Cardiac Flashcards

1
Q

Normal heart rate

Sinus tachycardia rate

Sinus bradycardia rate

A

Normal heart rate: 60-100 bpm

Sinus tachycardia: >100 bpm

Sinus bradycardia: <60 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Cardiac Markers (CIP).. Sensitivity and peak

Troponin

CK-MB

Myoglobin (Mb)

A

Troponin: most sensitive to cardiac damage, peaks around 12 hours

CK-MB: sensitive when skeletal damage isn’t present, 10-24 hours

Myoglobin: low specificity to infarction, 2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cardiac labs:

Potassium range

Hypokalemia

Hyperkalemia

A

Potassium range: 3.5-5

Hypokalemia: <3.5… ventricular dysrhythmias, ⬆️ digoxin toxicity, U wave, ST depression

Hyperkalemia: >5… Peaked T waves, wide QRS, ventricular dysrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cardiac labs:

⬆️ Hematocrit

⬇️ Hematocrit and hemoglobin

A

⬆️ Hematocrit: dehydration!

⬇️ Hematocrit and hemoglobin: indicates anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cardiac labs:

Lipids

A

Lipids:

🔸 Total cholesterol ⬇️200 mg/dl
🔸 LDL ⬇️130 mg/dl (bad cholesterol)
🔸 HDL 30-70 mg/dl (good cholesterol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cardiac labs:

BNP

A

BNP: brain natriuretic peptide. Normal is <100. Indicates ⬆️ ventricular stretching and heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Holter Monitoring

A

🔸 Important for patients having angina
🔸 24 hour continuous EKG monitor is stored, the patient records the times they’re having chest pain
🔸 helps physician identify what is causing abnormalities in the EKG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Holter Monitor placement

A

5 lead monitor

White on right
Snow over trees
Smoke over fire
Ground in the middle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cardiogenic shock

❤️ What is it?

❤️ Assessment

A

❤️ Heart is unable to maintain effective cardiac output… Heart failure/ disruptions in cardiac function = ⬇️ oxygen delivery to tissues = ⬇️ tissue function

❤️ Assessment: low urine output, ⬇️ BP, assess CVP (right atrial pressure preload)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which elements determine blood pressure?

A

🔸 Heart rate
🔸 Stroke volume (amount of blood pumped out of the ventricle with each heartbeat)
🔸 Total peripheral resistance (resistance of the muscular arteries to the blood being pumped through)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hypertension classification:

🔺 Normal blood pressure
🔺 Prehypertension
🔺 Stage 1 Hypertension
🔺 Stage 2 Hypertension

A

🔺 Normal: S <120 / D <80
🔺 Prehypertension: S 120-139 / D 80-89
🔺 Stage 1 Hypertension: S 140-159 / D 90-99
🔺 Stage 2 Hypertension: S >160 / D >100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

P wave

PR Segment

QRS complex

T wave

A

P wave- atrial depolarization

PR segment- delay at AV node

QRS Complex- ventricular depolarization

T wave- ventricular repolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is blood pressure equal to?

A

Blood pressure is equal to the cardiac output (cardiac output = volume pumped out of the heart per minute x arterial resistance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What organ systems are damaged by hypertension?

A

🔺 ❤️ must work harder to pump against resistance = need for more oxygen = angina or heart attack
🔺 Arteries/arterioles are damaged =arteriosclerosis =WBC plaques
🔺 Kidney capillaries can become permeable to proteins/other molecules = clogging of tubules = decreasing ability to filter blood and make urine
🔺 Retinas are damaged when capillaries hemorrhage = scarring
🔺 thrombotic or hemorrhagic strokes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cardiovascular Diseases (CVD):

History Assessment

A

🔸 Medical and surgical Hx
🔸 Family Hx (cardiac issues, diabetes, kidney problems?)
🔸 Medication Hx (including vitamins, herbals, OTCs)
🔸 Social Hx (nutrition🍩 (Sodium and fat intake), bowel and bladder habits (Urine output? Straining? Blood in stool?), activity level, sleep (orthopnea??? How many pillows?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Cardiovascular Diseases (CVD):

Risk factors (Non Modifiable and Modifiable)

A

Non modifiable- Older age, male gender, heredity (including race)

Modifiable- Hyperlipidemia, HTN, cigarette smoking, diabetes, obesity, physical inactivity

17
Q

Cardiovascular Diseases (CVD):

Physical Assessment

A

▪️ Inspection and palpation (skin color, temperature, capillary refill, peripheral pulses, edema, ulcers)
▪️ Vitals (BP.. Hypertension (>140/ 90), hypotension (<90/60), Orthostatic hypotension)
▪️ Auscultation of ❤️ (s1s2, rate, rhythm)
▪️ Respiratory (crackles, cough, wheezes, hemoptysis)
▪️ Abdominal (ascites, pulsatile mass (aneurysm))

18
Q

Cardiovascular Diseases (CVD):

Gerontologic considerations

Gender considerations

A

Gerontologic- peripheral pulses readily palpable due to decreased elasticity (bounding 🐰), intermittent claudication, ⬆️ risk for postural hypotension

Gender- men are at greater risk for CVD. Women have smaller blood vessels and estrogen

19
Q

Valvular Disorders:

Stenosis

A

Thickened valve = narrower space for blood to pass through = decrease flow and increased work for ❤️

20
Q

Valvular Disorders:

Prolapse

A

Valve leaflets balloon up as the ventricle collapses

21
Q

Valvular Disorders:

Regurgitation

A

Valve leaflets don’t close properly = blood leaks back into atrium = can lead to blood clotting inside the ❤️

22
Q

Valve Repair:

Mechanical Valves vs. Tissue Valves

A

Mechanical Valves- more durable but require anticoagulant therapy (ex. Warfarin… Want INR between 2 and 3.5), risk for endocarditis

Tissue Valves- less durable and lacks longevity, doesn’t require anticoagulants, risk for endocarditis

23
Q

Infective Edocarditis

A

🔸 Usually bacterial (strep!!! Also staph in acute IE!)
🔸 common in IV drug users, patients w/ a central line, invasive procedures r/t ❤️
🔸 Vegetations of bacteria destroy heart valves and can become dislodged from valve causing emboli