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00NCLEX > Adult Heart > Flashcards

Adult Heart Flashcards

1
Q

Weight gain to report

A

three to five pounds or more within one week

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2
Q

Congestive Heart Failure (CHF) diagnostic test

A

confirmed by an elevation of the B-type natriuretic peptide (BNP)
- increased risk for pulmonary edema
- tachypnea
- hypoxia
- tachycardia

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3
Q

Complication of acute pericarditis

A

cardiac tamponade

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4
Q

Minimize complications in tPA therapy

A
  • Implementing bleeding precautions
  • avoiding invasive procedures
  • caution with anticoagulant medications
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5
Q

Unexpected manifestation of atrial fibrillation

A
  • Blurred vision
  • may be sign of stroke
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6
Q

Heart structure

A
  • double pump
  • 4 chambers, 4 valves
  • conduction begins in right atrium
    • SA>AV>bundle of his>left and right bundle branches>Purkije fibers
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7
Q

Blood flow of heart

A

Try Pulling My Arm
Superior and Inferior vena cavas →
→ Right atrium →
→ Tricuspid valve →
→ Right ventricle →
→ Pulmonary valve →
→ Pulmonary artery →
→ Lungs →
→ Pulmonary veins →
→ Left atrium →
→ Mitral valve →
→ Left ventricle →
→ Aortic valve →
→ Aorta →
→ Systemic circulation

Vena Cava → RA → TV → RV → PValve → PA → Lungs → PVein → LA → MV → LV → Aorta

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8
Q

Varicose veins management

A

✓ Wear compression hose/stockings

✓ Keep the legs elevated to promote venous return

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9
Q

Left-sided heart failure

A
  • orthopnea (Shortness of breath when lying flat)
  • pulmonary congestion
  • productive cough
  • fatigue
  • acute confusion
  • S3 gallop

systolic

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10
Q

Right-sided heart failure

A
  • ascites
  • anorexia
  • nausea
  • jugular venous distention
  • weight gain
  • peripheral edema
  • S4 gallop

diastolic

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11
Q

S3 gallop

A
  • expected finding in heart failure
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12
Q

Increased intracranial pressure finding

A
  • widened pulse pressure
  • anisocoria
    • unequal pupil size
    • can be a sign of stroke
  • sun setting sign
    • eyes appear driven downwards
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13
Q

Cardiac output (CO)

A
  • volume pumped by the heart over one minute
  • CO = HR x SV
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14
Q

Preload

A
  • “filling pressure”
  • volume being returned to the heart
  • blood in ventricles
  • end of diastole
  • measured by central venous pressure (CVP 4-8mmHg)
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15
Q

Unconscious CPR

A
  • 2 minutes of CPR at a compression-ventilation ratio of 30:2
  • 100 to 120 per minute
  • infants = 1.5 inches
    • check BRACHIAL pulse
  • children = 2 inches
  • adolescent = 2-2.4 inches
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16
Q

Arterial insufficiency

A
  • decreased hair growth
  • absent peripheral pulses
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17
Q

Venous insufficiency

A
  • Swelling around the ankles
    • edema
  • hyperpigmentation
  • edema!!!
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18
Q

Infective endocarditis (IE) treatment

A
  • blood cultures
  • empirical antibiotics
    • give through PICC line
  • diagnose with echocardiography
  • vegetation on mitral valve
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19
Q

Infective endocarditis (IE)

A
  • Immune
    • fever/malaise
    • night sweats
  • Cardiac
    • murmur
    • stroke
    • HF
  • Skin
    • petechiae
    • splinter hemorrhages
    • Oslar nodes
      • palms of hands and feet
    • Janeway lesions
      • flat, reddened maculae on hands and feet
    • Roth spots
      • round/oval hemmorage lesions on retina
  • Respiratory
    • nonproductive cough
    • pulmonary emboli
  • Renal = ADVERSE EFFECTS
    • anorexia
    • abdominal/flank pain ADVERSE
    • high creatine**
      • monitor renal function**
    • hematuria
  • IV drug use increases risk
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20
Q

Exercise electrocardiography (ECG)

A
  • diagnose myocardial ischemia
21
Q

Ejection fraction (EF)

A
  • less than 50% is BAD
  • 55%+ is normal
22
Q

Acute coronary syndrome

A
  • Atypical (gastric/back)
    • nausea/vomiting
    • dyspnea
    • significant fatigue
    • epigastric pain
  • Typical (chest/arm/jaw)
    • gradual onset chest pain
      • not relieved with rest
      • ST + troponin elevation
    • pain radiating to arm or jaw
    • diaphoresis + pallor
  • Albuterol = CONTRAINDICATED
  • over 55, dyspnea, fatigue, indigestion
  • EKG PRIORITY
23
Q

Cardiac tamponade + cardiogenic shock

A
  • tachycardia
  • tachypnea
  • narrow pulse pressure
  • after myocardial infarction
    • priority is to increase cardiac output
      • increase stroke volume
24
Q

Cardiac tamponade

A
  • jugular vein distention
  • history of Lupus and pulmonary hypertension
  • hypotension!
    • give saline
    • narrow pulse pressure
  • muffled cardiac sounds
  • low CO
  • x-ray/echocardiogram
    • enlarged heart
    • pericardial effusion
      • treat with pericariocentesis, NOT thoracentesis
      • done at bedside
  • Positive pressure is DETRIMENTAL
25
Q

Acute myocardinal infarction

A
  • denial
  • normo/hypotension
  • orthopnea
  • tachypnea
  • oliguria
  • women
    • dyspnea
    • jaw pain
    • fatigue
  • ASAP percutaneous coronary intervention (PCI)
26
Q

Myocardial infarction enzyme

A
  • CK-MB isoenzyme
    • elevated 3-6 hours after
    • peak in 18 hours
27
Q

Apex location

A
  • infant
    • 4th intercostal space
    • left of the sternum at the midclavicular line
  • adult
    • 5th intercostal space
    • left of the sternum at the midclavicular edge
28
Q

Polycythemia

A
  • increased red blood cells
  • occurs due to hypoxia
29
Q

3rd degree heart block

Complete heart block

A
  • p-waves independent of QRS
  • HR less than 60
  • can result in hypotension
  • give oxygen and atropine
  • prepare for transcutaneous pacing
  • cure is pacemaker
  • critical care unit
30
Q

SVT care

A
  • preform Valsalva maneuver
31
Q

Aortic stenosis

A
  • narrowing of heart valve
  • heat murmur = wooshing sound
  • heard in 2nd intercostal space in right upper sternal border (aortic area)
32
Q

Mitral stenosis

A
  • heard at apex
33
Q

U-wave

A

seen in hypokalemia

34
Q

Variant angina

A
  • AKA prinzmetal’s angina
  • occurs at same time every day
  • usually at rest
  • can raise ST and resemble heart attack
  • give CCB
35
Q

Vasovagal response

A
  • decreased HR
  • decreased BP
36
Q

Premature ventricular contractions (PVCs)

A
  • normal sinus rhythm with occasiional PVC
  • wide, bizarre complexes
  • p-wave hidden with QRS
  • review labs
    • low magnesium and potassium may cause PVC
37
Q

Synchronized cardioversion

A
  • delivers a timed electrical current to reset electrical activity
  • tachydysrhythmias
    • atrial fibrillation
    • atrial flutter
38
Q

Transesophageal echocardiogram (TEE)

A
  • detects clots in heart
  • views left atrial appendage
    • major reservoir for thromboembolism
  • done before cardioversion
    • determines if anticoagulation is needed
39
Q

Peripheral arterial disease

A
  • caused by
    • hypertension
    • hyperlipidemia
    • diabetes mellitus
      • causes atherosclerosis
  • causes
    • intermittent claudication
      • sleep with legs dependent (below heart) to facilitate blood flow
      • do not wear restricitve clothes
  • decreased pulses
40
Q

Torsades de pointes

A
  • emergency
  • can progress to v. fib/death
  • prolonged QT interval
  • rapid, irregular QRS complex
  • give magnesium sulfate
41
Q

Imbalances that prolong QT interval

A
  • hypomagnesemia
  • hypokalemia
  • hypocalcemia
  • hypothermia
  • hypothyroidism
42
Q

Buerger’s disease

A
  • arterial and venous inflammation
    • causes blood flow impediement
  • SMOKING MAKES IT WORSE, MUST QUIT
43
Q

Hyperlipidemia diet

A
  • replace vegetable oil with canola oil
  • eat more fish and fiber
  • avoid red meat!!
44
Q

Ventricular fibrillation

A
  • can be fatal
  • first action is to assess
45
Q

Atrial fibrillation

A
  • irregular rhythm
  • above 100 BPM is major concern
  • no p-waves
46
Q

Ventricular tachycardia

A
  • can be fatal
  • assess
    • LOC
    • breathing
    • check carotid pulse
  • if no pulse = DEFIB
47
Q

Electroencephalography (EEG)

A
  • given for unexplained seizure activity
  • or to exclude certain neurological disorders such as epilepsy
48
Q

Asystole care

A
  • EPINEPHRINE
  • CPR
  • REPEAT STEPS 1 AND 2
  • NO DEFIB OR CARDIOVERT FOR ASYTOLE
    • no heart rhythm left to shock

00NCLEX (30 decks)

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