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Respiratory and Cardiac > Cardiac > Flashcards

Cardiac Flashcards

1
Q

Where is the heart located?

A

Lies in the mediastinum
Extends downward and to the left

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2
Q

What are the 3 layers of tissues of the heart?

A

Endocardium
Myocardium
Epicardium

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3
Q

What does the atria do?

A

Receives blood returning from body and lungs

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4
Q

What do the ventricles do?

A

Pumps blood to the body
and lungs

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5
Q

What is the purpose of capillaries?

A

Permits gas exchange, the transfer of nutrients and the
removal of waste between blood and the fluid of tissues

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6
Q

The SA node is the ___________

A

pacemaker of the heart

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7
Q

__________ is the contraction phase of the heart

A

systole

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8
Q

____________ is the relaxation phase of the heart

A

Diastole

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9
Q

Atria and ventricles contract and relax in a ___________

A

Organized fashion

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10
Q

What is cardiac output?

A

total amount of blood ejected from one ventricle of
the heart in L/min.

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11
Q

What is a normal cardiac output for a healthy adult at rest?

A

5-6 L/min

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12
Q

How is cardiac output calculated?

A

Stroke Volume times heart rate

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13
Q

What is stroke volume?

A

The volume of blood ejected by one ventricle per
heartbeat.

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14
Q

what 3 factors determine stroke volume?

A

preload, afterload, and contractility

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15
Q

What causes S1 heartbeat?

A

the first heart sound heard indicates the closure of the mitral and tricuspid valves (Lub)

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16
Q

what causes the S2 heartbeat?

A

the second heart sound signifies the closure of the aortic and pulmonic valves (Dub)

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17
Q

S3 and S4 are________

A

Abnormal heart sounds that require further assessment

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18
Q

Cardiac murmurs have a whooshing sound and indicate_______

A

Turbulent blood flow through normal or abnormal valves

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19
Q

What is pericardial friction rub?

A

an abnormal heart sound that is typically heard
over the left sternal boarder. (Grating sound)

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20
Q

What does a electrocardiogram do?

A

Records cardiac electrical activity

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21
Q

P wave is ___

A

atrial depolarization

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22
Q

What does the PR interval represent?

A

The rate of cardiac impulse transmitted from the
AV node.

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23
Q

What is the QRS complex?

A

Ventricular depolarization

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24
Q

ST segment

A

Follows ventricular depolarization and occurs prior to
the start of ventricular repolarization.

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25
Q

What is the T wave?

A

Ventricular repolarization is occurring

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26
Q

What is the QT interval?

A

The time for ventricular repolarization to complete.

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27
Q

Clients may be ______ or _______ with sinus bradycardia

A

Symptomatic or asymptomatic

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28
Q

Symptoms of sinus bradycardia:

A

fatigue, increased shortness of breath, dizziness

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29
Q

Main concern with sinus bradycardia

A

fall risk

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30
Q

Lab testing for sinus bradycardia:

A

Electrolytes
Thyroid hormone panel
Troponin
Blood and Urine for toxicology

31
Q

Manifestations of decreased cardiac output:

A

Dizziness
Chest pain
Near syncope
Mental status changes
Shortness of breath

32
Q

Sinus bradycardia treatment

A

Asymptomatic: Continue to observe client
Symptomatic:
IV atropine 1 mg repeat every 3-5 minutes not to exceed a total of 3 mg.
Monitor for changes in heart rate
Temporary transcutaneous pacemaker if client continues to remain unstable and symptomatic

33
Q

Sinus bradycardia is classified as less than

A

60 BPM

34
Q

Sinus tachycardia is classified as more than _________

A

100 BPM

35
Q

With sinus tachycardia clients may be ___ or __________

A

Symptomatic or asymptomatic

36
Q

Symptoms of sinus tachycardia

A

Palpitations
Dizziness
Lightheadedness
Elevated temperature
Chest pain
Difficulty breathing

37
Q

Main concern with sinus tachycardia is:

A

Fall risk

38
Q

Pt. education for sinus tachycardia:

A

Change positions slowly
Decrease physical intensity or activity
Stress management
Discontinue or reduce substances
that increase heart rate.

39
Q

Precipitating factors to sinus tachycardia:

A

Recent infection or illness
Chronic health conditions
Stress
Pain
Anxiety
Medications

40
Q

Sinus tachycardia treatment:

A

Identify underlying cause of tachycardia
Interventions to decrease fever, pain, stress fear or anxiety
Catheter ablation

41
Q

Medications given for sinus tachycardia:

A

Adenosine
Betablockers (metoprolol)

42
Q

Symptoms of PVCs

A

palpitations, lightheadedness, chest pain or shortness of breath

43
Q

Potential cause of PVS that can be detected in a blood test:

A

Potassium
Magnesium
Thyroid levels

44
Q

Medications used to treat PVCs

A

Beta blockers
Antiarrhythmic medications
Flecainide
Propafenone
Amiodarone

45
Q

If medications are ineffective for PVCs they can do a ___________ after 30 days

A

Catheter ablation

46
Q

T/F with PAC clients have symptoms?

A

false, they are usually found at routine physicals some people report feeling fluttering of the chest or carotids

47
Q

Can you see the p wav on a ekg for a patient with PAC?

A

No the p wave is hidden or unidentifiable

48
Q

How do PACs effect the PR interval?

A

may be shortened less than 0.12 or unmeasurable

49
Q

Symptom of Afib:

A

Irregular pulse
Hypotension
Heart palpitations
Increased heart rate
Chest discomfort
Shortness of breath (at rest or with activity)
Exertional fatigue
Anxiety
Dizziness
Lightheadedness
Syncope
Weight gain
Increased urination

50
Q

Safety considerations for Afib

A

Client at risk for stroke
Risk for spontaneous bleeding

51
Q

Blood test for afib

A

-TSH
-Thyroxine
-CBC
-Creatinine
-Glucose
-INR

52
Q

What is a TEE?

A

Transesophageal echocardiogram
detects the development of blood clots in the left atrium.

53
Q

Safety considerations for a fib

A

Bleeding precautions for clients on anticoagulant therapy
* Falls
* Shaving
* Vigorous teeth brushing and flossing
* Participation in contact sports

54
Q

Client education for afib

A

Report any manifestations of A-fib to provider
* Take medications as prescribed
* Bleeding precautions
* Healthy lifestyle modifications
* Avoid stimulants
* Avoid herbal supplements

55
Q

Afib interventions for rhythm control:

A

Electro cardioversion
Catheter ablation
Anticoagulants
Diet modification

56
Q

Sings and symptoms of atrial flutter:

A

Lightheadedness
Palpitations
Hypotension
Dizziness
Chest discomfort
Shortness of breath

57
Q

Manifestations of SVT may present______

A

Suddenly

58
Q

Signs and symptoms of SVT

A

Dizziness
Lightheadedness
Syncopal episodes
Hypotension
Shortness of breath
Palpitations
Increased risk of falls

59
Q

Treatment for SVT

A

Vagal maneuvers
* IV adenosine 6 mg IV over 1 to 3 seconds then flush with 20 mL NS
* If no change give a repeat dose of 12 mg followed by 20 mL NS
* Adenosine will the heart rate: have a defibrillator on hand
* IV diltiazem
* IV esmolol
* IV metoprolol

60
Q

What is CAD?

A

Occurs with a build up of plaque within the coronary arteries.

61
Q

Complications of CAD

A

Stable angina
ST Elevation myocardial infarction (STEMI)
Non-ST elevation myocardial infarction (NSTEMI)
Unstable angina

62
Q

What is stable angina?

A

Chest pain that occurs when the heart requires more oxygen than it usually does (such as during exercise).

63
Q

Treatment for angina:

A

Rest
Nitroglycerin

64
Q

Clinical presentation of CAD:

A

Initially CAD is asymptomatic
Manifestations appear when there is decreased blood flow and oxygen to the heart.

65
Q

Risk factors for CAD:

A

Weight
Diet
Sedentary lifestyle
Smoking
Hypertension
Hyperlipidemia
Diabetes

65
Q

Lab studies for CAD

A

Cholesterol
Homocysteine
C-reactive protein
Cardiac Enzymes
Troponin
Creatine kinase-MB (CK-MB)

66
Q

Diagnostic studies for CAD

A

Electrocardiogram
Cardiac cath
Stress test
X ray

67
Q

Treatments for CAD:

A

Health/lifestyle changes
Angioplasty
Coronary artery bypass graft
Medications

68
Q

MONA acronym for CAD

A

Morphine IV 2 mg to start can go up to 4 - lowers the pressure on the heart which decreases the oxygen demand (preload and afterload), pain, lowers BP
Oxygen start at 4 L and work your way up
Nitroglycerin up to 3
Asprin

69
Q

What is heart failure?

A

Heart is not able to meet the demands of the systemic circulatory system
Ventricles do not fill properly
Blood is not ejected into the systemic circulatory system properly

70
Q

Risk factors to heart failure:

A

Family history of heart disease
Chronic pulmonary disease
CAD
Hypertension
Chronic infection
Diabetes
Obesity
Metabolic disease
Alcohol abuse
Cardiotoxic agents

71
Q

Manifestations of heart failure impact client’s ability to carry out ADLs

A

Shortness of breath
Fatigue
Weakness
Difficulty sleeping
Edema
Depression
hopelessness

72
Q

Safety consideration for heart failure:

A

Self monitor manifestations
Proper administration of oxygen (if needed)

73
Q

What type of lungs sounds do you hear in the base of lungs with HF

A

Crackles in the bases of lungs

Respiratory and Cardiac (1 decks)

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