1533 basics Flashcards
ECG Isoelectric line
baseline
ECG P wave
atrial depolarization 0.12- 0.20 seconds
QRS complex
ventricular depolarization (and atrial depolarization) less than 0.12 seconds
Sodium restriction for HTN
less than 2.4g NA/day or less than 6g NaCl/day
HTN drugs
stage 1- thiazide diuretic
Stage 2- add ACE Inhibitor, Angiotensin 2 receptor blocker, beta blocker or calcium channel blocker
First TX for HTN
lifestyle changes- exercise, diet- DASH low sodium and fat, lose weight, less alcohol and less stress. then thiazide diuretic, stop smoking
@ risk preeclampsia
First pregnancy, family or personal hx, obesity, age 40 y/o, multifetal gestation, poor outcome in previous pregnancy, previous HTN, Renal disease, Type 1 DM, Lupus, RA, scleroderma, clotting condition
severe preeclampsia sxs
BP> 160/110, hyperreflexia, severe h/a, blurred vision, photophobia, irritability, epigastric pain, marked AST elevation, thrombocytopenia, serum creatinine elevation, decreased urinary output containing proteins. not severe- MAP over 105, but no other sxs or slight sxs, eclampsia- with seizure
Left side CHF
vascular resistance and increased preload cause pulmonary edema and lowers CO- lowers peripheral perfusion. Sx: pink tinged sputum, paroxysmal nocturnal dyspnea, restless, confused, orthopnea, tachycardia, fatigue, cyanosis, lungs- crackles, wheezes cough, tachypnea. can’t lay down flat at night.
Right side CHF
caused by chronic pulmonary probs or left side CHF. peripheral/ sacral/dependent edema, ascities- anorexia and GI discomfort, JVD, fatigue, enlarged spleen and liver
MI EKG
T wave inversion- zone of ischemia- NSTEMI
T wave inversion with ST elevation- STEMI- zone of injury
Twave inversion with STelevation & abnormal Q (inversion)- STEMI zone of necrosis
MVP manifestations
Mid systolic click and late systolic murmur, atypical chest pain, dizzy/ syncope, tachycardia, palpitations/ dysrhythmias, fatigues/weakness, hyperventilation, anxiety, depression, panic attacks.
basic Graves
Hyperthyroidism
Graves sxs
hyperthyroid. eye issues, anxiety/irritability, no concentration, emotional lability. fine tremor, weight loss, heat sensitivity and low grade fever- warm moist, sweaty skin. change in menstrual cycle, increase libido frequent BMs, increased appetite, increase heart and respiratory rate. goiter, decrease WBCs
basic Cushings
``hypercorticolism
Grave’s dermopathy
thick red skin usually on the shins or tops of feet
exophthalmos
eye protrusion seen in graves. more likely if smoker
Thyroid storm
risk with hyperthyroidism/ graves. increase in temp indicates onset. check temp q4h (at least). immediately report rise of 1 degree F. life threatening increase in temp and BP
hyperthyroid tx
calm, stress free cool environment. meds- thionamides block thyroid hormone production by pretending iodine from binding. surgical removal (life long thyroid hormone replacement, watch for hypocalcemia from parathyroid damage!) or radioactive thyroid- destroys some of the thyroid -radiation precautions
Thyroid storm
thyrotoxic crisis- hyperthyroid/ graves
sudden drastic increase in hormone from significant stress (surgery, illness, dental work)
sxs: fever (105+), sever tachycardia, restless, agitation, tremor, profuse sweating, diarrhea, vomiting, unconsciousness, coma, hypotnsn, heart failure
TX: sodium iodine solution, PTU, beta blocker, sedation, cooling measures, glucocorticoids and IV fluids
myxedema
facial and periorbital edema causing puffiness mask like look to face- sx of long term hypothyroidism
hypothyroid sxs
myxedema, cool dry skin, lethargy, mental impairment, reduced HR and temp, constipation, cold intolerance
hashimoto specific
usually women age 30- 50. painful enlargement of gland along with dysphagia
Akathisia
abnormal sensations
