Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Adult Health Test 1 > Cardiac Complications > Flashcards

Cardiac Complications Flashcards

1
Q

_________________ is the build up of ACS plaque inside coronary vessels.

A

Coronary Artery Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

CAD risk factors include:

A

DM, age, heredity, male, dyslipidemia, obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

_____________ and ________ are two populations who have issues with HTN and lipids.

A

African Americans and Hispanics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Estrogen is ________

A

Cardioprotective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

_____ angina is the most common type and occurs with stress and activity. It is relieved by ____.

A

Stable, rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Prinzmetal’s angina is caused by ________. In between spasms, tissue gets hypoxic.

A

vasospasm

alters calcium flow and reduces prostaglandins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Unstable angina occurs more frequently and lasts longer. It can occur with or without _____. Heralds an MI.

A

activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Angina pectoris is decreased ___.

A

O2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Causes of angina:

A

Hypotension (can be exercise induced), cocaine, HF, pulmonic diseases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clinical manifestations of angina include:

A

Chest pain, Description of pain – very important
Dyspnea, pallor, tachycardia, anxiety, and fear
Atypical symptoms – indigestion
Precipitating factors
Relieving factors – what made it go away? Nitro, bed rest, O2
Sense of “doom”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Diagnostic tests:

A 
EKG --> most important
Troponin --> lab of choice. CHF can bump levels
CK and CK-MB 
Stress test - Lexiscan and Dobutamine 
Echo or TEE
Coronary angiogram (Cath Lab)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Serum Cholesterol and Triglyceride Values

A

Total Cholesterol Under 200
LDL Less than 100
Tricglycerides < 150

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Meds for angina:

A

Nitrates (don’t give to patients who take Viagra)
Aspirin - antiplatelet
Beta-blockers –> work by decreasing workload of heart (decreases HR) Ex: Lopressor. Decreases O2 demands which limits ischemia. **c/a in COPD/asthma patients. Can send them into a bronchospasm.
Calcium Channel Blocker - for prinzmetals angina, bradycardia, conduction defects or certain types of HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Primary goal for angina:

A

increase oxygen. Put PT on 02 and 2L/min. Or if home, lay down and take deep breaths.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Nursing interventions:

A

Perform 12 Lead for acute CP – truly diagnostic
Have SL Nitro available
Continuous cardiac monitoring
4-6L/min of oxygen per NC
Space activities
Reduce risk factors: physician follow up, Na restriction, diet change, cholesterol meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MONA is what?

A

morphine, oxygen, nitrates, aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Acute coronary syndrome is what?

A

collaborations of s/s of sudden myocardial ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Causes:

A

unstable angina, STEMI, N-STEMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Clinical Manifestations:

A

chest pain – most defining characteristic. Sub-sternal or epigastric. Can radiate to L arm, radiate to jaw and neck. Pain lasts 10-20 mins. Dyspnea, diaphoresis, pallor, tachycardia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Diagnostic tests:

A

EKG & cardiac enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Treatment Modalities:

A

If blocked, revascularize. Do percutaneous!

Meds: tPA –> 2-3 large bore IV’s to draw labs off of

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Acute MI

A

Blood flow is completely blocked
Results in death of myocardial cells – goes through ischemia and then death
N-STEMI is a partial occlusion – minor elevation of cardiac enzymes
STEMI – abrupt disruption of blood flow – no way that the body can compensate
Elevated ST segments or Q wave on 12 lead. Once you’re “healed,” you will always keep your Q wave.
Damage usually occurs in 1 out of the 3 coronary arteries
Lethal arrythmias (v-fib and v-tach) and death can occur (more so than because of necrotic tissues.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Coronary Arteries:

A

Left Anterior Descending (widow maker) -> left ventricle pump failure
Right coronary artery -> supplies R atria and ventricle
Circumflex -> supplies the back of the heart
Left Main Coronary Artery -> divides into circumflex and LAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Resulting Damage to Walls of the Heart – can be full or partial

A

Subendocardium – non Q wave MI – only takes 20 mins for damage to show
Epicardium
Transmural – Q wave MI – through all layers of cardiac muscle. ST elevation
Remodeling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Goal of all nursing interventions r/t MI

A

re-establish oxygen supply to area of MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Door to ___ is 10 mins, to need IN artery is 90 mins.

A

EKG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Clinical Manifestations

A

Chest pain, nausea & vomiting, diaphoresis, tachycardia & tachypnea, hypotension or hypertension, dysrhythmias, signs of left heart failure, decreased LOC, fear and anxiety
Hiccupping – diaphormatic irritation,
cool/clammy, mottled skin

28
Q

Nursing Interventions

A 
12 Lead EKG
Assess Chest Pain (CP)
Vitals & cardiac monitoring
IV access and labs
Watch for dysrhythmias 
Monitor I & O – fluid balance and kidney fx (decreases GFR)
29
Q

Tx for MI

A

Revascularization:
PTCI – cath lab, femoral approach. Can do angioplasty. Drug-eluding stents or bare metal stent.
CABG – seen less and less. Usually take the saphenous vein from leg. Flip it upside down (because of valves)

30
Q

Types of Cardiomyopathies

A

Dilated, hypertrophic, & restrictive

31
Q

Cardiomyopathy definition:

A

enlarged, thickened, or rigid. Regular heart muscle is replaced with scar tissue (which is not functional). As the heart gets weaker due to nonfunctional cardiac muscle, it decreases the ability to pump the blood and maintain normal sinus rhythm. Most people get HF.

32
Q

Etiology

A

usually uknown, recurrent MI, small genetic component, high mortality rate

33
Q

Dilated cardiomyopathy definition

A

when heart chambers (atria and ventricles) are dilated…stretched thin. Chest X-ray shows enlarged heart – takes up most of chest. Usually starts in L ventricle and spreads to R ventricle.

34
Q

Incidence

A

in pts with heart failure. The thinner the muscle wall gets, the less pumping that occurs. The L ventricle wall is typically thicker. Most dilated pts are between the ages of 20-60. Men ^.

35
Q

Diagnosis

A

symptoms of HF. Echo, chest xray, stress test, murmur – valve – either rupture of cordi tendi or stretched valve.

36
Q

Clinical Manifestations

A 
SOB on exertion
Weakness
S3, S4, & AV murmur
Dysrhythmias – because of overload (same as arrhythmias) 
Activity intolerance
R and L heart failure signs
37
Q

Treatment

A 
Heart failure management
Beta blockers, anti-arrhythmic, ACE’s – decrease afterload (reduces work of heart), & ARBS
Diureticss
Anticoagulants
Inotropes – contractility 
Pacing therapies
Pacemaker/AICD – implantable defib/Bi-V
Revascularization therapies
38
Q

Hypertrophic Cardiomyopathy definition and incidence

A

thickening of muscle fiber, characterized by decreased compliance. Impairs ventricular filling, which decreases cardiac output

mostly genetic. Affects 600,000-1.5 million patients.

39
Q

Diagnosis

A

H&P, murmur, chest x-ray, Echo – can measure thickness of left ventricle

40
Q

Clinical Manifestations

A

Asymptomatic – for years! Sudden death, SOB, angina, syncope – decreased cardiac output, Ventricular arrhythmias, Fatigue, palpitations, S3 – marker for fluid overload

41
Q

Treatment

A 
•	Medications
	Beta blockers
	Calcium channel blockers
	Anti-arrhythmics 
•	Non-surgical/surgical procedures
	Ablations
	AICD
	Septal myectomy
42
Q

Restrictive cardiomyopathy defintion

A

rigid, wont expand with filling. Pumping or systolic can be normal, filling or diastolic is abnormal. Least common type.

43
Q

Diagnosis

A

Diagnosis – H&P, EKG, chest x-ray, TEE

44
Q

Clinical Manifestations

A 
S3 & S4
Dyspnea on exertion
Increased jugular venous pressures  - JVD
Exercise intolerance
Lungs crackly
45
Q

Treatment

A 
•	Lifestyle changes
	Diet, sodium restriction
	Exercise!
•	Medications
	ACE inhibitors
	Digoxin 
	Beta blockers (cautiously)
	Anticoagulants
	Anti-dysrhythmics
46
Q

Cardiogenic Pulmonary Edema

A

Definition-severe form of heart failure. Due to severe cardiac decompensation. Usually caused by MI, acute HF, or valvular disease. Contractility of ventricle is decreased. Ejection is decreased, lots of pressure in lungs. Large volume of fluid. Impaired gas exchange.

Can be due to cardiac or lungs
MEDICAL EMERGENCY!

47
Q

Clinical Manifestations

A
  • Respiratory: tachypnea, labored respirations, dyspnea, pink frothy sputum, crackles and wheezes
  • Cardiac-tachycardia, hypotensive, cyanotic, hypoxic, cool, clammy skin
  • Neuro: restless, anxious, impending doom – life-threatening medical emergency
48
Q

Interventions

A

Sit upright legs dangle
ABG’s – RESPIRATORY ACIDOSIS
Manage pain
tripod
Oxygen applied & sats continuously monitored (CPAP or BI-PAP or vent)
Morphine sulfate – alleviates air hunger
Chest X-ray
Meds – lasixs, 3-D’s  digoxin, dobutamine, & dopamine. Sometimes aminophylline. Narcan 0.4mg-2mg initial doses, up to 10mg
I&O
Suction or coughing secretions – pink frothy sputum.

49
Q

Rheumatic Heart Disease is caused by

A

occurrence of abnormal immune response to group A strep
 Rheumatic fever
 Carditis

Risk factors: crowded living conditions, poor hygiene, poor access to medical care

50
Q

Clinical Manifestations

Diagnosis

Treatment

A

Clinical Manifestations: chest pain, heart murmur, rash, migratory polyarthritis
• Diagnosis – H&P, labs: ESR, CBC, elevated WBC, C reactive protein – inflammatory marker, positive throat culture for strep
• Treatment
 Medications – antibiotic of choice is PCN, clindamycin or arythromycin
-manage joint pain, etc.

51
Q

Carditis

A

Occurs in 50% of rheumatic fever
Affects all three layers of heart
Clinical manifestations: Chest Pain, Tachycardia,
Pericardial friction rub- can hear it at L, lower sternal border on expiration**
Endocardial affects valve structure – murmur and additional scarring
HF symptoms
Treatment: Medications

52
Q

Endocarditis affects:

A

valves!

Definition-Inflammation of the endocardium
Diagnosis – TEE

damaged endothelium via valve damage, surgery, previous endocarditis, entry for pathogen. IV drug abuse… Central line. Foley catheter. Dental procedures.

53
Q

Clinical Manifestations

A 
Fever >101.5
Flu like symptoms and cough
SOB and joint pain
Heart murmurs heard in 90%
Anorexia & abdominal pain
Splenomegaly  -if spleen is removed, immunizations need to be up to date!
54
Q

Interventions

A

Medications – ABX (amoxicillin)
Anti-inflammatory
Anti-pyretics
Teaching – dentist, abx prior to procedure
Surgery
Valve replacements (regurgitation – back flow)
Removal of large vegetations

55
Q

Myocarditis can occur to an _________ response.

A

immunologic

Definition-Inflammation of the heart muscle.
Causes – due to a virus – coxsackie B (rules out ABX)
Incidence and risk factors – radiation, toxins, or drugs ***
Diagnosis – CBC, WBC, C reactive protein
Clinical manifestations – (depends on amount of tissue damage) HF symptoms
Asymptomatic for a while
Fever, fatigue, general malaise
SOB, palpitations, arthralgias
Sore throat, muffled S1, S3 murmur
if caught early, may not have a lot of symptoms

56
Q

Treatment

A

Medications
Antibiotics
Antiviral
Corticosteroids - swelling
ACE inhibitors, anti-arrhythmics, and anti-coagulants – no blood clots and make the blood less viscous
Bedrest (for a couple weeks) and activity restrictions
Dietary modifications – low salt diet “heart healthy”
Tx goal is for cause of inflammation – keep in mind myocardial O2 demand

57
Q

Pericarditis is the inflammation of the

A

pericardium! Usually viral.

High risk: end-stage renal disease pts, cancer pts

58
Q

Diagnosis

A

CBC
Cardiac enzymes-elevated but not as high as MI
EKG- ST segment elevation
Echo
Chest x-ray
CT and/or MRI
Hemodynamic monitoring – arterially monitor BP, decreasing window btwn systolic and diastolic. Why? Still have resistance r/t inflammation

59
Q

Clinical Manifestations

A 
Abrupt chest pain – usually the 1st sign
Pericardial friction rub
Low grade fever
Dyspnea
Reflex Tachycardia
60
Q

Treatments

A 
•	Medications
	Aspirin  
	Acetaminophen
	NSAIDS – anti-inflammatory 
	Corticosteroids
Incentive spirometer 
Oxygen
Positioning
Pericardiocentesis – aspirate the fluid  
Surgery – pericardectomy (large section of the pericardium is removed, done in severe cases, keep going into cardiac tamponade)
61
Q

Complications

A

Pericardial effusion

Cardiac tamponade – increase in pressure inside the heart (heart is trying to compensate for not filling, using more pressure to try to fill. Decreased diastolic filling – no room  drop in BP!) Pulsus paradoxus – pulses diminish during expiration.

Chronic Constrictive pericarditis – scar tissue develops between pericardial layers

62
Q

Valvular Heart Disease

A

• Aortic Valve Disease
 Aortic Stenosis
 Aortic Regurgitation

•	Mitral Valve Disease
	Mitral Stenosis 
	Mitral Regurgitation
	Mitral Valve Prolapse 
	Tricuspid Stenosis
63
Q

Diagnosis & Tx

A

Echo, Chest X-ray, EKG, cardiac cath, and exercise testing
Medications – diuretics, ACE inhibitors, vasodilators, anticoagulants
Teaching
Percutaneous balloon valvotomy
Surgery- Valve replacement

64
Q

Abdominal Aortic Aneurysms

A

(AAA) more common in men, aging, and smoking

65
Q

Clinical Manifestations

A

depends on where the AAA is. If it is thoracic (above the diaphragm – pretty uncommon. 10% are aortic) Neck pain, jaw pain, back pain. Non-descript. AAA is usually below the renal arteries. Urine output is decreased. Usually called the silent killer

66
Q

Diagnosis and Treatment

A 
CT/MRI
Arteriogram
TEE – can sometimes see the dissection 
Ultrasound – out pouching
Medications
Beta blockers – decrease HR
Anti-hypertensives  HTN will kill these patients, keep systolic under 120.
Surgery
Open
Endovascular stent grafts (EVSG)
S3 -->  heart failure (murmur after the lub-dub  diastolic murmur) kentuc-ky
S4 --> stiff ventricle (happens before S1, S2  systolic murmur) Tennessee – takes more effort

Adult Health Test 1 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions