Cardiac Flashcards
Activity instructions for a patient who experiences episodes of angina would not include which of the following points?
Do isometric exercise rather than isotonic exercise. Isometric exercises, such as weight lifting, cause Valsalva maneuver and should be avoided.
A 48-year-old male patient with a history of inferior myocardial infarction (MI) is admitted with an acute anterolateral MI. He is tachycardic and hypotensive. Cardiac index is 1.9 L/min/m2. Pulmonary artery occlusive pressure (PAOP) is 20 mm Hg, and systemic vascular resistance (SVR) is 2000 dynes/sec/cm-5. Which of the following is a priority in this patient?
Increase myocardial perfusion.
The primary way to reverse the hemodynamic changes occurring here is to save the myocardium and improve the ejection fraction. Reperfusion is the priority.
A patient with chronic atrial fibrillation has sudden, continuous, localized pain, pallor, and pulselessness of her right arm. Which of the following is most likely occurring?
Clinical indications of acute arterial occlusion include pain, pallor, pulselessness, paresthesia, paralysis, and polar (cold).
Which of the following pacemaker routes is most likely to be used in an emergency situation?
Transcutaneous
Which clinical or laboratory feature would indicate a significant adverse effect of clopidogrel?
Petechiae
A patient has had percutaneous transluminal coronary angioplasty and stent placement for stenosis in the left anterior descending artery. Nitroglycerin is infused to prevent which of the following complications?
Coronary artery spasm
Nitroglycerin is an excellent antispasmodic, and coronary artery spasm is a common complication after the insertion of a catheter in the coronary artery.
Unstable angina that presents as pain at rest is likely to be due to progression of coronary artery disease or which of the following?
Coronary artery spasm
Prinzmetal, vasospastic, and variant angina are names for myocardial ischemia caused by coronary artery spasm. Angina is a cause of pain at rest and frequently responds to nitroglycerin or calcium channel blockers.
The electrocardiogram monitor shows a wide QRS complex rhythm with a regular R-R rhythm and a rate of 160 beats/min. The initial action for this patient is to do which of the following?
Early defibrillation is the single most important intervention to improve survival in patients with pulseless ventricular tachycardia or fibrillation.
Which of the following findings would occur in dilated cardiomyopathy?
Mitral regurgitation is often present in dilated cardiomyopathy as a result of ventricular dilation and stretching of the mitral valve ring.
The first drug for a wide QRS complex tachycardia is
amiodarone
If dobutamine therapy is initiated, which of the following would not be an indication of effectiveness?
You would not want the heart rate to go up because this would decrease the time for diastolic filling and increase myocardial oxygen consumption. That would not be an indication of effectiveness.
selective β1 stimulator
Dobutamine HCl
drug most specific for acute heart failure in the presence of ischemia.
Which of the following would cause an increase in the amplitude of the v wave with a normal amplitude a wave on the pulmonary artery occlusive pressure (PAOP) waveform?
Mitral stenosis causes large a waves on the PAOP waveform. Cardiac tamponade and left ventricular failure cause high pressures and large a and v waves. Mitral regurgitation causes large v waves, so choose option “Mitral regurgitation.” The other pathologic condition that causes large v waves is ventricular septal rupture.
S4 what does it mean/represent?
An S4 occurs during the end of diastole when the atria contract but the ventricle is noncompliant. An S4 occurs in myocardial ischemia, infarction, and hypertrophy. Most patients with an acute myocardial infarction have an S4 for the first 48 hours.
pulse pressure of a patient with aortic regurgitation
Aortic regurgitation causes a wide pulse pressure and water-hammer pulse, which is a rapid upstroke and downstroke and shortened peak.
