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59 Cards in this Set
- Front
- Back
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What does poor cardiac perfusion cause initially?
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A change in mental status.
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What is between the visceral and parietal layers and how much fluid does it hold?
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The pericardial space. 5-20cc of fluid.
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What is the fluid's purpose?
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To lubricate, cushion, and protect.
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How much filling occurs during diastole?
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75%
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What is refractoriness?
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The inability to respond while in a state of contraction.
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How does the cardiac conduction system work?
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SA node, AV node, Bundle of His, and Purkinje fibers.
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What part of the stethoscope is for listening to high pitch sounds?
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Diaphragm
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What part of the stethoscope is for listening to low pitch sounds?
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Bell
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When does S3 occur? What's its sound?
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Occurs early in diastole. The sound is low-pitched.
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What causes this?
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Third heart sound abnormal rapid expansion of the ventricular walls.
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What occurs with S4?
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This is the heart sound for abnormal resistance in the atria to filling. Causes hypertrophy.
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How does contraction occur?
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It occurs in response to the depolarization and diffusion of calcium.
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What does cardiac output equal?
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Stroke volume X HR
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What is stroke volume?
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The volume of blood ejected with each contraction of the left ventricle.
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How is the cardiac index computed?
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Cardiac output divided by the body surface area. Normally 2.5 - 4.0 liters per minute per meter square.
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What is contractility?
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The inherent ability to contract, vigor, and hypoxemia decrease contractility.
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What biographical data influences cardiac problems?
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Race and culture.
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What are some risk factors?
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Cocaine toxicity, emotional stress, and herbs.
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What is significant in a patent's past medical history?
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Childhood infectious diseases (rheumatic fever) and ETOH abuse. Causes CHF.
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What physical symptom could indicate poor perfusion?
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Pale shiny skin or red systemic edema.
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What are cardiac disease symptoms?
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cardiac ischemia, pump insufficiency, and rhythm disturbances.
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What is paroxysmal nocturnal dyspnea?
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Patient wakes up at night coughing, fluid pools, symptoms of CHF.
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What is orthopnea?
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Inability to breathe flat, increases the number of pillows the patient sleeps with. This happens quickly, unlike PND which can take a while.
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What is the silent killer that accelerates CAD?
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Hypertension. It weakens the left ventricle (because it makes the ventricle work harder).
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What may vegetate valves?
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Strep infections (rheumatic fever).
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What can antipsychotic drugs cause?
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Anemias and dysrhythmias.
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What can cause digitalis toxicity?
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Low K.
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What effect can depression have on the body?
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It has an adverse outcome on outcome in patients with cardiovascular disease.
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What is a DASH diet?
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Dietary Approaches to Stop Hypotension
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What 3 things must be done during a physical assessment?
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Look, listen, and feel.
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What is a long-term sign of COPD or hypoxia?
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Clubbing of the fingers.
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What are some of the most common problems with cardiac patients?
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Inadequate circulatory volume, insufficient autonomic effect, and inadequate vasoconstrictor mechanisms.
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What must always be reported to an MD?
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Abnormal heart sounds, irregular HR, and palpitations.
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Where can PMI be assessed?
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Midclavicular, 4th or 5th intercoastal space.
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What is an early neuro sign of cardiac problems?
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Restlessness.
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What can be heard in the lungs of a person with CHF?
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Crackles at the bases.
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In the renal system, what could indicate CHF?
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Urine output; if the patient gains 3 or more pounds in 1 to 2 days.
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What are the desired ranges for CR, Li, and Dig?
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CR .5 - 1.2
Li .5 - 1.5 Dig .5 - 1.5 |
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At what level should Troponin be?
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Less than .3.
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How long are Troponin levels useful for?
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Within 1 to 2 hours of infarct.
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What indicates renal function, depletes with diuretics, and elevated levels depress the heart?
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K
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What is the range for K?
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3.5 to 5.0
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What level of Mg is necessary for cardiac contraction?
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2.0
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What can appear prior to cardiac events?
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C-Reactive protein
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At what level is BUN normally?
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less than 20
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At what level is central venous pressure normally?
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4 to 10 cms H20
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What could an increase in CVP indicate?
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Elevated with fluid overload, CHF. It's low when dehydrated.
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What must be done prior to angiography?
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Get informed consent, check allergies, and document pedal pulses.
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What should be done post-op and what labs?
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Bed rest for 8 to 12 hours, pressure bandage, straight leg, frequent VS, may use sandbags, encourage fluids. Check BUN, CR, CSM, pedal pulses.
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What should be checked pre-op?
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BUN and CR to assess renal function before test.
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What should an EJ be?
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Greater than 70%
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What chemical is used for a stress test?
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Persantine
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What's the antidote?
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IV aminophylline
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How long do patients usually wear a halter monitor?
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48 hours
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What must a patient refrain from doing while wearing a halter monitor?
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Don't get it wet. No showers!
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What is electrophysiologic studies (EPS) and what is it used for?
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Cardiac mapping. Used for A-fib and A-flutter.
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What must be monitored during a transesophageal echocariography (TEE)?
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The patient for aspiration.
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Post-op, when can a patient eat?
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When the gag reflex returns.
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What level of lithium is considered toxic?
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>2
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