Brainscape's Knowledge GenomeTM

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


See full index

Complex > Cardiac Emergencies 2 > Flashcards

Cardiac Emergencies 2 Flashcards

1
Q

if pt says having a heart attack…

A
  • they probably are
  • assume chest pain until ruled out (go to ER)
  • get them to sit/rest
  • **do NOT let them drive themselves (911)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

describe acute coronary syndrome

A
  • women have vague/GI symptoms
  • diabetic have decreased pain and muffled chest pain (may not be aware d/t neuropathy)
  • assess for pain and the s/s of acute coronary syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

acute coronary syndrome: assess for pain

A
  • burning/squeezing/crushing/radiation

- exercise, cold, stress, large meal may make it worse

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

acute coronary syndrome signs

A
  • fatigue, SOB
  • N and V
  • cool extremities and perspiration
  • muffled heart sounds, palpable pericordial pulse
  • hypo or HTN
  • feeling of doom
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

if complains of chest pain…

A
  • always call MD and get help

- MONA (morphine, O2, nitro, aspirin)

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

actual order if c/o chest pain

A

1) O2 2 l
2) chewable aspirin 4 x 81 mg (324 mg), stops prostaglandin from sticking (anti platelet)
3) nitro sublingual 0.04 mg x3 (every 3-5 min)
4) morphine 2-4 mg IV
5) heparin drip (bolus then drip)
6) go to catheter lab (only have 90 min to get there, <1hr best)
7) Integrilin, Repro (prevent more clot formation, on for 24 hrs) **big risk factor= bleeding

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

important things to remember about nitro

A

SE: tingling under tongue, headache, decreased bP

  • check BP BEFORE giving nitro (need baseline)
  • do not give nitro once BP is less than 100 (systolic), will drop BP too much
  • may need nitro drip
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ACS diagnostics

A
  • cardiac markers
  • 12 lead EKG
  • cardiac cath asap
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

ACS medications

A
  • nitrates first
  • BB to decrease workload (Metoprolol)
  • CCB (amlodipine) for vessel spasms
  • antiplatelets (aspirin)
  • antilipemics (statins)
  • Glycoprotein lib inhibitors (Integrilin, Repro): after cath to decrease platelet aggregation, used 12-24 hrs after
  • thrombin inhibitors (Bivairudin/Angiomax), keep vessels open
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

describe antiplatelets

A
  • prevent platelet aggregation (from sticking together)

* does NOT make you bleed

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

describe P2Y12 Inhibitors

A
  • Clopidogrel (Plavix): used for stroked, post MI
  • Prasugrel (Effient)
  • Ticagrelor (Brilmta)
  • used with ASA for 12 mos in pt w/ NSTEMI
  • Plavix shown to increase outcome after STEMI and PCI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

if ACS pt arrests…

A
  • 5 cycles CPR all compressions
  • then 30:2 with breathing
  • use cart: hook up pad (defib for vfib)
  • more CPR, shock again
  • meds (epi, no limit)
  • amiodarone (300 mg for code): vtach (150 mg), bolus then drip
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

describe anticoagulants

A
  • inhibit clotting at factor x-anticoagulants
  • will cause you to bleed (risk)
  • increase PT and PTT
  • works quickly but stays in system for long time
  • replacing coumadin
  • given to HF pts
  • must wean off
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

describe factor xa inhibitors

A

“xabans”

  • Rivaroxaban (xarelto)
  • Apixaban (eliquis)
  • antidote= andexanet alfa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

code blue meds

A
  • epi 1 mg IVP every 3-5 min
  • lidocaine if epi is unsuccessful
  • amiodarone 300 mg in arrest bolus then 150 mg drip
  • potentially ordered: NaHCO3, Ca, Mg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what do you watch for during code blue meds

A
  • watch for ROSC
  • return of spontaneous circulation
  • monitor for CO2 being expelled (determines if sufficient breath)
  • transfer to ICU, cooling blanket to decrease metabolism
17
Q

what to do during CPR

A
  • stay with pt call for help
  • call code
  • bring cash cart
  • leads, assess rhythm, shock
  • compressions: 30:2
  • code team: head, checks pulse, starts Ambu
  • don’t let the RN leave, answer questions about what happened
18
Q

causes of cardiac arrhythmias

A

fever, dehydration, stress, emboli, positional changes, fluid overload

19
Q

what to consider with cardiac arrhythmias

A
  • chest pain? change in BP?
  • think about Hs and Ts
  • tachycardia caused by pain and dehydration
  • a fib= HF
  • heart block, v tach, PVS = post MI
20
Q

causes of SVT

A
  • hypoxia, hypokalemia, MI, anxiety

- dig toxicity, caffeine, weed, CNS stimulant

21
Q

treatment of SVT

A
  • if unstable: cardioversion
  • if stable: vagal stimulation, valsalva maneuver, carotid sinus massage or Adenosine
  • after rhythm converts, CCB and BB
  • start with drug then electricity
22
Q

causes of sinus tachy

A

exercise, anxiety, pain, dehydration, anemia, MI, hypovolemia, L side HF

23
Q

treatment of sinus tachy

A

correct underlying cause

-BB and CCB

24
Q

causes of sinus brady

A

sleep, V, hypothyroidism, ICP, inferior wall MI, BB, CCB

25
Q

treatment of sinus brady

A

correct cause

  • if BP decreases or dizzy/weak or change in LOC call RRT and start ACLS
  • Pacemaker, Atropine
  • dopamine or epi IV
26
Q

what is important to remember about sinus brady

A
  • no way to reverse BB overdose

- if symptomatic (chest pain or BP decreases) atropine or pacemaker for brady

27
Q

causes of atrial flutter and a fib

A

HF, PE, pericarditis, COPD, HTN, alcohol

28
Q

treatment of atrial flutter and a fib

A
  • CCB (diltiazem) or amiodarone
  • *if meds do not work, cardioversion or ablation
  • may need anticoagulant therapy
  • new treatment: Tikosyn
29
Q

stable and unstable treatments for atrial flutter and a fib

A
  • unstable: with VR >150, cardioversion

- if stable, ACLS and any therapy (CCB, BB, amiodarone, digoxin)

30
Q

treatment for V tach

A
  • ICD if recurrent v tach

- pulseless: CPR, ACLS for epi or vasopressin, then amiodarone

31
Q

when is mg sulfate given

A

torsades de pointes only

32
Q

how much amiodarone is given for v tach

A

150 mg for v tach (IV) then 1 mg drip/hr

33
Q

if wide QRS and v tach give what

A

adenosine and cardioversion

34
Q

if irregular v tach…

A

defibrillate

Complex (38 decks)

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