Cardiac 1 Flashcards
When is a palpated blood pressure used?
When the BP is too low to register
Range for normal blood pressure
Under 120/under 80
What range is pre-hypertension?
120-139/80-89
What is the range for hypertension?
> 140/90
What is the swish sound being heard because vessels are narrowed?
Bruits
What is the term for the volume pumped out of the heart?
Cardiac output
What is the term for the amount of each pump?
Stroke volume
Where can you locate the point of maximum impulse?
Mid collarbone-fifth intercostal-left ventricle
In what order do you listen to heart sounds? (Aptm)
Aortic, pulmonary, tricuspid, mitral
What is it called when the atrium pumps too fast and the ventricle pumps too slow?
A fib
What is the crunching sound that is usually a sign of inflammation or infection in the heart?
Pericardial friction rub
What sound will you hear with a s3 ventricular gallop?
ken-TUCK-e
What sound will you gear with a s4 atrial gallop?
ten-ah-SEE
What term is used for blood entering non-compliant chambers?
Diastolic filling sound
What is the name for a group of risk factors that develope into heart disease, DM, and stroke?
Metabolic syndrome
True or false: metabolic syndrome happens around the age of 60-70; happens over a lifetime.
True
Name the disease by symptoms: central obesity, elevated BP (long term), elevated lipid panel, insulin resistance.
Metabolic syndrome
What is the yellowish slightly raised plaque in the skin around the nasal portion or the eyelids?
Xanthelasma
What is the thinnish gray/white area at the corner of the cornea?
Arcus cornealis
What is the patchy velvety brown hyper pigmentation of the skin caused by elevated glucose?
Acanthosis nigricans
What is another namer for coronary artery disease?
Arthlerosclerosis
What is the term for insufficient o2 to the myocardium?
Ischemia
What is the term for severe ischemia that is prolonged and irreversible that causes necrosis?
Infarction
What is the term given to extra blood vessels that are formed when a main vein is no longer functioning correctly over a matter of time?
Collateral circulation
What is another name for ischemia?
Angina pectoris
True or false: chest pain only occurs after 75% of the vessel is occluded.
True
What is the term given to chest pain that the pt knows with a certain amount of exertion and will go away with nitro and rest?
Stable angina
What is the term for angina that comes sooner than the pt expects and rest/meds don’t work or more meds are needed and the pain stays longer?
Unstable angina
Name the disease by signs/symptoms: squeezing/aching/heaviness, aching tooth/neck/jaw, aching back/arms, feeling of choking/gas, pale/sweaty skin
MI
What does 80-90% heart deprived of o2, cocaine use, hypotension, shock, and arrhythmia cause?
MI
What happens in the ischemic phase of an infarction?
Plaque causes clot-clot blocks o2-vessels open to get more area-acidosis
What happens in the injury phase of an infarction?
Cardiac arrhythmia-nerves rescue heart-hr increase and BP increases-low cardiac output causes vasoconstriction and makes heart work harder
What is the blood volume in the ventricles at the end of diastole, stroke volume, ventricles filling to max?
Preload
What is the force the left ventricle has to work against to eject blood?
Afterload
What 3 factors determine the severity if an MI?
Collateral circulation, how long they can function without o2, workload demand
What infarction spreads thru all 3 layers if the heart?
Transmural
How do you assess MI pain?
Where is pain, quality, radiation, severity, time
What is the classic sign of a heart attacking which someone grabs their chest?
Levine sign
What are atypical signs of an MI in women?
Sob, fatigue, anxiety, back pain, numbness/tingling
What is the only marker specifically for cardiac heart muscle?
Troponin
When is the onset and return to normal status of creatinine kinase?
Onset 4-6 hrs
Return 24-48 hrs
What is the onset and return to regular level god troponin?
Onset 3-5 hrs
Return at least a week
What does an abnormal Q wave below baseline mean?
Silent MI
What does an elevated ST wave indicate?
Ischemia
What does a heart echo show?
Visual Changes in valves/chambers, total stroke volume
What does a transesophageal echo show?
Back of heart
What is a stress test?
Pt exercises to see how the heart deals with exertion from exercise
What is a non-stress test?
Pt can’t handle exercise. They are given medications to test heart function.
What us the purpose of a cardiac catheter?
To look at the structure of the coronary artery to check for patentcy and it’s ability to pump.
Why are you supposed to cough after a cardiac cath?
Expel dyes
What is angio mesh angio seal used for?
Seals the vessel to close hole after procedure, apply pressure above site
What are the 3 percutaneous coronary interventions?
Balloon catheter, stent, angioplasty
What is the wire mesh that covers the balloon catheter, the mesh stats in place when the balloon is removed?
Stent
What is the purpose is thrombolytic therapy?
Dissolve blood clots
True or false: you will know that thrombolytic therapy worked if u see an ugly v tach on the EKG within 5-20 min of therapy
True
What are the two anti-platelet agents (platelet aggrigation) meds used?
Plavix and 81mg aspirin
What does nitroglycerine do?
Vasodilator, reduces stress on heart, redistributes blood flow
How many nitro pills can u give and over what period of time?
Up to 3 times, every 5 mins if pain is still present
What is the reason for caution with nitro and erectile dysfunction pills?
Decreases BP more quickly
What medications decrease the size of the infarction and come in cardio selective and noncardioselective types?
Beta blockers
What medications prevent ventricular remodeling? Prevents necrosis and fibrosis. Causes a dry cough.
Ace inhibitors
What medications are used for chronic stable angina, example cozaar? No cough.
Arbs
What medications are given for angina with dysrythmias? Med- cardizem
Calcium channel blocker
What is Renexa used for?
Chronic angina only
What are statins used for and what needs to be checked?
Decrease cholesterol and lipids, check blood sugar
What are the actions of morphine?
Decrease catacholines, relax smooth muscle, decrease pain
What is the first medication given during an MI?
Aspirin
