Cardiac Flashcards
Ischemia is what
Pain
How do you asses chest pain
Provokes Quality Radiation Severity Timing
Snapshot in time
ECG
What does chest x ray show
Heart size and fluid lungs
What does echo show
Chambers and valves
What does a TEE show
Behind heart looking for clots
What does MRI show
Home organ soft tissue
Acute intermittent chest pain syndrome caused by imbalance between myocardial oxygen demand and supply resulting in ischemia
Angina
Angina that occurs with exertion relieved by rest
Stable angina
Severe pain not relieved by rest requires more nitro
Unstable
Teaching with nitro
One tablet every five min times 3 store dark bottle dry place
What is nitro action
Smooth muscle relaxant vasodilator
Caused by reduced blood flow to an area of the myocardium resulting in significant and sustained oxygen deprecation
Acute myocardial infarction
Asses,net of a pt with an MI
Sudden chest pain can radiate down neck arms jaw skin cool clammy pale diaspore tic nitro does not help pain
Nursing interventions with someone having a heart attack
Morphine
Oxygen
Nitro
Aspirin
What does morphine do
Decreases anxiety pain smooth muscle relaxant decreases preload and afterload
Teaching with aspirin
Chewable 81mg 2-4
What does beta blockers do
Decreases heart rate and contractility
What do ACE inhibitors do
Decreases stroke volume
What does phosphodiasterase do
Increase contractility decrease afterload
What does dopamine do
Stimulates adrenergic receptors treats low cardiac output
What does doubt amine do
Ehances contractility av co blood flow
Which is low and high pressure of heart
Left high power house
Right low
Pressure equals
Flow times resistance
Force exerted on the liquid
Pressure
Amount of fluid moved over time
Flow
Measure of the ease which the fluid flows through the lumen of a vessel
Resistance
Normal lactate level
0.5-1.6
Level of phlebostatic axis
4th intercostal space midaxillary line
Amount of blood ejected by the heart each min and is calculated from her and av
Cardiac output
Co adjusted for an individual’s size or body surface area
Cardiac index
Four factors that affect svo2
Hemoglobin
Co
Atrial oxygen sat
Oxygen consumption
A progressive narrowing of one or more coronary arteries by atherosclerosis
Coronary artery disease
Thin walled low pressure chambers receive blood
Atria
An additional 30 percent of blood volume into ventricles
Atrial kick
Thick walled high pressure
Ventricles
Detect changes in by
Baroreceptors
Detect changes in ph 02 and co2 levels in blood
Chemoreceptors
Slows heart rate
Parasympathetic
Accelerator fight or flight
Sympathetic
Myocardial cell function
Mechanical
Primary electrical
Pacemaker
Primary chemical
Action potential
Contraction/pressure
Systole
Relaxation filling
Diastole
Number for at rest
-90mv
Phase o
Rapid depolarization
Phase 1
Early repolarization
Phase2
Repolarization
Phase 3
Rapid repolarization
Phase 4
Resting membrane potential
Absolutely can’t be stimulated to conduct electrical
absolute refractory period
Can be stimulated if pulse is strong enough
Relative refractory period
SA node electrical conduction
60-100
Av node conduction
40-60
Purkinjes electrical
20-40
A record of the spread of electrical activity through the heart
ECG
On ECG paper how many seconds is one big box
0.20 seconds
How long is small box
.04
Isoelectric line equals
-90mv
First wave in cycle atrial depolarization smooth round
P wave
Normal PR interval
0.12 to 0.20 sec
What is pr interval show
Timing from atrial depolarization to entering the bundle of his
QRS complex shows
Ventricular depolarization
QRS complex measures
0.06 to 0.12
Displace,net of an at segment means
MI
What is the T wave
Ventricular repolarization
What changes shape of T
Electrolyte imbalance
What is normal QT interval
Varies with age
Step 1 of analyzing strip
Heart rate… Count the r in a 6 second strip times by 10
Step 2
Regular or not … Measure R intervals
Step 3
P wave… Does it precede QRS
Step 4
QRS.. Does it measure 0.06 to 0.12
Step 5
Intervals PR 0.12 to 0.20
Step 6
Overall apparence
Step 7
Name for point origin and mechanism
Contraction of the heart with blood ejected from heart chambers into system
Systole
Slow passive filling of blood back into the heart
Diastole
Electrical firing of impulse
Depolarization
Electrical recharging
Repolarization
Symptoms of low co
Altered LOC low BP chest pain SOB decreased UO cool clammy pale skin
Heart rate less than 60 norm everything else
Sinus bradycardia
What do you give for bradycardia if symptomatic
Atropine 0.5 to 1 mg
Heart rate greater than 100 everything else norm
Sinus tachycardia
A site when atria fires before the next SA node impulse early P wave
PAC
Atrial rate 400-600 no P waves no Pr interval
Atrial fibrillation
Dangers of atrial fibrillation
Loss of atrial kick thrombi
Drug for a fib
Anticoagulant amiodrone
Sawtooth flutter waves rate 250-300
Atrial flutter
What do you give for SVT
Adenosine
Ectopic site in ventricle no P wave wide QRS
PVC
3 or more PVC in a row
Ventricular tachycardia
No P waves no QRS NO PULSE CODE
Ventricular fibrillation
No ventricular activity see straight line always confirm more than 1 lead
As systole
No p waves no pulse rate 20-40 ventricular focus dominant pacemaker
Idiots tricolor rhythm
