Cardiac Emergencies 1 Flashcards
assessment findings when cardiac emergency
- chest pain
- drop in BP
- change in HR
- fainting
- change in rhythm
what are the cardiac emergencies risk factors
- stressors
- smoking, alcohol, caffeine, exercise, dies
- meds
- diabetic
- any new change with relationships
first three things to start if pt complains of chest pain
1) IV in AC
2) Ox (2 L Oxygen)
3) EKG
- also need full set of vitals
what to draw for the IV
- draw troponin 1 (most common)
- draw troponin T
- regular chemistry (platelets, BS, anemic?, INR)
what do you ask if potential cardiac emergency?
- 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?
A fib causes what symptoms
palpitations and feeling of fluttering
what can leg cramps be indicative of
electrolyte imbalance or peripheral vascular disease
what should be the physical assessment of cardiac emergencies
- VS
- orthostatic BP
- look at rhythm strip
- listen to heart (assess for valve problems)
- check pulses
- check for edema
what does S3 sound indicate
HF, MI, mitral and tricuspid insufficiency
what does S4 sound indicate
acute MI, HTN, CAD, cardiomyopathy, aortic stenosis
what does S4 sound like
tighter, sounds like clicking (stiffness)
this is the most common murmur
this sounds like swooshing
aortic regurgitation
describe the PMI
- point of maximal impulse
- loudest heart sound
- if enlarged heart, will be displaced and thrill will be heard at wrong place (palpate for thrill)
diastolic heart murmurs usually indicate what
heart disease
systolic heart murmurs can be heard in who
both healthy people and people with heart disease
broadly describe 12 lead EKGs
- used to identify ischemia, infarction and conduction delays
- 3 limb leads (1, 2, 3)
- 3 augmented limb leads (aVF, aVL, AVR)
- 6 precordial leads
describe the three limb leads
1) Left arm to Right arm
2) left leg to right arm
3) left leg to left arm
describe three augmented leads
aVF
aVL
aVR
if abnormally in 2, 3 and aVF where is the damage?
inferior leads (front and bottom of heart and left anterior descending)
what do the 2, 3, aVF leads mean
inferior MI/problem
typically L ventricle, worst as cannot pump blood out of heart
what do the 1, aVL, V5, V6 leads mean
lateral MI /problems
what do the V1 and V2 leads mean
septal MI
difficult to treat, causes electrical abnormalities
what does aVR leads mean
R atrium (do NOT give nitro, will increase workload and make problem worse)
EKG will look different after MI…
- ST segment appear slurred d/t ischemia
- Q wave typically longer
