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NURS 366 > Adult Cardiac > Flashcards

Adult Cardiac Flashcards

1
Q

What does S1 sound like?

A

lub

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2
Q

What does S2 sound like?

A

dub

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3
Q

When is S3 normal?

A

kids and up to age 30 in adults

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4
Q

When does S3 become abnormal?

A

After 30!

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5
Q

What is blood flow across an obstruction?

A

stenosis

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6
Q

What will happen with backflow of blood from an incompetent valve?

A

regurgitation

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7
Q

What happens when there is a septal defect?

A

shunting

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8
Q

How are murmurs graded?

A

I-VI

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9
Q

What are rubs?

A

pericardial inflammation or effusion or pericarditis

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10
Q

When may rubs occur?

A

2-7 days s/p MI

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11
Q

What does a rub sound like?

A

grading, squeaking, or scratching sound (inspiration- friction w/ movement)

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12
Q

What is a murmur?

A

increased rate of flow through heart

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13
Q

Where is edema most common?

A

feet, ankles, legs, scrotum, hands

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14
Q

2 factors that influence blood pressure

A

cardiac output and SVR

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15
Q

What kind of hypertension is the majority of cases?

A

Primary or essential HTN

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16
Q

What percentage of hypertensive patients have secondary hypertension?

A

5-10%

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17
Q

What pain level is ideal for a cardiac patient?

A

0

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18
Q

A cardiac pt came in complaining of headache, blurred vision, and severe chest pain. Rated at a 7. The patient has been treated and now his pain level has gone down to a 1, which is tolerable for this patient. Is he okay to be discharged?

A

no. cardiac patients must have a pain level of 0 before being discharged

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19
Q

If a patient comes in with chest pain, what is that indicative of?

A

oxygen supply is not meeting oxygen demand

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20
Q

How does an infarction occur?

A

Ischemia first and continued o2 demand that does not meet the supply is infarction and that leads to muscle death that cannot be restored

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21
Q

What are the s/s of CM?

A

HA, blurred vision, fatigue, dizziness, palpitations, angina, dyspnea, nosebleeds

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22
Q

What is the first diagnostic study that should be done when assessing cardiac health?

A

NIBP

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23
Q

What are diagnostic studies that should be done after NIBP when assessing cardiac health?

A

Fasting BG, UA, BMP cGFR, CBC, Lipid Panel, 12-lead EKG

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24
Q

How does coronary artery disease progress?

A

stable angina–> unstable angina–> NSTEMI or STEMI

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25
Q

What is the leading cause of death in the world?

A

Coronary Artery Disease

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26
Q

What is the most common CVD?

A

CAD

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27
Q

What is the etiology behind CAD?

A

damaged endothelium (nicotine, HTN, toxins, DM, infection, inflammation)+ lipid deposits under endothelium= atherosclerosis–> fatty streak–> fibrous plaque–> complicated lesion

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28
Q

Is coronary artery disease reversible?

A

Yes. Meds, diet, and lifestyle changes can reverse CAD

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29
Q

What are risk factors for developing CAD?

A

gender, ethnicity, family hx, HLD, HTN, DM, Nicotine, sedentary lifestyle, obesity, depression/anxiety, hostility/bitterness, substance abuse, high homocysteine levels, those with autoimmune disease

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30
Q

What factors are indicative of stable angina when referencing pain?

A

follows similar onset, duration, and intensity

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31
Q

Why is unstable plaque a concern?

A

it can rupture and activate a clotting cascade and a thrombus may form at that spot

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32
Q

What factors are indicative of unstable angina?

A

rupture of unstable plaque exposing thrombogenic surface

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33
Q

What meds are used to treat angina in the hospital?

A

morphine and nitroglycerin

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34
Q

If a patient has chest pain that is relieved by NTG and/or rest, what may this be indicative of?

A

stable angina

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35
Q

If a patient presents with new onset angina or chronic angina that increases in frequency, duration, and/or severity, occurs at rest or minimal exertion, lasts more than 10 min, what may this patient be presenting with?

A

unstable angina

36
Q

ABCs of angina treatment

A

Antiplatelet therapy, antianginal therapy, ACE?
Beta blocker, BP control
Cigarette smoking cessation, cholesterol mngmt, Ca++ blockers, Cardiac rehab

37
Q

After addressing the ABCs of angina treatment, what are other things that should be assessed?

A

diet, DM management, Edu, exercise, Flu vaccine

38
Q

What is a late indicator of an MI occurrence?

A

Troponin

39
Q

What kind of EKG is used to address unstable angina/acute coronary syndrome?

A

12-lead

40
Q

What can be used to treat UA-NSTEMI and STEMI?

A

MONA

41
Q

What are some long-term medications that can be used to treat unstable angina/acute coronary syndrome?

A

Beta Blockers, ACE, ARB, Statin

42
Q

When should O2 be administered to a patient?

A

less than 92% O2 saturation on room air

43
Q

Why should O2 not be immediately administered when angina occurs?

A

oxygen toxicity may occur

44
Q

What is the most common anticoagulant that is used to prevent more clots from forming?

A

heparin

45
Q

When would a CABG be used?

A

Plaque is too solidified for a stent

46
Q

Is a STEMI or a NSTEMI more emergent?

A

STEMI

47
Q

How long should it take for a PCI once a patient walks in the door?

A

90 minutes

48
Q

5 ways to treat a UA-NSTEMI

A

MONA, stress testing, Anticoagulant, PCI-stent, CABG

49
Q

5 ways to treat a STEMI

A

MONA, PCI, thrombolytic therapy, CABG, Antiplatelet/anticoag

50
Q

What is a therapy that is common to strokes and STEMI treatment?

A

thrombolytic therapy

51
Q

What is the difference in treatment for a right-sided MI vs a left-sided MI?

A

DO NOT administer nitroglycerin for a right sided MI

52
Q

What can cause a dysrhythmia from ischemia?

A

dead muscle can’t send signals

53
Q

What are the benefits of using a 12 lead EKG?

A

tells exactly where heart is blocked

54
Q

What can PCI stenting potentially cause?

A

Acute kidney injury

55
Q

What can happen if an artery is completely (100%) occluded?

A

collateral arteries form to feed tissues around the blockage

56
Q

What does CABG stand for?

A

Coronary artery bypass graft

57
Q

Is an artery or a vein graft more problematic?

A

vein graft

58
Q

What is the number one reason for hospital admission?

A

heart failure

59
Q

How many patients die within 5 years once being diagnosed with HF?

A

50%

60
Q

What is the normal EF%?

A

55-70%

61
Q

If EF% is less than __% in the either ventricle or both, it is considered heart failure

A

45%

62
Q

What does the EF% have to be to qualify for a transplant?

A

less than 30%

63
Q

what does cor pulmonale cause?

A

Right-sided heart failure

64
Q

What kind of heart failure can pregnancy induce?

A

left sided heart failure

65
Q

Why can pregnancy induce heart failure?

A

high volumes of fluids build up during pregnancy

66
Q

Why does hyperthyroidism cause left sided heart failure?

A

too much stimulation of the heart

67
Q

Why is it important to treat sleep apnea?

A

untreated can lead to cor pulmonale which can lead to right-sided heart failure which can lead to death

68
Q

What is a late sign of left-sided heart failure?

A

cyanosis

69
Q

If you are assessing a patient who has left sided heart failure, what would you expect to find?

A

Decrease BP
Crackles, wheezes
Dyspnea
S3 (new onset under 30 yo) & S4
Gallop
Decrease UO
Tachycardia, dysrhythmias

70
Q

What is an important question to ask patients about their sleep if they have left sided heart failure?

A

How many pillows are they sleeping with

71
Q

Why is there a decrease in urine output for a patient with left sided heart failure?

A

kidneys shunt blood to the brain

72
Q

If a patient is experiencing right sided heart failure, what would be expected findings on an assessment?

A

Fluid retention
JVD
Peripheral edema
Abd tenderness, ascities
Hepatomegally, splenomegally
N/V, anorexia
Bounding pulses

73
Q

Which kind of heart failure can lead to liver failure?

A

Right sided heart failure

74
Q

Why might a QRS segment be elevated in a patient with heart failure?

A

more electricity going through ventricles because of hypertrophy of heart muscles

75
Q

Labs that are diagnostic of heart failure

A

Na+/Cl- decreased
BUN/Cr/LFT elevated
RBC decreased
PaO2/PaCO2 decreased
BNP
Specific to HF
Heart stretching causes release
Diruetic
>100 = HF
Always checked on admit & PRN

76
Q

What is the ONLY lab that is specifically related to heart failure?

A

BNP

77
Q

What BNP level is indicative of heart failure?

A

> 100

78
Q

What kind of weight gain is seen in patients with heart failure?

A

2 lbs in 1-2 days or 5 lbs per week

79
Q

What should a Mg level be for a cardiac patient?

A

2

80
Q

What should K level be for a cardiac patient?

A

4

81
Q

How long do you have to open an artery if there is an infarction?

A

90 minutes

82
Q

How can an artery be opened when there is a myocardial infarction?

A

A PCI or a thrombolytic (fibrinolytic) therapy

83
Q

When is ST elevation significant?

A

if it is 1mm or more above the isoelectric line in at least 2 contiguous leads

84
Q

Is a STEMI or NSTEMI more of an emergency?

A

STEMI

85
Q

What causes a STEMI?

A

an occlusive thrombus

86
Q

What causes a NSTEMI?

A

a non-occlusive thrombus

87
Q

How long do NSTEMI patients have to receive PCI treatment?

A

usually will be done within 12-72 hours

NURS 366 (29 decks)

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