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NCLEX > Cardiac > Flashcards

Cardiac Flashcards

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1
Q

Heart chamber hemodynamic pressures:

A 
CVP / RA: 0-5 (nickle)
RV: 25 (quarter)
PAWP: 5 - 12 
LA: 10 (dime)
LV: 120 (buck and change)
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2
Q

PRELOAD is the amount of blood ___ to the ___ side of the heart and the muscle ___ that the volume causes.
___ is released when the RA is ___.
(Remember what ANP leads to?)

A 
returning
right
stretch
ANP
overstretched
(ANP is opposite of aldosterone...it excretes Na and H20 to lower BP)
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3
Q

Name 3 drugs that can decrease preload:

A

(Vasodilate or diurese)
Diuretics
Nitro
Morphine

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4
Q

AFTERLOAD is the pressure in the ___ and ___ ___ that the ___ ___ has to pump against to get the blood out.

A

aorta
peripheral arteries
left ventricle

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5
Q

Name 4 types of drugs that decrease afterload:

A 
(Vasodilate)
ACE inhibitors
ARBs
Calcium channel blockers
Hydralazine (this is a nitrate...treats severe HTN)
Nitrates
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6
Q

What is stroke volume?

A

Amt of blood pumped out of LV with EACH STROKE

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7
Q

CO = HR x SV

What is average cardiac output?

A

5 L/ min

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8
Q

3 types of drugs to DECREASE HR

A

calcium channel blockers (-dipine)
beta blockers
digoxin

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9
Q

3 drugs to increase CONTRACTILITY

A

Inotropes

  • dopamine
  • dobutamine
  • milrone
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10
Q

3 types of drugs to control RHYTHM

A

Antiarrhythmics

  • amiodarone
  • sotalol
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11
Q

With beta blockers, it decreases HR and thus contractility and CO…what should we watch for with pts on BB?

A

Heart failure

indicates, BB is suppressing the heart too much!

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12
Q

Name some common calcium channel blockers:

A

(the -dipines) Also…
verapamil
diltiazem

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13
Q

Verapamil is contraindicated in what population…why?

A

elderly b/c of significant constipation

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14
Q

Calcium channel blockers do what 3 things

A

dilate coronary arteries
decrease afterload
increase O2 to heart muscle

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15
Q

What are the 5 Ps

A 
Pulselessness
Pallor
Pain
Paresthesia
Paralysis
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16
Q

How long must a pt be on supine bedrest post cath?

A

4 - 6 hrs

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17
Q

Unstable chronic angina = ____ ____

A

impending MI

18
Q

Acute Coronary Syndrome (ACS)

  • ___ angina
  • Relieved or not relieved by NTG?
A

unstable angina

NOT relieved by NTG

19
Q

Normal troponin T and I values

A

Troponin T < 0.10

Troponin I < 0.03

20
Q

What is the #1 sign of MI in the elderly?

A

SOB

also think about sudden confusion

21
Q

CPK-MB increases when:

Elevates within ___ - ___ hrs and peaks in ___-___ hrs

A

damage to cardiac cells
elevates within 3 - 6 hrs
peaks in 12 - 24 hrs

22
Q

Troponin is a cardiac biomarker with high specificity to ___ damage.
Elevates within ___-___ hrs and remains elevated for up to ___ ___.

A

myocardial
elevates within 3 - 4 hrs
remains elevated for up to 3 wks

23
Q

Myoglobin is not as a preferred lab b/c:

Increases within ___ hr and peaks in ___ hrs

A

not specific enough to diagnose MI
Increases within 1 hr
Peaks in 12 hrs

24
Q

How soon after the onset of myocardial pain should thrombolytics be administered?
(Also, how long for stroke…why?)

A

Heart 6-8 hrs

Brain 3 hrs…b/c “time is brain”

25
Q

If the thrombolytic steptokinase causes an allergic rxn, what should you do?

A

Still give, but treat rxn with benadryl

26
Q

What are the ABSOLUTE contraindications for thrombolytics?

A
  • intracranial neoplasm
  • intracranial bleed (hemorrhagic stroke)
  • aortic dissection
  • internal bleeding
27
Q

What is the difference between systolic and diastolic HEART FAILURE?

A

Systolic HF –> heart can’t contract and eject

Diastolic HF –> ventricles can’t relax and fill

28
Q

Systolic is ___ (S___)
Diastolic is ___ (S___)
___ is when the carotid artery pulses

A

systolic is EJECTION (S1)
diastolic is REFILLING (S2)
Systole

29
Q

3 Standard types of meds for heart failure are

A 
ACE INHIBITOR (drug of choice for HF!)
- arterial dilation and increased SV
ARBs
- decrease in arterial resistance
DIGOXIN
- decreases HR, increases contractility... + inotrope
30
Q

Most common complication after placement of permanent pacemaker

A

electrode displacement

keep pt from raising arm above shoulder

31
Q

Who is at risk for pulmonary edema?

A
  • receive fluids too fast (like burn, DKA)
  • very young/very old
  • hx of heart or kidney disease
32
Q

What time of day/night does pulmonary edema usually occur?

A

Night (pt lays down)

33
Q

5 signs of pulmonary edema

A

1) sudden onset
2) breathless
3) restless/anxious
4) severe hypoxia
5) pink frothy sputum

34
Q

Priority action for treatment of pulmonary edema

A

High flow O2

Titrate to keep SpO2 > 90%

35
Q

What meds given for pulmonary edema:

A
  • diuretics (furosemide, bumetanide)
  • NTG
  • morphine
  • nesiritide (synthetic BNP)
36
Q

What to remember about nesiritide (synthetic BNP)

A

IV infusion…short term, not more than 48 hrs
Vasodilates veins and arteries and has a diuretic effect
Turn off 2 hrs before drawing a BNP level

37
Q

Positioning for pulmonary edema

A

Sit upright with legs down…moves fluid to lower extremities and away from lungs

38
Q

Hallmark signs for cardiac tamponade

A

CVP increased

BP decreased

39
Q

Other S/S of cardiac tamponade

A
  • muffled / distant heart sounds
  • pressures in all 4 chambers are the same
  • shock
  • narrowed pulse pressure
40
Q

Narrowed pulse pressure…think ___

Widened pulse pressure…think ___

A

narrowed –> cardiac tamponade

widened –> increased ICP

41
Q

Intermittent claudication is a hallmark sign of ___ ___;

Pain at rest means ___ ___

A

arterial disorders

severe obstruction

NCLEX (13 decks)

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