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Nursing 205 > Cardiac 2 > Flashcards

Cardiac 2 Flashcards

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0
Q

What 3 issues cause left sided heart failure?

A

Hypertension, cad, valvular disease

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1
Q

Etiology: 75% of all heart failure cases come from what?

A

Systemic hypertension

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2
Q

What type of left sided heart failure is described by the heart not pumping enough blood out?

A

Systolic heart failure

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3
Q

What type of left sided heart failure is described as insufficient filling of the chambers and a stiffening of the left ventricle?

A

Diastolic heart failure

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4
Q

What type of heart failure is described by: the heart backing up into the lungs

A

Left sided heart failure

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5
Q

What is the term for the percentage of blood ejected from the heart during systole? And what is normal?

A

Ejection fraction. 60-75%

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6
Q

What is this process? Abnormal relaxation and stiffness of heart-elevated left ventricle filling pressure-elevated pulmonary pressure-reduced exercise tolerance.

A

Diastolic dysfunction

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7
Q

What 3 things cause right sided heart failure?

A

Left sided heart failure, right side mi, pulmonary hypertension

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8
Q

What happens when the right ventricle cannot fully empty causing an increase in Volume and pressure in the venous system resulting in peripheral edema?

A

Right sided heart failure

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9
Q

True or false: all compensatory mechanisms add to increase need for o2

A

True

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10
Q

Name the disease: clinical manifestations –weakness, confusion, sob, pulmonary congestion, no urine output

A

Left sided heart failure

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11
Q

Name the disease: clinical manifestation- dependent edema, weight, distended neck veins, hepatomegaly, ascities

A

Right sided heart failure

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12
Q

How many lbs of water must a person gain before putting edema sets in?

A

10-15 lbs

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13
Q

What does a bnp lab test tell?

A

How much fluid overload is in the body

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14
Q

Sob + elevated bnp=

A

Heart failure

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15
Q

Sob + normal bnp =

A

Pulmonary cause

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16
Q

What are the goals of interventions for impaired gas exchange?

A

Increased pulse of and reduce o2 given

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17
Q

What medicine is the first line of defense for decreased cardiac output?

A

Ace inhibitor

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18
Q

What medication do you use to enhance contractility of the heart?

A

Beta blocker

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19
Q

What is the widespread abnormal cellular metabolism that occurs when human need for o2 and tissue perfusion is not met for function?

A

Shock

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20
Q

What are the 3 classifications for shock?

A

Cardiogenic, hypovolemic, and distributive

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21
Q

What are the 4 causes of shock?

A

Fluid loss, hypo-perfusion, injury, weakened cardiac contractility

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22
Q

What are the 3 components of the cascade of metabolic metabolism?

A

Hypothermia, coagulopathy, acidosis

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23
Q

True or false: manifestations of shock are similar regardless of what starts the process.

A

True

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24
Q

What measures tissue perfusion?

A

Mean arterial pressure

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25
Q

What is the normal range for MAP?

A

75-110mmHg

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26
Q

How do you calculate MAP

A

(2 x diastolic + systolic) / 3

27
Q

What factors influence MAP?

A

Total blood volume, cardiac output, sz of vascular bed

28
Q

True or false: Increased blood volume, cardiac output, and vasoconstriction increases MAP

A

True

29
Q

True or false: decreased blood volume and cardiac output with vasodilation cause decreased MAP

A

True

30
Q

What 4 factors determine the severity of hypovolemic shock?

A

Co-morbidity, age, time before treatment, venous vs arterial

31
Q

What are the four stages of shock?

A

Initial- early
Non-progressive- compensatory
Progressive- immediate stage
Refractory- irreversible

32
Q

In what stage of shock does shunting occur?

A

Non-progressive compensatory

33
Q

What is shunting?

A

Blood is used for important organs first

34
Q

What is the goal of compensatory shock?

A

Keep volume in central blood vessels

35
Q

True or false: a person can stay In the non-progress phase for hours and not have lasting damage.

A

True

36
Q

Name the state of shock: compensatory is working but not enough 02 for organs, anoxic cell death, life threatening

A

Progressive immediate

37
Q

Name the state of shock: rapid loss of confusion, non palpable pulses, cold mottled skin, cell/tissue death, depressed heart, can lead to MODS

A

Refractory - irreversible

38
Q

Name the disease: massive release of toxins, trigger small clots, blocks tissue oxygenation, damage more cells

A

MODS

39
Q

What are the odds of surviving progressive shock?

A

50/50

40
Q

True or false: you can have more than one type of shock at the same time

A

True

41
Q

What is the triad of shock

A

Coagulopathy, hypothermia, acidosis

42
Q

What determines the amount for transfusion for a pt?

A

Amount loss in 24 hrs

43
Q

What is the best monitor for tissue perfusion?

A

Pulse ox

44
Q

What is interesting about BP in hypovolemic shock?

A

Systolic decrease diastolic increase

45
Q

What is a lactate test?

A

Determines how much lactic acid is in the blood. Lower the better

46
Q

True or false: 02 should remain around 95% to ensure safety. Any higher can cause organ and lung damage

A

True

47
Q

What are synthetic plasma expanders?

A

Used by military, no cross match needed

48
Q

What do you use to pre medicate before a transfusion?

A

Antipyretic and anti inflammatory

49
Q

What is the only solution that can be a primary with a blood transfusion?

A

Normal saline only

50
Q

What disease will a pt present with kussmaul breathing?

A

Dka

51
Q

What disease will a patient present with biots breathing pattern?

A

Neuro issues

52
Q

Breath sound= high pitched, narrowing, musical sound

A

Wheeze

53
Q

Breath sound: crowing in trach and upper airway

A

Stridor

54
Q

Breath sound: fluid in lungs, light popping sound, not musical

A

Crackles

55
Q

What monitors co2 and ph

A

Brain stem

56
Q

What is the name for the constant change of o2 and co2?

A

Diffusion

57
Q

What is the most common cause of hypoxemia?

A

Abn ventilation to perfusion rate

58
Q

What patients get hypercapneia ( too much co2)?

A

Unconscious pt, drug overdose, copd

59
Q

What is atelectasis?

A

Complete collapse of alveoli

60
Q

What does carbonic acid regulate?

A

Regulates ph

61
Q

What is aat relating to copd?

A

Protein that protects the lungs

62
Q

Name the disease: abn permanent enlargement of air space, loss of lung elasticity, alveoli wall fibrosis, hyperinflation/distension of alveoli, flattened diaphragm

A

Emphysema

63
Q

What is an avelolar bleb?

A

When it bursts open

64
Q

What is an avelolar bullae?

A

Collapse of alveola

65
Q

Poor gas exchange in lungs leads to vasoconstriction that leads to pulmonary hypertension. Right ventricle fails die to pumping against high pressure in lungs . Right sided failure

A

Cor pulmonale

Nursing 205 (4 decks)

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