Cardiac Emergencies Flashcards

1
Q

The conduction system

A

SA, AV, Bundle of HIS, Purkinje

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2
Q

SA node

A

Pace Maker

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3
Q

AV node

A

Pauses the impulses so the ventricles can fill with blood

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4
Q

Bundle of HIS

A

Elongated segment connecting the AV and the left and right bundle branches

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5
Q

Intrinsic Rates

A

Set unless sympathetic NS has an effect

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6
Q

What dysrhythmias can lead to sudden cardiac arrest

A

Ventricular fibrillation (V-Fib)
Ventricular Tachycardia (V-Tach)

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7
Q

How do occluded coronary arteries occur?

A

When damage is caused to the artery wall (hypertension/ smoking), plaque can build (high cholesterol), vessels are narrowed so less blood reaches the heart

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8
Q

Coronary Artery Diseases

A

Atherosclerosis
Arteriosclerosis

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9
Q

Atherosclerosis

A

Fatty plaque build up

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10
Q

Arteriosclerosis

A

Hardening of the arteries, mostly due to age

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11
Q

What can come from Coronary Artery Diseases?

A

The plaque can cause a rupture and platelets will attempt to remain resulting in clotting (blockage) that then leads to a heart attack

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12
Q

Angina Pectoris

A

Inadequate O2 supply to the heart (Myocardial Ischemia), can be stress induced, pain will go away with rest and nitroglycerin

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13
Q

Angina S/S

A

-Chest discomfort, possibly radiating to L arm or neck
-Cool, clammy skins/ possibly sweating profusely
-Shortness of breath
-Nausea or vomiting

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14
Q

Angina Treatment

A

-O2, low flow, maintain O2 Sat of >94% (UNLESS difficulty breathing or ineffective respiratory= high flow)
-Patient remain calm
- Assist with nitroglycerin and/ or aspirin if prescribed

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15
Q

What does it mean if Angina doesn’t go away

A

Worsening or no relief may mean myocardial infarction

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16
Q

What is a Silent MI?

A

No chest pain or vague symptoms. Common in elderly, women, or diabetics

17
Q

Aortic Aneurysm

A
  • Weakening in lining of Aorta (caused from hypertension)
  • Leads to ballooning
  • If balloon ruptures => life threatening
18
Q

Aortic Dissection

A
  • Tear in inner lining of Aorta (shreds)
  • Blood enters opening causing separation of the lining
19
Q

Aortic Dissection S/S

A
  • Chest pain (described as tearing or ripping; will radiate to back, flank, arm)
20
Q

Aortic Dissection Treatment

A
  • High flow O2
  • Rapid Transport
21
Q

Congestive Heart Failure (CHF)

A
  • Heart no long pumps blood effectively (previous myocardial infarction)
    Two types: Left and Right Heart Failure
22
Q

Left Heart Failure

A
  • Affects lung side
    -Cannot pump blood to the rest of the body
  • Traffic jam in the lungs (RALES)
  • Fluid will build in alveoli
23
Q

What causes LHF?

A
  • Hypertension/ HTN
  • Coronary artery disease
  • Heart attack history
24
Q

LHF S/S

A
  • Chest pain/ shortness of breath
  • rales
  • pale, cool, sweaty skins
  • anxiety
  • high BP/ rapid HR
  • pink frothy sputum (LATE sign/ SERIOUS)
25
Right Heart Failure
- Systemic side - Cannot pump blood to the lungs - from right ventricular AMI or pulmonary hypertension
26
RHF S/S
- Lower extremity edema - JVD - Abdominal distension
27
RHF Treatment
- Sit up, dangle legs - Rapid transport - High flow O2, PPV
28
Nitroglycerin (NTG)
- Trade names: nitrostat, nitro-bid, nitrolingual spray
29
Indications for NTG
- SS of chest pain or discomfort, consistent with acute coronary syndrome - Prescription - Approval to administer
30
Contradictions for NTG
- Viagra in the past 24 h (can cause DEATH) - HR less than 50 bpm or more than 100 bpm - 3 doses have been taken
31
Side effects of NTG
- Headache - BP drop - Change in pulse rate
32
Aspirin
- Trade names: ASA, Bayer, Ecotin
33
Indications for ASA
- Chest pain/ discomfort that is suggestive of acute coronary syndrome - Medical direction to give
34
Contradictions for ASA
- Not given to patient who are known to be allergic (hypersensitive to drug)
35
Side effects of ASA
- Overall a very good drug - Stomach irritation
36
How is NTG given?
- Sublingual - Spray, tablet, or paste
37
How is ASA given?
- Oral or chewable
38
What does NTG do?
- Relieves chest pain - Dilates coronary arteries, allowing for increase of blood flow - Reduces workload of heart
39
What does ASA do?
- Does not allow platelets to combine together, prevent vessel blockage - Makes platelets slippery