Cardiac Flashcards
increased preload = increased ______
workload
_____ released with stretch caused by _______
ANP, preload
afterload = _______
resistance
stroke volume = ______
amount of blood with each contraction
________ depends on CO
perfusion
______ influences CO
MORE _______ = ________ CO
LESS ________ = _______ CO
volume
volume = increased
volume = decreased
preload meds ________ to _______ preload
diuretics ________
nitrates _______
vasodilate, reduce
furosemide
NTG
afterload meds \_\_\_\_\_\_ to \_\_\_\_\_\_\_ afterload ACE \_\_\_\_\_\_ ARB \_\_\_\_\_\_ hydralazine nitrates \_\_\_\_\_
vasodilate, reduce -pril -sartan hydralazine NTG
these drugs improve contractility
1. ______ 2. ______ 3. ______
inotropes
1. dopamine 2. dobutamine 3. milrinone
these drugs control rate
beta blockers ______
CCB ______
Digoxin
-olol
diltaizem, verapamil, amlodipine
this drug controls rhythm
antiarrhythmic, used for _______
amiodarone
v-tach
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 \_\_\_\_\_
left
less, less, decreased, poor
decreases chest wet YES! cool, clammy decreases weak arrhythmias, CO
These arrhythmias are always a big deal
V-tach
V-fib
Asystole
CAD includes:
- Chronic Stable Angina
2. Acute Coronary Syndrome
Chronic Stable Angina Patho: \_\_\_\_\_\_\_ leads to temporary \_\_\_\_\_\_\_ low \_\_\_\_\_\_ due to \_\_\_\_\_\_ relieved by \_\_\_\_\_\_ and \_\_\_\_\_\_\_
ischemia, chest pain
oxygen, ischemia
rest, NTG
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 ______
vasodilation, decreased, decreased, decreased
coronary, increases
swallow, 1, 5, 3
pockets
burn, fizz
HEADACHE, vasodilation
3-5, 2
decrease, vasodilation
rest, NTG
CSA Meds--Beta Blockers: for \_\_\_\_\_\_\_\_\_ of angina BP, HR, contractility all \_\_\_\_\_\_\_\_\_\_ workload of the heart \_\_\_\_\_\_\_\_\_ = \_\_\_\_\_\_\_ CO check \_\_\_\_\_\_\_ before giving
prevention
decreased
decreased, decreased
BP
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
prevention
decreases
vasodilation, decrease
afterload, oxygen, coronary
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
rest, balance
overeating: decrease, increase
caffeine
2, warm, warmth
NTG
SMOKING
weight, decrease
isometric, stress
EVERYTHING, DECREASE
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 _______
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
unstable chronic angina = IMPENDING ______
MI
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 _______
decreased, ischemia, necrosis, rest, NTG
crushing, GI, SOB
BP, decreasing
changes, vagus, CO
STEMI
increased
TROPONIN, elevated, 3
negative
Treating MI
SPECIFIC ORDER: _____, ______, ______, _______
elevate ______ because it decreases ______ on the heart and increases __________
oxygen, aspirin, nitroglycerin, morphine
HOB, workload, CO
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 = ________
v-fib, v-tach, asystole
defibrillation
epi
amiodarone
neuro
hypotension
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
dissolve, blood flow, decrease
-plase or -ase
streptokinase
BLEEDING, HEMORRHAGE
contraindication
ABGs, sticks
peripheral, central, pressure
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
coronary
stents, angioplasty
MI, bleed, re-occlude
CALL THE PROVIDER IMMEDIATELY, re-occluding
arteries
LEFT, ENTIRE
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 _________
SMOKING
gradually
NO, low, low, low
isometric, walking
docusate
walk up stairs with no pain, morning
gain, edema, tight, breath, confusion
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
heart valve, acute, hypertension
forward, lungs, venous
dyspnea, S3, crackles, tachycardia, restlessness
edema, ascites/weight gain, distended neck veins
BNP, heart, pulmonary
4
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 _________
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
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
sodium, decrease, preload
potassium
sodium
HOB, breathing
weights, 2-3
HEART
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 ______
60, decreased increase, symptomatic DROPS, SET RATE displacement immobilize, frozen
above
contraction, capture
sense, firing
pulse, above
ID
MRIs
airport
sports
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 _______
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
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 _______
fluid, leaking
compression
MI, hemorrhage
decreased, increased, decreased
INCREASING, DECREASING
distant, distended
NARROWED
fluid
surgery
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
everywhere
occulsion, emergency
pain, cool, NO
lower
INTERMITTENT arterial peripheral rest, severe OXYGEN, VEIN/VENOUS VEINS, ARTERIES angioplasty
