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52 Cards in this Set
- Front
- Back
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what is it called when the valve does not close properly and blood backflows through the valve?
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regurgitation
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what is it called when the valve doesn't open completely and blood flow thru the valve is reduced?
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stenosis
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what is it called when the atrioventricular valve leaflet stretches into the atrium during diastole?
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valve prolapse
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what's the target level of total cholesterol?
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less than 200
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what's the target level of HDL cholesterol?
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above 40
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what's the target level of LDL cholesterol?
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below 100
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according to JNC7, what is hypertension?
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systolic greater than 140 AND
diastolic greater than 90 based on the average of 2 or more accurate BP measurements in 2 visits with a health care provider |
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according to JNC7, what are the classifications of blood pressure (18 or older)
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normal <120 and <80
preHTN 120-139 OR 80-89 Stage1 HTN 140-159 OR 90-99 Stage2 HTN 160+ OR 100+ |
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What affects cardiac output?
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heart rate * stroke volume
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what is pulse pressure?
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the difference between systolic and diastolic blood pressure
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What's the purpose of the myocardium?
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myocardium is responsible for the heart's ability to contract
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What is the purpose of the endocardium?
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Endocardium is the smooth inner surface of the heart and heart valves that allows blood to move more smoothly throughout the heart
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what is the purpose of the pericardium?
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To protect and lubricate the heart
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What are the 3 layers of the heart?
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endocardium, myocardium, and pericardium
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What happens to the valves during diastole?
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aortic and pulmonic valves are closed and mitral and tricuspid valves open
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What happens to the valves during systole?
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AV valves close; semilunar valves open
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which valve has 3 cusps and is located between the RIGHT atrium and ventricle?
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Tricuspid valve
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which valve is similar in structure to the tricuspid valve, but has 2 cusps and is located between the left atrium and ventricle?
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Bicuspid or mitral valve
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How do you administer NTG?
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sublingually, 1 tab every 5 minutes at onset of pain, max of 3 tabs. if pain not relieved after 3rd tab, call 911.
Do not chew or swallow tabs, and do not eat, drink, or smoke while a tab is in the mouth. |
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side effects of NTG?
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headache, dizziness, flushing or restlessness, burning or tingling under the tongue
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Difference between hypertensive crisis and emergency:
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emergency: extremely high blood pressure with failure of one or more organs imminent
crisis: high blood pressure but no organ damage imminent |
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Difference between treating HTN crisis and emergency?
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HTN emergency - BP should be lowered immediately w/ IV drugs, admit to ICU
HTN crisis - manage in ER with oral anti-hypertensives. follow up within 72 hours and treat on OP basis |
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explain the conduction system of the heart:
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4 steps: 1) SA node (natural pacemaker) creates an electrical signal.
2) signal follows pathways thru both atria. movement of electicity causes atria to contract, pushing blood into the ventricles 3) electrical signal reaches the AV node (electrical bridge). There, the signal pauses to give the ventricles time to fill with blood 4) electrical signal spreads thru the His-Purkinje system. The movement of electricity causes the ventricles to contract and push blood out to lungs and body. |
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purpose of cardiac cath
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may be diagnostic (determining amount of blockage or presence of stenosis) or therapeutic (removing blockages, inserting stents)
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post-procedure care of a cath pt
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pt lies flat for 6 hours. check BP, pulse, and cath site for bleeding
pedal pulses and temp of feet. watch I&O. keep pressure on cath site. may place a Foley. |
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What is PTCA?
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Perc Transluminal Balloon Angioplasty
(balloon angioplasty) |
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What's the purpose of PTCA?
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used to treat moderately severe chronic stable angina unrelieved by medication, coronary ischemia, unstable angina, and AMI
use a balloon to dilate, then usually place a stent |
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Post-procedure care of a PTCA pt?
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same as cath, but monitor and treat chest pain, and vasovagal response during removal of femoral sheath.
maintain infusions, usually heparin and NTG |
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what is unstable angina?
how is it treated? |
pain is unpredictable and occurs with rest, low activity, stress
morphine, reperfusion with thrombolytic agent or percutaneous coronary intervention |
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purpose of echo studies?
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uses ultrasound to evaluate cardiac structure and function
evaluation of myocardial wall for ischemia or infarction |
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S&S of pericarditis
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sharp severe substernal or epigastric pain - mild to severe
fever, malaise, dyspnea, cough, nausea, dizziness, palpitations |
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treatment of pericarditis
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sit upright, analgesia, anti-inflammatory meds
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etiology of pericarditis
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inflammatory process may lead to accumulation of fluid in pericardial sac (aka pericardial effusion) and increased pressure on the heart, leading to cardiac tamponade
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etiology and treatment of rheumatic endocarditis
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develops after episode of group A betahemolytic strept pharyngitis. evidenced by new heart murmur, cardiomegaly, pericarditis, and heart failure.
prevented by prompt treatment of "strep throat" |
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etiology and treatment of endocarditis:
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infection of endocardium, usually in people with prosthetic valves or devices.
prevent with prophylactic abx before invasive procedures S/S fever and heart murmur treatment: abx |
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blood glucose levels:
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50-60 hypoglycemia
60-110 normal 300-800 DKA greater than 600 - HHNS |
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what is HHNS?
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hyperglycemic hyperosmolar nonketotic syndrome
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DKA s/s
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mostly seen in Type 1 hyperglycemia, dehydration, acidosis
the 3 Ps blurred vision, weakness, headache, n/v, acetone breath, mental status changes |
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Treatment of DKA
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IV rehydration
IV continuous infusion of regular insulin Reverse acidosis and resotre electrolyte balance Monitor: blood glucose and renal function (BUN, creatinine) EKG and lytes (K+) VS, lung assessments, signs of fluid overload transfer to ICU |
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HHNS: s/s
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ketosis is minimal or absent
poluria, polydypsia, hypotension, profound dehydration, tachy, variable neuro signs due to cerebral dehydration HIGH MORTALITY |
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Treatment of HHNS:
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rehydration (NS or half NS)
administer insulin monitor fluid volume and lyte status |
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Purpose of Doppler study:
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uses sound waves to evaluate blood as it flows thru a vessel
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what is intermittent claudication?
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pain in the legs during exertion from stenosis or blockage
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care of a pt with leg ulcers?
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wet to dry drsg (mechanical debridement)
wound assessment (chart dressing dry clean and intact - no odor noted, amount of exudation if any, also color, amount, smell) adequate nutrition, albumin, exercise, stop smoking |
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What is a colloid dressing?
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provides moisture and protection, looks like cheesecloth
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etiology of mitral regurgitation
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blood flows back from L ventricle into L atrium during systole.
Edges of mitral valve leaflets don't close during systole. Leaflets can't close completely because leaflets and chordae tendineae have thickened and fibrosed, resulting in their contraction. |
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Treatment of mitral regurgitation
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arterial dilation with ACE inhibitors, ARBs, and beta blockers
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S/S of mitral regurgitation
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usually asymptomatic, but severe cases can show up as CHF
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what is mitral stenosis?
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obstruction of blood flow from left atrium to left ventricle
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S/S of mitral stenosis
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dyspnea on exertion, progressive fatigue, left atrium may enlarge and put pressure on bronchial tree, causing wheezing or dry cough
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treatment of mitral stenosis
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anticoagulants, avoid strenuous activities, valvuloplasty, or mitral valve replacement surgery
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target LDL for a diabetic
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less than 70
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