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NCLEX > Cardiac > Flashcards

Cardiac Flashcards

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1
Q

Arrhythmias are no big deal until they affect ________.

A

Cardiac output

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2
Q

Decreased blood flow to the myocardium that results in temporary pain/pressure in the chest. Low oxygen that is usually due to excretion. Pain is relieved by rest and nitroglycerin.

A

Chronic stable angina

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3
Q

How often should you replace nitroglycerin tablets? Spray?

A

Tablets: 3-6 months
Spray: 2 years

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4
Q

What do calcium channel blockers cause?

A

Vasodilation

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5
Q

Are palpitations normal with contrast dye?

A

Yes

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6
Q

What does unstable chronic angina mean?

A

Impending MI

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7
Q

Should you hold Glucophage (Metformin) for a cardiac catheterization?

A

Yes hold for 48 hours post procedure - worried about kidneys

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8
Q

Does nitro relieve MI or unstable angina pain?

A

No

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9
Q

What is the number sign of an MI in an elderly person?

A

Syncope

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10
Q

What is the goal for a STEMI patient to get to the cath lab?

A

90 minutes

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11
Q

Cardiac biomarker with high specificity to myocardial damage. Elevates within 3-4 hours and remains elevated for up to 3 weeks.

A

Troponin

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12
Q

Cardiac specific isoenzyme. Increases with damaged to cardiac cells and elevates in 3-12 hours and peaks in 24 hours.

A

CPK-MB

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13
Q

What 4 drugs are used for chest pain when they get to the ED? (In order)

A
  1. Oxygen
  2. Aspirin - chewable
  3. Nitro
  4. Morphine
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14
Q

What position should you put a chest pain patient in?

A

Head up - decreases workload and increases cardiac output

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15
Q

How soon after the onset of myocardial pain should fibrinolytics be administered?

A

Within 6-8 hours

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16
Q

What are 4 absolute contraindications for fibrinolytic therapy?

A
  1. Intracranial neoplasm
  2. Intracranial bleed
  3. Suspected aortic dissection
  4. Internal bleeding
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17
Q

How long after fibrinolytic therapy is administered do we take bleeding precautions?

A

At least 72 hours

18
Q

What is the best exercise for an MI patient?

A

Walking

19
Q

Left sided heart failure: The blood is not moving forward into the aorta and out of the body. This will cause the blood to go backwards into the ______.

A

Lungs

20
Q

What are 8 symptoms of left sided heart failure?

A
  1. Pulmonary congestion
  2. Dyspnea (at night too)
  3. Cough
  4. Blood tinged sputum
  5. Restlessness
  6. Tachycardia
  7. Orthopnea
  8. S-3
21
Q

Right sided heart failure: the blood is not moving forward into the lungs. It causes the blood to back up into the _______.

A

Venous sytem

22
Q

What are 5 symptoms of right sided heart failure?

A
  1. Distended neck veins
  2. Edema
  3. Enlarged organs
  4. Weight gain
  5. Ascites
23
Q

Heart can’t contract and eject

A

Systolic heart failure

24
Q

Ventricles can’t relax and fill

A

Diastolic heart failure

25
Q

What happens if the cardiac output is decreased:
Brain: LOC ______
Heart: ______ pain
Lungs: Short of breath and lungs sound ______
Skin: ______ and _____
Kidneys: Urinary output goes _____
Peripheral pulses: _______

A 
Brain: LOC goes down
Heart: chest pain
Lungs: Short of breath and lungs sound wet/crackles
Skin: cool and clammy
Kidneys: Urinary output goes down
Peripheral pulses: weak/thready
26
Q

What classification of medications are the drug of choice for heart failure?

A

ACE inhibitors (then ARBS)

27
Q

Type of catheter that is floated into the right side of the heart and pulmonary artery. It provides information to rapidly determine hemodynamic pressures, cardiac output, and provided access to mixed venous blood sampling.

A

Swan Ganz catheter (pulmonary artery pressure)

28
Q

What’s a normal digoxin level?

A

0.5-2.0

29
Q

What are 4 signs of digoxin toxicity?

A
  1. Anorexia
  2. NV
  3. Arrhythmias
  4. Visual changes
30
Q

_________ + digoxin = digoxin toxicity

A

Hypokalemia

31
Q

What daily weight gain should be reported to a heart failure patient’s doctor?

A

2 pounds or more

32
Q

Fluid is backing up into the lungs. The heart is unable to move the volume forward. Symptoms include sudden onset, breathless, restless, anxious, productive cough, and severe hypoxia. Treated with oxygen, diuretics, nitro, and morphine.

A

Pulmonary edema

33
Q

How should oxygen be administered to a patient in pulmonary edema?

A

Nonrebreather

34
Q

What position is best for a patient in pulmonary edema?

A

Reverse trendelenberg (promotes pooling of blood in lower extremities; don’t care if feet are big, want fluid away from heart)

35
Q

Blood, fluid, or exudates have leaked into the pericardial sac resulting in compression of the heart. Treatment includes a pericardiocentesis to remove fluid/blood from around the heart. Surgery is used to repair the hole.

A

Cardiac Tamponade

MI, Pericarditis, MVC, hemorrhage

36
Q

What are the 2 hallmark signs for cardiac tamponade?

A
  1. Increased CVP

2. Decreased BP

37
Q

What does pain at rest mean when a patient has an arterial disorder?

A

Severe obstruction - medical emergency

38
Q

_______ veins

_______ arteries

A

Elevate veins

Dangle arteries

39
Q

What 4 things should you watch for when a patient is on an ACE inhibitor (-pril)?

A
  1. Hyperkalemia
  2. Orthostatic syncope
  3. Hypotension
  4. Renal dysfunction
40
Q

What 3 things should you watch for when someone is on an ARB
(-sartan)?

A
  1. Hypotension
  2. Hyperkalemia
  3. Renal dysfunction
41
Q

Should you give beta blockers to asthmatics or diabetics?

A

No
BB can constrict bronchioles
BB blocks the symptoms of hypoglycemia

NCLEX (16 decks)

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