina pectoris, literally choking in the chest.
|
|
|
|
Treatment of the respiratory depressed heroin abuser
|
ABC's
Narcan |
|
|
|
Parameters of Repolarization
|
Channels close
|
|
|
|
Characteristics of monomorphic V-Tach
|
Looks like torsades but has no pulse
|
|
|
|
ECG waveform that represents ventricular depolarization
|
QRS
|
|
|
|
How the hypoxic drive phenomenon occurs
|
26.31
|
|
|
|
Where abnormal breath sounds are heard in pneumonia or CHF pt
|
Bases of lung
|
|
|
|
Receptors that causes vasoconstriction
|
Alpha and Beta
|
|
|
|
Primary cause of death in the pre-hospital setting following AMI
|
27.29
Arrhythmia commonly V-Fib |
|
|
|
Low pressure or high pressure
Which describes the right side of the heart? |
Low pressure
|
|
|
|
The electrolyte that maintains the depolarization stage
|
Calcium
|
|
|
|
BP contraindications of nitroglycerin administration
|
Systolic > 90 mm Hg
|
|
|
|
The definition of atrial kick
|
The final phase of diastole, atrial contraction forces remaining blood into the ventricles; providing 20% ventricular filling. The atrial kick is lost in A-Fib cusing blood to stagnate in the atria increase risk for atrial and systemic emboli.
|
|
|
|
Duration parameters of the QRS complex
|
Consist of the Q (downward), R (upward), and S (downward) waves and represents the conduction of the electrical impulse from the bundle of His throughout the ventricular muscle, or ventricular depolarization. Normal time length is 0.12 seconds.
|
|
|
|
Most common symptom of hypertension
|
Early stages are usually asymptomatic.
Symptoms usually show in later stages as headaches, dizziness, weakness, epitaxis, and blurring of vision. |
27.40
|
|
|
Where is the mitral valve located?
|
Also known as the bicuspid valve, an atrioventricular valve located between the lt atrium and lt ventricle.
|
|
|
|
Pain differences in the AMI vs Dissecting Aortic Aneurysm pt
|
AMI is more of a pressure or crushing pain. Pain is often gradually increasing over time. Rarely involves back. Equal BPs and pulses.
AA is ripping, tearing, and shedding. Pain is at the max on onset. Often involves back, and check for decrease pulses and BP difference between sides. Pain does not really get better. |
27.39
|
|
|
Descripting of Perkinje fibers
|
Conduction fibers at the very end of the ventricles.
|
|
|
|
S/S of pulmonary embolism
|
Respiratory distress not relieve with oxygen, often leading to the need for intubation.
|
|
|
|
Characteristics of COPD
|
Destruction of aveoli or atelectasis, which is not reversible.
|
|
|
|
BP parameters that indicate hypertension is present
|
Present when the BP at rest is consistently greater than 140/90 mm Hg.
|
|
|
|
Hypocalcemia effects in the Q-T interval
|
Prolonged Q-T interval thus longer absolute refractory period.
|
|
|
|
PRI considerations in second degree Mobitz II rhythm
|
PRI wnl except for dropped beats
|
|
|
|
The most effective drug in treatment of non-vagal bradycardia
|
Epinephrine
|
|
|
|
S-T segment and its correlation to the isoelectric line
|
Should be at the level of the isoelectric line.
|
|
|
|
Classification of Ipratropium
|
Anticholinergic
Sympathetic Bronchiodilator |
|
|
|
When myocardial ischemia occurs
|
Due to lack of oxygen to heart muscle, hardening of arteries, clot, narrow vessels secondary to vaso constriction.
|
|
|
|
When pulse oximetry reading are lease accurate
|
CO2 poisoning, lack of circulation, cold ext, finger nail polish, etc.
|
|
|
|
S/S of lung cancer
|
Coughing up blood
|
|
|
|
The definition of Cor Pulmonale
|
Heart dz that develops secondary to a chronic lung disease, usually affecting the right side of the heart primarily.
|
G.9
|
|
|
Adults vs. Children and the onset of croup
|
The swelling is more significant in children due to the smaller airway.
|
|
|
|
Definition and description of the pathologic Q wave
|
Downward deflection deeper than 1/3 total height of the the R wave. Usually indicates and old MI.
|
|
|
|
False positive causes in the ETCO2 detector
|
The machine can be fooled if the pt has carbon dioxide trapped in the stomach from the ingestion of carbonated beverages, so confirm the reading over at least six breaths.
|
26.24
|
|
|
Indications secondary to diffuse rhochi in the lungs
|
Infectious/inflammatory process, pulmonary edema, and cough up fluid.
|
|
|
|
Treatment considerations for the hypertensive pt
|
Start a line TKO so that the high pressure does not collapse your IV.
|
|
|
|
SA node characteristics
|
?
|
|
|
|
How A-fib is interpreted
|
?
|
|
|
|
Complications if too much blood is returned to the heart
|
Increases preload and afterload.
Stretches the heart overtime causing lose of elasticity. |
|
|
|
Characteristics of biot respirations
|
Irregular pattern, rate, and depth with intermittent patterns of apnea, indicates server brain injury or brain steam herniation.
|
26.14
|
|
|
Cellular causes of V-Fib
|
Multiple sites/cells are firing
|
|
|
|
Pulmonary infection location in the upright vs. bedridden pt
|
Upright pts will be in the bases
Bedridden are often diffuse |
|
|
|
What purulent sputum represents
|
Pus like
Green/Brown indicates infection |
|
|
|
Onset of bronchodilator vs. corticosteroid therapy
|
Bronchodiliators are rapid while corticosteroid have slow onsets
|
|
|
|
How Percutaneous Coronary Interventions (PCI) work
|
Open coronary artery with a balloon or stint
|
|
|
|
Physiologic causes of respiratory alkalosis
|
Often cause by hyperventilation b/c they blow off too much CO2
|
|
|
|
Regulation of cardiac contraction strength
|
The nervous system regulate contractions.
|
|
|
|
What the firing of artifical pacemaker causes on the ECG
|
Pacer spike
|
|
|
|
S/S of aortic dissection
|
One femoral or carotid pulse missing.
BP different on either side. |
|
|
|
Who present with atypical S/S of AMI?
|
Females and diabetics (nerve degeneration)
|
|
|
|
Negative lead placement location when assessing in Lead II
|
Rt arm
|
|
|
|
What the left main coronary artery subdivides into
|
circumflex (back)
and Lt anterior descending (front) |
|
|
|
What can untreated V-tach lead into?
|
V-Fib
|
|
|
|
Characteristic of cardiac arrhythmias following AMI
|
Deadly rhythms being V-Fib and V-Tach.
Stable rhythms being pathological Q wave, A-Fib, AV blocks, Bradycardia the pt will get a pacemaker most likely. |
27.44 bottom
Between the QRS and the T wave |
|
|
What does the J point represent?
|
Located where the QRS ends and the ST segment begins. It represents the end of depolarization and the apparent beginning of repolarization.
|
|
|
|
Results of the heart's secondary pacemaker failing
|
slow HR
junctional or ventricular |
|
|
|
How to calculate the heart rate off of a six second strip
|
Count the QRS complex than add a 0 for ex 12 QRS is 120
5 little boxes is 0.2 5 big boxes is 1 second 30 big boxes is 6 seconds |
|
|
|
Mechanisms that cause hypertension
|
Most HTN is the result of advanced atherosclerosis or arteriosclerosis, which decreases the lumen of the arteries and reduces the elasticity. The resulting high afterload on the heart leads to an increase in filling volume and stimulates the Frank-Starling reflex, which raises the pressure behind the blood leaving the heart.
|
27.40
|
|
|
Definition of cardiac output
|
The amount of blood that is pumped out by either ventricle. The lt and rt are approximately equal in interior size, so the the two ventricles have relatively equivalent outputs. Normal CO for an average adult is 5 to 6 L/min.
|
27.13
|
|
|
Parameters and description of a PAC
|
-Rates usually normal.
-Rhythm is usually normal, except for PAC. -The PAC P wave is different in shape, size and location from normal P wave rhythms. -PRI varies depending on pacemaker. -QRS is similar to all in underlyning rhythm < 0.12 |
brady 88
|
|
|
Presentation characteristics of a 3rd degree heart block
|
Complete and lethal dysrhythmia characterized by the P waves not marrying to the QRS complex, thus the P waves are not causing the QRS, the QRS is cause by an escape pacemaker. Thus causing an irregularity due to complete electrical block between the SA and the ventricles.
|
|
|
|
The primary treatment of Bronchospasm
|
Albuterol and of course oxygen
Relax the broncho with a smooth muscle relaxer/bronchodilator |
|
|
|
Stable vs. unstable angina
|
Stable angina-Periodic pain with a predictable pattern.
Unstable angina-A changing, unpredictable pattern of pain, which may signal an impending acute myocardial infraction. Pts who have chest pain without an ST-segment elevation. |
27.28
|
|
|
Characteristics of a pure alpha agent
|
constricts vessels
|
|
|
|
Causes of infarctions on the inferior myocardial wall
|
Mainly causes when the RCA that feeds the apex (bottom) of the heart is blocked.
|
|
|
|
Types of calcium channel blockers
|
Not dig, and does not end with lol.
Cardizem |
|
|
|
The composition of the AV junction
|
AV node, bundle of His, and surrounding tissue.
|
|
|
|
Definition of the Dromotropic effect
|
Velocity
|
|
|
|
Common S/S of left sided heart failure
|
Wheezing
Crackles JVD Edema HTN orthopnea cough with foamy sputum recent weight gain |
|
|
|
Limb lead impulses moving toward a positive electrode cause what on an ECG
|
A positive deflection
|
|
|
|
The definition of aberrant conduction
|
Abnormal conduction of the electrical impulse through the heart.
|
27.88
|
|
|
S/S of status asmaticus
|
Silent cx and extreme dyspnea
|
|
|
|
What a cardiac pt with respiratory distress may be experiencing
|
May be experiencing cardiac asthma, often a CHF problem which happens very rapidly in minutes.
|
|
|
|
Characteristics of WPW syndrom
|
Its tachy and includes delta waves, often cause by accessory pathways that bypass the AV node.
|
|
|
|
What paroxysmal means in PSVT
|
means you either saw it start or stop
|
|
|
|
Parameters of 2nd degree heart block - Mobitz I
|
Prolonged PRI till there is a dropped beat
|
|
|
|
When cardiogenic shock occurs
|
Read 27.37
|
|
