Cardiac Flashcards
normal blood flow through the heart
RA RV PA lungs PV LA LV Aorta Body
the amount of blood returning to the right side of the heart and the muscle stretches that the volume causes
preload
_____ is released when the heart stretches
ANP
is the pressure in the aorta and peripheral arteries that the LV has to pump against to get the blood out
afterload
after load is referred to as ____
resistance
the amount of blood pumped out of the ventricles with each beat
stroke volume
___ ____ is dependent on adequate cardiac output
tissue perfusion
factors that affect CO
heart rate
blood volume
decreased contractility
meds to decrease preload
furosemide
nitro
meds to decrease afterload
ACE inhibitors
ARBS
hydralazine
nitrates
meds to improve contractility
inotropes (dopamine, dobutamine, milrinone)
meds for rate control
BB
CCBs
Digoxin
meds for rhythm control
anti-arrhythmics (amiodarone)
3 arrhythmias that are always a big deal
pulselessl v. tach
v. fib
asystole
the most common type of cardiovascular disease
coronary artery disease
coronary artery disease is a broad term that includes which 2 things?
chronic stable angina
acute coronary syndrome
chronic stable angina has pain that is brought on by?
low O2 on exertion
what relieves pain with chronic stable angina
rest and/or nitro
nitro causes venous and arterial _____
vasodilation
can you swallow nitro?
NO
where do you keep nitro?
in a dark glass bottle
most common sx of nitro
HA
renew nitro how often?
every 3-5 months
what to BB do to BP, HR, and myocardial contractility?
drops!
CCBs dilate the _____ arteries
coronary
2 benefits of CCBs are that they ?
decrease after load and increase Oxygen to the heart muscle
avoid what type of exercises for chronic stable angina?
isometric
pre-procedure for cardiac cath need to ask?
iodine/shellfish allergy
check ____ function before heart cath?
kidney
_____ is a med most HCP order prior to heart cath to protect the kidneys
acetylcysteine
main priority concern post op heart cath
bleeding
assess for the 5Ps post op heart cath
pulselessness pallor pain paresthesia paralysis
unstable chronic angina = impending _____
MI
acute coronary syndrome is also known as ____ and ___ ____
MI
unstable angina
does acute coronary syndrome have ischemia, necrosis or both?
both
does the client with acute coronary syndrome have to be doing anything to bring this pain on?
NO
will rest or nitro fix the pain with acute coronary syndrome?
NO
sx of acute coronary syndrome
pain cold/clammy/BP drops decreased CO ECG changes vomiting
with acute coronary syndrome they may describe pain as ____
crushing
1 sign of an MI in elderly?
SOB
this indicates that the client is having a heart attack
STEMI
the goal with STEMI is to get them to the cath lab for PCI in less than ____ minutes
90
cardiac specific isoenzyme
increases with damage to cardiac cells
CPK-MB
CPK-MB elevates within __-__ hours and peaks in __-__ hours
3-6
12-24
cardiac biomarker with high specificity to myocardial damage
troponin
troponin elevates within ___-___ hrs and remains elevated for up to ____ weeks
3-4 hrs
3 weeks
troponin T level
<0.10
troponin I level
<0.03
increases within 1 hour and peaks in 12 hours
myoglobin
with myoglobin ____ results are a good thing
negative
which cardiac biomarker is the most sensitive indicator for an MI?
troponin
which enzyme or biomarker are most helpful when the client delays seeking care?
troponin
treatment for V. fib
shock
defib the v.fib
if the first shock for v. fib doesn’t work….give?
epi
an anti-arrhythmic used when v. fib and pulseless VT are resistant to treatment, and also for fast arrhythmias
amiodarone
how to monitor for lidocaine toxicity
neuro changes
the first antiarrythmic of choice
amiodarone