cardiac Flashcards
What is preload
amount of blood returning to heart
what is afterload
pressure against which the left ventricle must mumps to eject blood
what is contractility
strength of contraction
what is compliance
how easily heart muscle expands when fired
what is ejection fraction
amount of blood ejected
normal is 55% or higher
indicator of ventricle function
what is stroke volume
blood pumped out of ventricles with each contraction
what determines stroke volume
preload
afterload
contractility
how is cardiac output calculated
SV X HR
signs of poor cardiac output
decreased LOC
chest pain, weak peripheral pulses
SOB, Crakles, Rales
cool, clammy, mottled extremities
decreased up
causes of decreased CO
bradycardia
hypotension
MI
Cardiac muscle disease
causes of increased CO
increased blood volume (sometimes)
tachycardia (sometimes)
Ace inhibitors
ARBS
nitrates
inotropes
classes of antihypertensives
Ace inhibitors
angiotensin 2 blockers
arterial and venous violators
calcium channel blockers
beta blockers
types of ace inhibitors
catopril
enalapril
lisinopril
name an angiotensin 2 receptor blocker
losartan
arterial and venous dilators
hydralazine
nitro
calcium channel blockers
amlodipine
nifedipine
verapamil
enalapril indication and considerations
hypertension, CHF
can cause dry cough (discontinue if so)
monitor BP
contraindicated in pregnancy
losartan indication and considerations
HTN, DM neuropathy, CHF
monitor BP
monitor fluid levels
monitor liver and kidneys
contraindicated in pregnancy
amlodipine indications and considerations
HTN, angina
avoid grapefruit
monitor BP (orthostatic Hypotension)
can cause gingival hyperplasia
arterial dilators
hydralazine
minoxidil
hydralazine side effects
orthostatic hypotension
reflex tachycardia
headache
nausea
long term use can lead to RA or lupus like symptoms
characteristics of minoxidil
more potent than hydralazine
can cause myocardial ischemia and pericardial effusion, hirsutism
topically used as rogain
list some venodilators
nitrates-nitro and isosorbide dinitrate
side effects of nitrates
can cause headache, dizziness, flushing, orthostatic hypotension
types of beta blockers
propranalol
atenolol
metoprolol
esmolol
sotalol
indications for propranalol
HTN, angina, arrhythmias, MI, cardiomyopathy, alcohol withdrawal, anxiety
considerations for propranalol
do not discontinue abruptly
can mask signs of hypoglycemia
caution with asthma and COPD (can cause bronchospasm)
amiodarone indications and considerations
arrhythmias
has iodine and can disturb thyroid
not given in pregnancy
adverse effects of amiodarone
dizziness
tremors
ataxia
pulmonary fibrosis
bradycardia
heart block
blue grey skin
adenosine indications and considerations
SVT
period of systole after administration
will feel like being kicked in the chesgt
rapid push or won’t work
extreme caution in asthmatics
atropine indication and considerations
excessive secretions, sinus Brady, heart block
monitor urinary retention and constipation
avoid in people with gluacoma
indications for digoxin
hear failure,
a fib a flutter,
chf
cariogenic shock
therapeutic level for digoxin
.5-2
early signs of digoxin toxicity
nausea
vomiting
anorexia
vision changes (yellow, green halos)
late signs of digoxin toxicity
bradycardia>arrhythmias
risk factors for digoxin toxicity
hypokalemia (loop diuretics)
licorice extracts (black licorice)
hypomagnesemia
hyprcalcemia
elderly (liver and renal function)
antidote for digoxin toxicity
digoxin immune fab
what meds are inotropes
dopamine
dobutamine
milrinone
(increase contractility)
what drugs are vasopressors
norepinephrine
epinephrine
vasopressin
phenylephrine
(increase BP)
name sieges of veins
chronic venous insufficiency/PVD
DVT
superior venacava syndrome
what is peripheral vascular disease
inadequate venous return over a long period
what can peripheral vascular disease cause
pathologic ischemia
signs of pathologic ischemia
blood flow back to heart is affected
brown discoloration
uneven wound edges around ankle
swelling
pedal pulse is present
treatment of peripheral vascular disease
elevate legs
focus on proper wound care
causes of DVT
venous stasis
vein wall damage
hypercoaguable state
factors leading to venous stasis
immobility
age
LHF
prevention of DVT
anticoagulant
what happens during superior vena cava syndrome
can’t drain blood from upper body
(pressure on superior vena cava like tumor)
symptoms of superior vena cava syndrome
facial plethora
non pulsative distende neck veins
glossitis
headache
blurry vision
distention of thoracic veins
dypnea
upper extremity edema
diseases of arteries
atherosclerosis
hypertension
orthostatic hypotension
aneurysm
peripheral artery disease
coronary artery disease
chronic stable angina
acute coronary syndrome
what Diseases are included in acute coronary syndrome
unstable angina
MI
what happens with atherosclerosis
begins with endothelial injury and evolves to fibrotic plaque that builds and and decreases blood flow and can rupture
what happens if plaque in atherosclerosis ruptures
can cause
thrombosis
vaso constriction
ischemia
is the most common cause of coronary artery disease and cerebrovascular disease
HTN BP parameters
normal 120/80
elevated 120-129/80
HTN >130/>80
HTN crisis >180/>120
symptoms of hypertension
dizziness
headache
vision changes
angina
SOB
nose bleed
risk factors for hypertension
smoking
stress
excessive salt intake
family history
african american
increased age
obesity
hyperlipidemia
coronary artery disease
caffeine
complications of hypertension
stroke
MI
renal failure
heart failure
vision loss
treatment of hypertention
ace inhibitors
beta blockers
CCB
diuretics
Dash diet
avoid caffeine and alcohol
weight loss
quit smoking
exercise
what are aneurysms
localized dilation of vessel wall (aorta most common)
causes of aneurysms
atherosclerosis
HTN
family history
smoking
symptoms of abdominal aortic aneurysm
most common
abdominal pain, back pain
gnawing and sharp
thoracic aortic aneurysm symptoms
SOB
hoarseness/ difficulty swallowing
back pain
characteristics of ruptured aortic aneurysm
life threatening
severe pain
do not palpate pulsating mass
who is most at risk for embolism
pregnant women
people with A-fib
long bone fracture
what is an air embolism
complication of surgery
high risk placement of CVC or arterial catheter
position in left lateral trendelenberg (Durants maneuver
symptom of fat embolism
hypoxia
tachypnea
altered LOC
confusion
dypnea
petechia rash (sometimes)
what is peripheral arterial disease
atherosclerosis of peripheral arteries
assessment of PAD
pallor
pulselessness
hairlessness
intermittent laudation
pain in legs while walking
gets better with rest
treatment of PAD
dangle legs
anti platelet therapy
what is coronary artery disease
occlusion of coronary artery resulting from atherosclerotic plaques
risk factors of coronary artery disease
increased age
dyslipidemia
obesity
hypertension
smoking
sedentary life
what can coronary artery disease cause
myocardial ischemic chronic stable angina-reversable
what’s chronic stable angina
narrowing of coronary arteries and plaque build up with periods of decreased blood flow leading to decreased o2 and ischemia that causes chest pain that is predictable and goes away with rest and nito
what is unstable angina
pain that does not go away with rest and nitro, reversible myocardial ischemia can progress to MI
MI assessment
chest pain that is crushing and can radiate to left arm or jaw and between shoulder blades
epigastric discomfort
fatigue
SOB
vomiting
increased troponin
disorders of the heart wall
pericarditis
pericardial effusion
cardio myopathies
valve disorders
endocarditis
causes of pericarditis
infection
tumor
drugs
signs of pericarditis
chest pain
tachypnea
fever, chills
weakness
treatment of pericarditis
NSAI
D
what is pericardial effusion
collection of fluid in pericardial sac the impairs cardiac function if severe obstructive cariogenic shock
signs of pericardial effusion
chest pain
muffled heart sounds
treatment of pericardial effusion
pericardiocentesis
what can endocarditis lead to
valve abnormalities (stenosis, regurgitation)
poor CO
bacteremia
bacterial emboli
treatment for endocarditis
ABX
