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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
What is the leading cause of death in the world?
Coronary Artery Disease
26
What is the most common CVD?
CAD
27
What is the etiology behind CAD?
damaged endothelium (nicotine, HTN, toxins, DM, infection, inflammation)+ lipid deposits under endothelium= atherosclerosis--> fatty streak--> fibrous plaque--> complicated lesion
28
Is coronary artery disease reversible?
Yes. Meds, diet, and lifestyle changes can reverse CAD
29
What are risk factors for developing CAD?
gender, ethnicity, family hx, HLD, HTN, DM, Nicotine, sedentary lifestyle, obesity, depression/anxiety, hostility/bitterness, substance abuse, high homocysteine levels, those with autoimmune disease
30
What factors are indicative of stable angina when referencing pain?
follows similar onset, duration, and intensity
31
Why is unstable plaque a concern?
it can rupture and activate a clotting cascade and a thrombus may form at that spot
32
What factors are indicative of unstable angina?
rupture of unstable plaque exposing thrombogenic surface
33
What meds are used to treat angina in the hospital?
morphine and nitroglycerin
34
If a patient has chest pain that is relieved by NTG and/or rest, what may this be indicative of?
stable angina
35
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?
unstable angina
36
ABCs of angina treatment
Antiplatelet therapy, antianginal therapy, ACE? Beta blocker, BP control Cigarette smoking cessation, cholesterol mngmt, Ca++ blockers, Cardiac rehab
37
After addressing the ABCs of angina treatment, what are other things that should be assessed?
diet, DM management, Edu, exercise, Flu vaccine
38
What is a late indicator of an MI occurrence?
Troponin
39
What kind of EKG is used to address unstable angina/acute coronary syndrome?
12-lead
40
What can be used to treat UA-NSTEMI and STEMI?
MONA
41
What are some long-term medications that can be used to treat unstable angina/acute coronary syndrome?
Beta Blockers, ACE, ARB, Statin
42
When should O2 be administered to a patient?
less than 92% O2 saturation on room air
43
Why should O2 not be immediately administered when angina occurs?
oxygen toxicity may occur
44
What is the most common anticoagulant that is used to prevent more clots from forming?
heparin
45
When would a CABG be used?
Plaque is too solidified for a stent
46
Is a STEMI or a NSTEMI more emergent?
STEMI
47
How long should it take for a PCI once a patient walks in the door?
90 minutes
48
5 ways to treat a UA-NSTEMI
MONA, stress testing, Anticoagulant, PCI-stent, CABG
49
5 ways to treat a STEMI
MONA, PCI, thrombolytic therapy, CABG, Antiplatelet/anticoag
50
What is a therapy that is common to strokes and STEMI treatment?
thrombolytic therapy
51
What is the difference in treatment for a right-sided MI vs a left-sided MI?
DO NOT administer nitroglycerin for a right sided MI
52
What can cause a dysrhythmia from ischemia?
dead muscle can't send signals
53
What are the benefits of using a 12 lead EKG?
tells exactly where heart is blocked
54
What can PCI stenting potentially cause?
Acute kidney injury
55
What can happen if an artery is completely (100%) occluded?
collateral arteries form to feed tissues around the blockage
56
What does CABG stand for?
Coronary artery bypass graft
57
Is an artery or a vein graft more problematic?
vein graft
58
What is the number one reason for hospital admission?
heart failure
59
How many patients die within 5 years once being diagnosed with HF?
50%
60
What is the normal EF%?
55-70%
61
If EF% is less than __% in the either ventricle or both, it is considered heart failure
45%
62
What does the EF% have to be to qualify for a transplant?
less than 30%
63
what does cor pulmonale cause?
Right-sided heart failure
64
What kind of heart failure can pregnancy induce?
left sided heart failure
65
Why can pregnancy induce heart failure?
high volumes of fluids build up during pregnancy
66
Why does hyperthyroidism cause left sided heart failure?
too much stimulation of the heart
67
Why is it important to treat sleep apnea?
untreated can lead to cor pulmonale which can lead to right-sided heart failure which can lead to death
68
What is a late sign of left-sided heart failure?
cyanosis
69
If you are assessing a patient who has left sided heart failure, what would you expect to find?
Decrease BP Crackles, wheezes Dyspnea S3 (new onset under 30 yo) & S4 Gallop Decrease UO Tachycardia, dysrhythmias
70
What is an important question to ask patients about their sleep if they have left sided heart failure?
How many pillows are they sleeping with
71
Why is there a decrease in urine output for a patient with left sided heart failure?
kidneys shunt blood to the brain
72
If a patient is experiencing right sided heart failure, what would be expected findings on an assessment?
Fluid retention JVD Peripheral edema Abd tenderness, ascities Hepatomegally, splenomegally N/V, anorexia Bounding pulses
73
Which kind of heart failure can lead to liver failure?
Right sided heart failure
74
Why might a QRS segment be elevated in a patient with heart failure?
more electricity going through ventricles because of hypertrophy of heart muscles
75
Labs that are diagnostic of heart failure
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
What is the ONLY lab that is specifically related to heart failure?
BNP
77
What BNP level is indicative of heart failure?
>100
78
What kind of weight gain is seen in patients with heart failure?
2 lbs in 1-2 days or 5 lbs per week
79
What should a Mg level be for a cardiac patient?
2
80
What should K level be for a cardiac patient?
4
81
How long do you have to open an artery if there is an infarction?
90 minutes
82
How can an artery be opened when there is a myocardial infarction?
A PCI or a thrombolytic (fibrinolytic) therapy
83
When is ST elevation significant?
if it is 1mm or more above the isoelectric line in at least 2 contiguous leads
84
Is a STEMI or NSTEMI more of an emergency?
STEMI
85
What causes a STEMI?
an occlusive thrombus
86
What causes a NSTEMI?
a non-occlusive thrombus
87
How long do NSTEMI patients have to receive PCI treatment?
usually will be done within 12-72 hours

NURS 366 (29 decks)

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