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Acute care > cardiac > Flashcards

cardiac Flashcards

1
Q

The cardiac cycle what is the pressure on the right side

A

low due to equal pressure on both sides and short route blood has to take

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2
Q

what is the pressure system on the left side

A
  • high
  • due to the heart pressure needs to be high to push blood to the body
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3
Q

arterial systole is?

A

arterial kick

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4
Q

arterial diastole

A

arterial filling of blood

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5
Q

ventricular systole

A

contraction 1st reading BP

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6
Q

ventricular diastole

A

filling of blood and 2nd reading

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7
Q

what is normal EF?

A

60%

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8
Q

What is the perfusion triangle

A
  • involves the heart pump function ( cant move blood) , blood vessel container function ( not norm blood volume = not enough blood in body) , blood content function ( not enough volume in the container )
  • if one of these things are off= decrease off blood in the body
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9
Q

Within the examination what is the PT doing and what does the telmetry machince tell us

A
  • observation, palpation , edema pitting
  • BP , MAP, HR,RR , SpO2
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10
Q

what is telementry

A
  • machine that can read vital signs constanly
  • depending on the pt we need to constanly monitor them and rate/ rhythm can alternate during activities
  • can be portable
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10
Q

how telemetry pads set up ?

A
  • whit on right
  • white cloud above green grass
  • black smoke above fire
  • chocolate close to my heart
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11
Q

SaO2 tachypnea tachycardia

A

90

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12
Q

PaO2 tachypnea and tachycardia

A

80

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13
Q

SaO2 cardiac dysthymia

A

85

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14
Q

PaO2 cardia dysthymia

A

50

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15
Q

Cardiac meds

A

-amiodarone
-warfin, apixaban
- BBs CCBs ACE-i , ARBs
- aspirin clopoidigrel
- statins
- vasopressin
-tPA

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16
Q

amiodarone AE

A

turn blue / arrythmias

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17
Q

warfin / apixaban

A
  • bleeding
  • no potassium
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18
Q

antihypertensives

A
  • tongue can become swollen ( angioedema)
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19
Q

antiplatelets

A

bleeding

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20
Q

statins

A

tendon rupture

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21
Q

pressors

A

hemodynamic stability effected

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22
Q

tPA

A

clot buster ( increase internal bleeding )

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23
Q

HTN

A

risk factor and asymptotic

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24
Q

ACS

A

umbrella term for ischemic conditions

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25
Q

CAD

A

plaque in walls of artery

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26
Q

angina

A

chest pain due to cardiac condition
stable ( predictable) vs. unstable (unpredictable)

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27
Q

MI

A

ischemia to infarction

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28
Q

agonal rhythm

A

irregular less than 20 bpm near death ( not good )

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29
Q

A-fib

A

most common arrythmia and no arterail kick

30
Q

ventricular tachycardia

A

more than 100 bpm reg rhytm and most common after acute MI

31
Q

ventricular fib

A

chaotic rhythm lead to death if untreated

32
Q

VT

A

irregular rhythm rate more than 150 bpm

33
Q

AV blocks

A

rhythm disturbance electrical conduction block complete / partial

34
Q

Heart failure

A
  • pump dysfunction that reduces co

-left , right , high output , low output , systolic , diastolic

-most common cardiomyopathy

35
Q

valvular heart disaese

A
  • affecting one of the 4 valves
    (stenosis , regurgitation , prolapse)
36
Q

myocardial heart disease

A

heart muscle tissue messed up

37
Q

pericardial heart disease

A
  • pericardium effect
38
Q

how do we address blood vessels

A

-revascularized / reperfusion my drugs antithrombotic or surgery usually a CABG

39
Q

addressing rhythm disturbance

A
  • pacemaker
  • external defibrillator life vest ( shock person back into rhythm see blue goo about to administer shock
40
Q

how do we address heart mechanics

A
  • LVAD RVAD ( have to carry a battery )
  • valve replacement
41
Q

thrombolytic therapy

A
  • acute managmnet
  • thrombolytic agents
  • indications chest pain , elevated st segment and bundle branch block
42
Q

For thrombolytic therapy what of the time of administration

A

3hrs onset of chest pain , studies vary between 6-24 hours of onset of symptoms

43
Q

what is the contraindications for thromboyltiv therapy

A

excessive bleeding

44
Q

Percutaneous revascularization

A

PTCA
-balloon placed in the artery and inflated to maintain patency usually an outpatient procedure

45
Q

CABG

A

helps address pumping dysfunction by revascularized the myocardium

46
Q

standard vs minimal invasive

A
  • sternal precautions
  • no sternal precautions
47
Q

sternal percautions

A
  • no lifting over 90 ROM
  • no lifting over 10 pounds
  • no driving
  • no pulling/ pushing
    ( try not use a walker )
48
Q

cardiac pacemaker

A

help with having regular rhythm

49
Q

automatic implantable cardiac defibrillator

A
  • help restore normal rhythm by defibrillating myocardium
  • battery power device under skin monitors HR and delivers shock ( pt hr can change w/ physical therapy activities.
50
Q

stable angina

A
  • predictable
  • triggered by physical / psychological stressors
  • constant/ frequent time
  • rest by nitrogyclerin
51
Q

unstable angina

A
  • unpredictable
  • can be progressive increase episodes
  • can use meds
    likely to have MI
52
Q

absoulte indication

A
  • decompensated CHF
  • greater than 10 PVcs/ min at rest
  • chest pain with new ST segment changes
  • new onset A-Fib w/ rapid ventricular response HR greater than 100 bpm
53
Q

relative indication maybe modify / withold tx

A
  • resting HR greater than 100 bpm
  • resting HTN greater than 160 systolic and great than 90 diastolic
    -hypotension at rest less than 80 systolic
  • A- fib w/ ventricular response at rest greater than 100 bpm
54
Q

MET value sitting (at desk, watching TV, reading )

A

1.3

55
Q

MET value standing ( at computer , talking on the phone )

A

1.8

56
Q

home activity( folding and putting away laundry)

A

2.3

57
Q

home activity moderate effort of cleaning )

A

3.5

58
Q

brisk walk

A

4.3

59
Q

yardwork

A

5.0

60
Q

running (4.3 min./ mile )

A

23.0

61
Q

stable response vs. unstable response

A
  • tells us if pt is capable to do the activity
  • hemodynamically stable and hemodynamically unstable
62
Q

cardiac intervention goals

A

-make sure hemodynamic response is good while mobilizing
- max activity tolerance
- educate pt/ caregiver of activity

*** all activity must be supported by pt activity levl

63
Q

AICD what is the target HR

A

20-30 beats

63
Q

how many beats do we not want to exceed if pt is on beta blockers

A

20

63
Q

For a post transplant can you use HR to determine exercise

A

NO, due to the heart not being able to pump as much since it has to get use to it working

63
Q

What are abnormal response of BP

A

systolic decrease 10 mmHg below resting
systolic response greater than 180 mmHg
diastolic response greater than 110 hg

64
Q

RPE borg

A

6-20

65
Q

mod borg scale RPE

A

1-10

66
Q

general guidelines for intensity RPE

A

5 or less 10 point scale 13 or less on 6-20 scale

67
Q

cardiac interventions

A
  • warm up ( low level activity )
  • conditioning (func. mobility )
  • cool down ( stretching and deep breathing )
  • pt edu( self monitoring, safe exercise program, lifestyle mod. med managemnet)
68
Q

phase 1 cardiac

A
  • still in the hospital
  • stable start working w/ them
  • 1-4 mets to go up stairs and start working on walking / functional activities
  • educate on lifestyle modifications/ risk factors
69
Q

Phase 2 cardiac rehab

A
  • 2 weeks after event
  • continue pt edu
  • progress exercise
70
Q

phase 3 cardiac rehab

A
  • maintenance and prevention
  • happens after 2-3 months after event

Acute care (3 decks)

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