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Hurst Elevate Module 2 > Cardiac > Flashcards

Cardiac Flashcards

1
Q

increased preload = increased ______

A

workload

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2
Q

_____ released with stretch caused by _______

A

ANP, preload

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3
Q

afterload = _______

A

resistance

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4
Q

stroke volume = ______

A

amount of blood with each contraction

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5
Q

________ depends on CO

A

perfusion

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6
Q

______ influences CO
MORE _______ = ________ CO
LESS ________ = _______ CO

A

volume
volume = increased
volume = decreased

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7
Q

preload meds ________ to _______ preload
diuretics ________
nitrates _______

A

vasodilate, reduce
furosemide
NTG

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8
Q 
afterload meds \_\_\_\_\_\_ to \_\_\_\_\_\_\_ afterload
ACE \_\_\_\_\_\_
ARB \_\_\_\_\_\_
hydralazine
nitrates \_\_\_\_\_
A 
vasodilate, reduce
-pril
-sartan
hydralazine
NTG
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9
Q

these drugs improve contractility

1. ______ 2. ______ 3. ______

A

inotropes

1. dopamine 2. dobutamine 3. milrinone

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10
Q

these drugs control rate
beta blockers ______
CCB ______
Digoxin

A

-olol

diltaizem, verapamil, amlodipine

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11
Q

this drug controls rhythm

antiarrhythmic, used for _______

A

amiodarone

v-tach

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12
Q 
Patho of Decreased CO
\_\_\_\_\_\_ ventricle
\_\_\_\_\_\_ volume, \_\_\_\_\_\_ pressure, \_\_\_\_\_\_ CO, \_\_\_\_\_\_ perfusion
LOC \_\_\_\_\_\_\_
\_\_\_\_\_\_ pain
lungs \_\_\_\_\_\_
SOB? \_\_\_\_\_
skin is \_\_\_\_\_\_ & \_\_\_\_\_\_\_\_
urine output \_\_\_\_\_\_\_
pulses are \_\_\_\_\_\_
\_\_\_\_\_\_\_ are no big deal until they affect \_\_\_\_\_
A

left
less, less, decreased, poor

decreases
chest
wet
YES!
cool, clammy
decreases
weak
arrhythmias, CO
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13
Q

These arrhythmias are always a big deal

A

V-tach
V-fib
Asystole

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14
Q

CAD includes:

A
  1. Chronic Stable Angina

2. Acute Coronary Syndrome

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15
Q 
Chronic Stable Angina
Patho:
\_\_\_\_\_\_\_ leads to temporary \_\_\_\_\_\_\_
low \_\_\_\_\_\_ due to \_\_\_\_\_\_ 
relieved by \_\_\_\_\_\_ and \_\_\_\_\_\_\_
A

ischemia, chest pain
oxygen, ischemia
rest, NTG

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16
Q

CSA Meds–Nitro:
NTG which causes _______ = ________ preload & afterload = _______ workload & ______ O2 demand
______ arteries are also dilated, which ______ O2 to the heart
do not _______ NTG, take _____ pill every ______ minutes for a max of ____ pills
do not store in _________
different brands may cause ______ or _______
client WILL get a _________ d/t _________
new pills after _____ months or new spray after ____ years
expect BP to _______ d/t ________
prophylactically, ______ then take ______

A

vasodilation, decreased, decreased, decreased

coronary, increases

swallow, 1, 5, 3

pockets
burn, fizz
HEADACHE, vasodilation
3-5, 2

decrease, vasodilation
rest, NTG

17
Q 
CSA Meds--Beta Blockers:
for \_\_\_\_\_\_\_\_\_ of angina
BP, HR, contractility all \_\_\_\_\_\_\_\_\_\_
workload of the heart \_\_\_\_\_\_\_\_\_ = \_\_\_\_\_\_\_ CO
check \_\_\_\_\_\_\_ before giving
A

prevention
decreased
decreased, decreased
BP

18
Q

CSA Meds–Calcium Channel Blockers:
for ________ of angina
BP _______
cause _______ of arterial system, ______ afterload
since they decrease ________, they increase _________ to the heart muscle by dilating ________ arteries

A

prevention
decreases
vasodilation, decrease
afterload, oxygen, coronary

19
Q

CSA Teaching/Education
_______ frequently: _______ activity with rest
avoid ______: ______ fat, _______ fiber
avoid _________
wait ____ hours after eating to exercise, dress ______ in cold weather because _____ decreases workload
take _______ prophylactically
QUIT ________
lose ______ and ______ calories
avoid _______ exercises and reduce ________

DO __________ YOU CAN TO ________ THE WORKLOAD ON THE HEART

A

rest, balance
overeating: decrease, increase
caffeine
2, warm, warmth

NTG
SMOKING
weight, decrease
isometric, stress

EVERYTHING, DECREASE

20
Q

Cardiac Cath
asses for allergies to: _____ & ______
using contrast dye, so check _______ function
_______ pre-procedure with kidney problems
client will feel ________ during contrast dye
__________ are normal
Monitor ________ post-procedure
assess for ________ at the puncture site
assess extremity ______ to the puncture site with the 5 P’s plus skin _______ and ________
client is on __________, keep extremity
major complication: ________
report any ________ ASAP
hold _________ for _______ hours post procedure because we’re worried about the _______

A 
iodine, shellfish
kidney
Mucomyst
flushing/hot shot
palpitations
VS
bleeding
distal, Pulse, Pallor, Paresthesia, Paralysis, Pain, temp, cap refill
BEDREST, straight
HEMORRHAGE
PAIN
metformin, 48, kidneys
21
Q

unstable chronic angina = IMPENDING ______

A

MI

22
Q

Acute Coronary Syndromes: MI and Unstable Angina

________ blood flow to myocardium = _____ AND _______; ______ and ______ do NOT relieve this pain
S/S include pain, described as ________, women usually have _______ symptoms, elderly often have ________; ______ drops because cardiac output is __________; ECG ______, vomiting due to _______ nerve stimulation (via decreased HR, ____ and BP)

WORRY ABOUT THE ________ CLIENT

CPK-MB will be _______ with damage to cells
______ is the most sensitive to MI–remains _____ for up to _____ weeks
Myoglobin results we want to be _______

A

decreased, ischemia, necrosis, rest, NTG

crushing, GI, SOB

BP, decreasing
changes, vagus, CO

STEMI

increased
TROPONIN, elevated, 3

negative

23
Q

Treating MI
SPECIFIC ORDER: _____, ______, ______, _______
elevate ______ because it decreases ______ on the heart and increases __________

A

oxygen, aspirin, nitroglycerin, morphine

HOB, workload, CO

24
Q

Complications of ACS
three untreated arrhythmias will lead to DEATH

v-fib PRIORITY treatment is _______
after defibrillating, if client is still in v-fib, give ______
if epi doesn’t work, give ______

lidocaine toxicity results in _______ changes

significant side effect of amio = ________

A

v-fib, v-tach, asystole

defibrillation
epi
amiodarone

neuro

hypotension

25
Q

goal of thrombolytics is to ________ the clot which is blocking ________ and will _______ the size of infarction

these drugs end in _______; examples include alteplase, tenecteplase, reteplase and streptokinase

Which one has allergic reaction potential? _____

_________ PRECAUTIONS because _______ is the MAJOR COMPLICATION

any bleeding will be a ____________

NO _______, decrease number of needle ______

given in ______ lines, NOT ______ lines–easier to hold _____ if they bleed

A

dissolve, blood flow, decrease

-plase or -ase

streptokinase

BLEEDING, HEMORRHAGE

contraindication

ABGs, sticks

peripheral, central, pressure

26
Q

Interventions: PCI & CABG

percutaneous coronary interventions all open _______ arteries, including ______ and ________
major complication is ______, the site could _____ or re-________

IF CLIENT HAS CHEST PAIN POST-PROCEDURE: ________ because it’s ________

thrombolytics and antiplatelets are given to keep ________ open

CABG is used for ______ main coronary artery occlusion, it supplies the _______ left ventricle

A

coronary
stents, angioplasty
MI, bleed, re-occlude

CALL THE PROVIDER IMMEDIATELY, re-occluding

arteries

LEFT, ENTIRE

27
Q

Cardiac Rehab Teaching:

QUIT _________
increase activity _________
diet changes include _____ fried foods, _____ fat, ______ salt, _____ cholesterol
no _______ exercises, ______ is ideal
no straining, so give _______
sex can be resumed when they can _______, safest time of day for sex is ________
S/S of HF to teach include weight ______ d/t fluid, ankle _______ (Shoes fit too _____), short of _______, mental changes like _________

A

SMOKING
gradually
NO, low, low, low

isometric, walking
docusate
walk up stairs with no pain, morning

gain, edema, tight, breath, confusion

28
Q

Heart Failure is caused by cardiomyopathy, _______ disease, _______ MI, _______, endocarditis

Blood does not move ______ so it backs up into the ______ or ______ system

Left sided = Lung symptoms
Right sided = Venous symptoms

diagnosed with ______; chest x-ray shows ______ enlargement and _____ infiltrates; echocardiogram

classes 1-4, ______ is most serious

A

heart valve, acute, hypertension

forward, lungs, venous

dyspnea, S3, crackles, tachycardia, restlessness
edema, ascites/weight gain, distended neck veins

BNP, heart, pulmonary

4

29
Q

HF Treatment–Meds
ACEs #1: _________, ARBs #2
both block aldosterone = losing ______ & ______, which retains ________
these drugs _____ workload on heart, _____ CO, keeping blood moving _______
ACE = arterial ______, increased ______
ARB = decreased arterial ______, decreased _____
ACE has ______, _____ cough
Need to monitor for ____________ with BOTH

Digoxin
enhances _________, decreases _______, cardiac output ______, kidney perfusion will ______
earliest signs of toxicity: GI 3
late signs of toxicity: ______ and _____ changes
measure ________ pulse before admin
ANY __________ IMBALANCE CAN PROMOTE ________ TOXICITY, BUT ______ IS WORST
_______ + digoxin = ________
TOXIC OVER _____ ng/mL

Diuretics
always ______ the HF client because they can’t handle the ______
decrease ________, the ______ returning to heart
give in the _________

A

drug of choice
sodium, water, potassium

decrease, increases, forward

dilation, SV
resistance, BP
dry, nagging
HYPERkalemia

contractility, HR, increases, increase

anorexia, nausea, vomiting
arrhythmias, vision
apical
ELECTROLYTE, DIGOXIN, POTASSIUM

HYPOkalemia, toxicity
2

diurese, fluid

preload, volume
morning

30
Q

HF Misc.
Low ______ diet _____ fluid retention, which decreases _______; salt substitutes contain excessive ______ whereas canned/processed foods contain a lot of _____

Elevate _______ because this helps with ______

Daily _____, report a gain of _______/day

FLUID RETENTION? THINK _______ PROBLEMS FIRST

A

sodium, decrease, preload
potassium
sodium

HOB, breathing

weights, 2-3

HEART

31
Q

Pacemakers
heart rate below ______ = _______ CO
______ HR with ________ bradycardia
ALWAYS WORRY IF HR _____ BELOW _______
most common post-op complication is electrode ______
_______ the arm post-op, PROM to prevent ______ shoulder
no movement of arm ________ shoulder height
if no _____ follows stimulus = loss of _______
failure to ______ = inappropriate _______
teach client to check ______ daily as it must be ______ the set rate
wear ______ bracelet or carry a card
avoid _______ and electromag fields
might set off alarms at _______
avoid contact ______

A 
60, decreased
increase, symptomatic
DROPS, SET RATE
displacement
immobilize, frozen

above
contraction, capture
sense, firing
pulse, above

ID
MRIs
airport
sports

32
Q

Pulmonary Edema
at risk clients include those getting IV fluids really ______, the very ______ and very ____, anyone with _____ or _____ disease
fluid backs up into _____, heart can’t move it ________
usually occurs at _____

S/S = _____ onset, restless/_____ d/t severe ______, pink, ______ sputum, breathless
treat with ____, titrate to keep SpO2 above _____%

Treat with: Diuretics to reduce ______, push lasix _____ to avoid ________/____toxicity; _____ for rapid fluid _______; NTG for ______ to decrease _______ so that blood can be moved _________; Morphine for ________ which will ______ preload & afterload; Nesiritide vasodilates ______ & _____ and has a _______ effect

Position client ______ which _____ CO and promotes _______ of blood in lower extremities

Prevent pulmonary edema by checking _____ sounds and avoiding fluid volume _______

A

fast, old, young, heart, renal

lungs, forward
night

sudden, anxious, hypoxia, frothy

oxygen, 90

preload, slowly
hypotension, oto; Bumex
removal; vasodilation, afterload
forward; vasodilation
decrease
arteries, veins, diuretic

upright, decreases
pooling

lung
excess

33
Q

Cardiac Tamponade
blood, ______, exudate ______ into pericardial sac, resulting in ______ of the heart
causes include MVC, ______, pericarditis, _____ post CABG

S/S = _______ CO, ______ CVP, BP will ________
HALLMARK SIGNS: _____ CVP, ______ BP
muffled/______ heart sounds, ______ neck veins, shock, ______ pulse pressure

Treat with pericardiocentesis to remove ______ or do _______

A

fluid, leaking
compression
MI, hemorrhage

decreased, increased, decreased
INCREASING, DECREASING
distant, distended
NARROWED

fluid
surgery

34
Q

Arterial Disorders
if you have atherosclerosis, you have it ______
acute arterial ________ is a medical _______
numbness and ______, ______ extremity, ____ PALPABLE PULSE, ______ extremities are more symptomatic
HALLMARK SIGN: _________ CLAUDICATION– always a sign of ______ disorder
PRIORITY ASSESSMENT: ________ pulses
pain at ______ = _______ obstruction
DON’T ANSWER _______ FOR _______ QUESTION
ELEVATE _______, DANGLE _______
usually treated with ______ or endarterectomy

A

everywhere
occulsion, emergency
pain, cool, NO
lower

INTERMITTENT
arterial
peripheral 
rest, severe
OXYGEN, VEIN/VENOUS
VEINS, ARTERIES
angioplasty

Hurst Elevate Module 2 (2 decks)

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