Cardiac Flashcards
what is the difference between negative and positive inotropic meds
- negative = cardiac depressant, relax the heart
- positive = cardiac stimulants
calcium channel blockers are which type of med?
- negative inotropic meds
ca channel blockers are used for?
Antihypertensives
Anti-Anginals
Anti Atrial Arrythmia (any arrythmia that says atrial, NOT ventricular, ex. afib, atrial flutter, etc. with the exception of supraventricular tachy (bc supraventricular means atria)
(think A, AA, AAA)
DO NOT USE IF HAS CHF
what are 2 side effects of ca channel blockers
- headache
- hypotension
ca channel blockers end in…
- dipine
what are 2 ca channel blockers that don’t end in ___dipine
- verapamil
- cardizem (diltiazem)
which ca channel blocker can be given IV drip?
- cardizem (diltiazem)
what should be monitored with continuous IV cardizem
- BP before
- BP during
what BP parameters are used with cardizem/diltiazem
hold if systolic <100, titrate so >100
4 cardiac arrythmias to know by sight:
- NSR
- v fib
- v tach
- asystole
NSR looks like…
- peaks of P wave equal distance from each other
- P for every QRS
v fib looks like..
- chaotic squiggly line
if a question says “lack of QRS”, what arrythmia do you assume it is?
- asystole
if a question says “QRS polarization” assume it has to do with…
- ventricular
if a question says “P wave”, assume it has to do with…
- atrial
if a question says “sawtooth” P wave, assume it is…
- atrial flutter
if a question says “chaotic”, assume it means
fibrillation
if a question says “chaotic QRS”, assume it is…
- ventricular fibrillation
if a question says “chaotic P wave”, assume it is..
- atrial fibrillation
if a question says “bizarre”, assume it is?
- tachycardia
ex. “bizarre QRS” = ventricular tachycardia
if a question says “periodic” wide bizarre QRS, what do you assume it is
- PVC
describe the prioritiy if your pt has PVCs
- low
what would make the priority of a pt with PVCs moderate? (3)
1) >6 PVCs in 1 min
2) >6 PVCs in a row
3) PVC falls on T wave of previous beat
what are 2 lethal arrythmias
- asystole
- v-fib
what arrythmia is potentially life-threatening
- v tach (do have CO, where with v-fib and systole you do not)
what is the treatment for asystole (2)
- epi (#1)
- then atropine
what is the treatment for v-fib
- de-fib (think v-fib rhymes with de-fib)
what is the treatment for PVC & v-tach
- lidocaine
- amiodarone (think V upside down is an A)
what is the treatment for atrial & supraventricular arrythmias (ex. afib, atrial flutter)
Adenocard/Adenosine
Beta blockers
Ca channel blockers
Digitalis/Digoxin
adenosine is given how?
- IV push over 8 seconds
IV push adenosine can cause…
- temporary (<30 sec) asystole
beta blockers are..
- negative intropic
beta blockers end in…
____lol
beta blockers are used for…
Anti hyptensives
Anti Anginals
Anti Atrial Arrythmias
in what case are beta blockers vs Ca channel blockers used?
- if the pt has asthma
what is the purpose of a chest tube
- re-establish negative pressure in pleural space, so the lung expands when the chest wall moves
a pneumothorax removes…
hemothorax removes…
and pneumohemothorax removes…
- pneumo = air
- hemo = blood
- pneumohemo = blood and air
ex. a pt has a hemothorax with a chest tube placed. what finding would you report?
a. chest tube not bubbling
b. drained 800mL in an hour
c. no drainage
d. intermittently bubbling
C
(with questions like these, look at the reason why it was placed - hemo = expect blood drainage. If pt had a pneumothorax in this question, you would answer a & b)
chest tubes can be placed in what 2 locations?
- atrial
- basilar
describe the apical location of a chest tube, what does it remove?
- up high = remove air
(think A and A)
describe the basilar location of a chest tube, what does it remove?
- lower = remove blood
(think B and B)
how many chest tubes for a unilateral pneumohemothorax?
2 –> apical and basilar
how many chest tubes for a bilateral pneumo
2 –> apical on right and left side
how many chest tubes for a postop chest surgery
2 –> apical & basilar on right side of surgery
how many chest tubes for a postop right pneumoectomy?
0
what do you do if you know over the plastic collection container of a chest tube?
- pick up and DB (as long as its not broken)
what do you do if the water seal breaks
1) clamp it
2) cut away from broken device
3) submerge in sterile water (if asked the best option when this happens, this is it)
4) unclamp
what do you do if a chest tube is pulled out
- first: cover with gloved hand
- best option: cover with vaseline gauze
bubbling in the water seal that is intermittent is ____
good
bubbling in the water seal that is continuous is _____
bad, indicates a leak (find tape and cover)
bubbling in the suction control chamber and intermittent is _____
bad, indicates not enough suction (turn up suction)
bubbling in the control chamber that is continue is _____
good
what is the rule when clamping a chest tube
- do not clamp for longer than 15 sec without doctors order
congenital heart diseases are either…
- trouble or not trouble
what type of clamp should be used when clamping a chest tube
- rubber tip double clamp
what are characteristics of “trouble” congenital heart diseases
- require emergency surgery
- growth and development is delayed
-causes stress, anxiety - needs cardiology
- longer hospital stays
etc.
all congenital heart diseases that start with ____, are “trouble”
T
trouble congenital heart defects shunt blood which way? the pt is ?
- shunt from right to left
- cyanotic
(think when spelling trouble, right comes before left)
no trouble congenital heart defects shunt blood which way? and the pt is?
- left to right
- acyanotic
all congenital heart defect kids will have…. (whether trouble or not)
- murmur
- echo done
what are the 4 defects of tetralogy of fallot
1) Ventricular defect
2) pulmonary stenosis
3) overriding aorta
4) right ventricular hypertrophy
(think: Valentine’s Day Pick Someone Out A Red Heart)
