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NURS 2501 > Acute Cardiac > Flashcards

Acute Cardiac Flashcards

0
Q

12 Lead ECG Placement

A
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1
Q

12 lead ECG Placement

A

V1 -4th Intercostal space to the right of the sternum

V2 - 4th Intercostal space to the left of the sternum

V3 - Midway between V2 and V4

V4 - 5th Intercostal space at the midclavicular line

V5 - Anterior axillary line at the same level as V4

V6 - Midaxillary line at the same level as V4 and V5

RL- Anywhere above the ankle and below the torso

RA -Anywhere between the shoulder and the elbow

LL- Anywhere above the ankle and below the torso

LA - Anywhere between the shoulder and the elbow

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2
Q

Measured from P wave - Q wave

( R & L ventricles fill with blood )

Prolonged - delay through atria or AV nodal area

A

PR interval

0.12 - 0.2 (3-5 small boxes)

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3
Q

Measured from Q wave - S wave

Ventricular contraction ( depolarization)

A

QRS complex

less than 0.12 sec ( 3 small boxes)

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4
Q

Ventricles are relaxing ( repolarization )

A

T wave

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5
Q

Begins at QRS - terminates at end of T wave

Time of ventricular depolarization & repolarization & venticular refractory time

Influenced by - electrolyte balance, drugs, and ischemia

A

QT interval

0.36-0.44 sec ( 9-11 small boxes)

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6
Q

Recovery of the Purkinje fibers ; upright and follows T wave

A

U wave

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7
Q

Label the EKG tracing

A
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8
Q

Anticholinergic , inhibits vagus nerve ( parasympath. NS)

A

Atropine

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9
Q

Atropine: used to treat

A
  1. Bradycardia
  2. Heart block
  3. Asystole
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10
Q

Atropine : SE

A
  1. Dysrhythmias
  2. Increased HR
  3. Ischemia
  4. Restlessness
  5. Anxiety
  6. Mydriasis ( dilation of the pupils)
  7. Thirst + urinary retention
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11
Q

Antidysrhythimic , prolongs repolarization ; used in emergency tx of ventricular dysrhythmias when other antidysrhythmics are ineffective

A

Amiodarone ( Cordarone )

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12
Q

Amiodarone TX:

A
  1. A-flutter
  2. A-fib
  3. PVC
  4. V-tach
  5. V-fib
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13
Q

Amiodarone SE:

A
  1. 2nd-3rd degree AV block
  2. Bradycardia
  3. Hypotension
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14
Q

Antidysrhythmic, fast sodium channel blocker ( class 1 B) - decrese myocardial irritability - local anesthetic effect on heart

A

Lidocaine

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15
Q

Lidocaine TX :

A
  1. PVC
  2. V-tach
  3. V -fib
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16
Q

Lidocaine SE: toxicity !!!

A
  1. Confusion
  2. Drowsiness
  3. Hearing impairment
  4. Conduction defects
  5. Myocardial depression
  6. Muscle twitching + seizures
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17
Q

Antidysrhythmic to treat paroxysmal supraventricular tachycardia (PSVT) - slows conduction through AV node

A

Adenosine ( Adenocard )

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18
Q

Adenosine : SE

A
  1. Hypotension
  2. Dysrhythmias
  3. Short period of asystole following injection
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19
Q

Defibrilation is used …

A
  1. V-fib
  2. V-tach ( pt has no pulse )
20
Q

Beta - adrenergic blockers - decrese the effects of sympathetic NS - decrese HR + BP

A

Metoprolol ( Lopressor)

21
Q

Beta-blockers : SE

A
  1. Bradycardia
  2. Dizziness
  3. Hypotension
22
Q

Beta-blockers: TX

A
  1. sinus tachycardia
  2. SVT
  3. A-fib
23
Q

Calcium - channel blockers , negative chronotropic (rate) + inotropic ( strength )

A

Verapamil + Ditiazem ( Cardizem )

24
Q

CCB: TX

A
  1. Sinus tachycardia
  2. SVT
  3. A-flutter
  4. A-fib
25
Q

CCB: SE

A
  1. Hypotension
  2. Bradycardia
  3. Myocardial depression
26
Q

Rate above 100; wide, uniform, regular ORS complexes, no P waves

A

V-tach

27
Q

Wavy pattern with no P or QRS waves

A

V-fib

28
Q

QRS is wider than normal ; T wave is opposite to QRS; P wave is absent; look the same

A

Unifocal PVC

29
Q

ORS is wider than normal; T wave is opposite to QRS; P wave is absent ; look different

A

Multifocal PVC

30
Q

P waves - sharp. sawtooth; PRI cant be measured

A

A-flutter

31
Q

Very irregular ; no characteristic P waves ( small) ; No PRI ; normal QRS

A

A-fib

32
Q

HR > 150 BPM; difficult to see P waves

A

SVT

33
Q

Prolonged PRI

A

1st degree HB

34
Q

PRI gets gradually longer until P fails to conduct and QRS is dropped

A

2nd degree HB - Morbitz type 1

35
Q

Each PRI is the same ; 2nd + 5th P waves do not conduct to the ventricles - no QRS; Rate - 40-45 BPM ;

A

2nd degree HB - Morbitz type 2

36
Q

P waves unrelated to QRS

A

3rd degree HB - Complete HB

37
Q

MI: ECG changes

A
  1. Inverted T waves - ischemia - repolarization is impaired
  2. ST elevation - injury
  3. Pathological Q waves - wide ( 1 sb) + more than 1/3 the height of the R wave - cells are dead
38
Q

Stable ( Classic Angina )

A

predictable ( occurs with activity ) ; consistent; relieved with rest

39
Q

Unstable Angina

A

preinfarction angina; can occur at rest; unpredictable

40
Q

Prinzmetal’s Angina

A

occurs at rest; due to spasm of coronary artery not plaque

41
Q

MI: Pain

A
  1. Radiates to back, abdomen, neck, jaw, left arm
  2. W: diffuse -all over the heart ; M: one artery
  3. Impending doom
  4. Anxious
  5. SOB
  6. Cold sweat
  7. Numbness/ tingling in one or both arms
42
Q

MI - TX : MONA

A

Morphine

Oxygen

Nitroglycerin ( SBP > 90 )

Aspirin ( 325 mg chew )

43
Q

MI: STEMI

A

ST elevation MI - occlusion !!!

44
Q

MI : NSTEMI

A

non ST elevation MI - ST depression - ischemia - early phase - if blocked area is opened up , it may not cause permanent damage

45
Q

Recovery from MI

A
  1. ST segment returns to normal ( 1-6 weeks )
  2. T wave inverts for 1-2 weeks
  3. Q-wave alternations usually permanent ( can tell on EKG if patient has had an MI in the past )
46
Q

Cardiac catheterization

A

see where blockages are and how significant the blockage is

47
Q

Cardiac markers ( enzymes ) - released from damaged heart tissue

A
  1. _Troponin - cardiac muscle protein ( T and I ) - specific; increased within few hours; peak in 24 hrs; _
  2. Creatinine Kinase ( CK MB ) - increased only when cardiac muscle is damaged ;
  3. Myoglobin - protein found in cardiac and skeletal muscle ; non spesific - peaks in 12 hrs

NURS 2501 (11 decks)

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