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Complex > Cardiac Emergencies 1 > Flashcards

Cardiac Emergencies 1 Flashcards

1
Q

assessment findings when cardiac emergency

A
  • chest pain
  • drop in BP
  • change in HR
  • fainting
  • change in rhythm
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2
Q

what are the cardiac emergencies risk factors

A
  • stressors
  • smoking, alcohol, caffeine, exercise, dies
  • meds
  • diabetic
  • any new change with relationships
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3
Q

first three things to start if pt complains of chest pain

A

1) IV in AC
2) Ox (2 L Oxygen)
3) EKG
- also need full set of vitals

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4
Q

what to draw for the IV

A
  • draw troponin 1 (most common)
  • draw troponin T
  • regular chemistry (platelets, BS, anemic?, INR)
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5
Q

what do you ask if potential cardiac emergency?

A
  • what were you doing (activity) that triggered this?
  • palpitations?
  • SOB/cough
  • wt gain
  • swelling (legs)
  • dizziness, headache
  • ever had heart problems before?
  • is this new pain?
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6
Q

A fib causes what symptoms

A

palpitations and feeling of fluttering

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7
Q

what can leg cramps be indicative of

A

electrolyte imbalance or peripheral vascular disease

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8
Q

what should be the physical assessment of cardiac emergencies

A
  • VS
  • orthostatic BP
  • look at rhythm strip
  • listen to heart (assess for valve problems)
  • check pulses
  • check for edema
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9
Q

what does S3 sound indicate

A

HF, MI, mitral and tricuspid insufficiency

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10
Q

what does S4 sound indicate

A

acute MI, HTN, CAD, cardiomyopathy, aortic stenosis

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11
Q

what does S4 sound like

A

tighter, sounds like clicking (stiffness)

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12
Q

this is the most common murmur

this sounds like swooshing

A

aortic regurgitation

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13
Q

describe the PMI

A
  • point of maximal impulse
  • loudest heart sound
  • if enlarged heart, will be displaced and thrill will be heard at wrong place (palpate for thrill)
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14
Q

diastolic heart murmurs usually indicate what

A

heart disease

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15
Q

systolic heart murmurs can be heard in who

A

both healthy people and people with heart disease

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16
Q

broadly describe 12 lead EKGs

A
  • used to identify ischemia, infarction and conduction delays
  • 3 limb leads (1, 2, 3)
  • 3 augmented limb leads (aVF, aVL, AVR)
  • 6 precordial leads
17
Q

describe the three limb leads

A

1) Left arm to Right arm
2) left leg to right arm
3) left leg to left arm

18
Q

describe three augmented leads

A

aVF
aVL
aVR

19
Q

if abnormally in 2, 3 and aVF where is the damage?

A

inferior leads (front and bottom of heart and left anterior descending)

20
Q

what do the 2, 3, aVF leads mean

A

inferior MI/problem

typically L ventricle, worst as cannot pump blood out of heart

21
Q

what do the 1, aVL, V5, V6 leads mean

A

lateral MI /problems

22
Q

what do the V1 and V2 leads mean

A

septal MI

difficult to treat, causes electrical abnormalities

23
Q

what does aVR leads mean

A 
R atrium
(do NOT give nitro, will increase workload and make problem worse)
24
Q

EKG will look different after MI…

A
  • ST segment appear slurred d/t ischemia

- Q wave typically longer

25
Q

what is the most common cardiac markers

A

most commonly drawn is troponin 1

26
Q

what are normal troponin levels

A

0.02 (ie/ 0.1 is elevated, BAD)

27
Q

what is troponin

A
  • break down from muscle contraction, if heart is normal and will mostly use up troponin
  • elevates if heart is not beating (work is not being done)
  • troponin increases in 3-6 hrs
28
Q

when does troponin 1 peak and return

A

peak: 14-20 hrs
returns: 5-7 days

29
Q

what does troponin T peak and return

A

peak: 12-24 hrs
returns: 10-15 days

30
Q

describe when myoglobin peaks and returns

A
  • increases in 30 min to 4 hrs
  • peaks 6-7 hrs
  • returns in 24 hrs
31
Q

what hemodynamics

A
  • arterial line
  • swan line
  • SVO2 catheter
32
Q

describe ECHO

A
  • most important diagnostic for heart failure
  • shows what valves are doing and size of heart wall
  • in HF, tissue in heart wall is usually thick (may go into surgery to thin wall and improve heart contraction)
  • shows ejection fraction
  • *size, shape and motino of heart
33
Q

describe cardiac catheter

A
  • invasive, only way to evaluate perfusion
  • most important for diagnosing MI
  • run risk if done in facility where OHS can not be done
34
Q

5 Hs and 5 Ts that are related to cardiac emergencies

A
  • hypoxemia
  • hypotension
  • hypo/hyperkalermia
  • hypo/hyperglycemia
  • thrombosis
  • cardiac tamponade (OHS recently?)
  • tablets/meds

Complex (38 decks)

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