Brainscape's Knowledge GenomeTM

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


See full index

Critical Care > Cardiac Exam 1 > Flashcards

Cardiac Exam 1 Flashcards

1
Q

Acute Coronary Syndrome

A
  1. stable angina
  2. unstable angina
  3. non-ST elevation (NSTEMI)
  4. ST elevation (STEMI)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ACS patho

A

begins with rupture / erosion of plaque
-thrombus progresses and occludes blood flow

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

stable angina

A

chest pain that occurs with physical activity but is RELIEVED WITH REST / MEDS (nitroglycerin)

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

unstable angina

A

chest pain that occurs at rest NOT RELIEVED WITH REST OR MEDS

-scary kind!! could mean MI

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

prinzmetal’s angina

A

type of unstable angina , due to coronary artery spasm

-occurs at night

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

ACS non-modifiable risk

A

male
postmenopausal female
family hx

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

ACS modifiable risk

A

smoking
obesity
high fat diet
sedentary lifestyle
HTN
type II DM

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

MI occurence

A

normally happen in the morning, BP is highest and blood most viscous

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

ACS meds

A
  1. OXYGEN!!!
  2. nitro
  3. beta blockers
  4. CCB
  5. antiplatelets
  6. antithrombins
  7. morphine
  8. ACE inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MI modifiable risk

A

smoking
high LDL
type II DM
obesity
HTN

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

MI nonmodifiable risk

A

male
postmenopausal female
family hx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

MI s/s

A

ches pain
L shoulder / arm pain
tooth / jaw pain
n/v
sweating
fatigue
SOB
upper back pain

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

MI female s/s

A

achiness in arms (elbows)
fatigue
SOB
indigestion
n/v
stress level

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

MI questions

A
  1. how long have symptoms occurred
  2. chest pain , location , scale 1-10
  3. n/v
  4. surgical hx
  5. family hx
  6. smoking
  7. meds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

MI assessment

A

neuro assessment
skin assessment
respiratory assessment
vitals
pulses
heart sounds

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

MI tests

A
  1. Oxygen !!
  2. 12 lead EKG
  3. CXR
  4. ABGs
  5. CBC
  6. CMP
  7. lipid panel
  8. cardiac enzymes
  9. coag studies
    IV access
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

cardiac enzymes

A
  1. myoglobin
  2. creatinine kinase
  3. troponin I and T
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

coag studies

A

PT / PTT
international normalized ratio

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

STEMI

A

ST elevation indicating one or more vessels are blocked

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

NSTEMI

A

ST depression , only partial occlusion of vessel

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

MI MONA

A

morphine
oxygen
nitroglycerin
aspirin

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

MI meds

A
  1. O2
  2. MONA
  3. betal blockers
  4. heparin drip
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

MI cardiac enzymes

A

will show elevation

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

MI lipids

A

elevated , most MI are secondary to atherosclerosis

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

MI therapy

A

tPA (fibrinolytic therapy)
PCI

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

tPA

A

-symptoms must be present for < 12 hours
-not effective on NSTEMI

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

MI PCI

A

cardiac cath , uses balloon to open lumen of blocked artery

-radial artery preferred
-2-6 hours heal time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

door to balloon time

A

90 MINUTES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

MI coronary artery stent

A

wire mesh is placed to prevent blocked artery from renarrowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

MI home meds

A

aspirin
plavix
lisinopril
metoprolol
atorvastatin
nitroglygerin
stool softener

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

MI education

A

follow up w/ cardiologist
med education
cardiac rehab
MI s/s
low cholesterol diet
high fiber diet
healthy weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

CABG

A

alternative MI tx , major surgery

-bypass blockages of coronary arteries
-unsuccessful PCI or 3 vessel disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

CABG complication

A

bleeding
dysrhythmias
MI
stoke
nonunion of sternum
sternal infection
renal failure
HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

post CABG assessment

A

monitor HR and BP continuously
hemodynamic monitor
cardiac monitor
s/s of infection
assess heart tones
core temp hourly
intake / output
pulses, skin , cap refill
chest tube
H and H
electrolytes
BUN / creatinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Valvular heart disease

A
  1. stenosis
  2. regurgitation
  3. prolapse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

valvular stenosis

A

stiffening / thickening of valve , caused by calcium deposits or scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

valvular regurgitation

A

blood flows or leaks backwards because of incomplete closing of valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

valvular prolapse

A

valves bulge backwards and do not close

-normally not tx unless needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

valvular disease risk

A
  1. infective endocarditis
  2. STREP INFECTIONS
  3. CAD
  4. MI
  5. HF
  6. congenital defect
  7. cardiomyopathy
  8. older age
  9. pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

valvular disease s/s

A
  1. MURMUR (systolic or diastolic )
  2. dyspnea
  3. SOB
  4. orthopnea
  5. dizziness
  6. palpitations
  7. weight gain
  8. decrease physical activity ability
  9. palpitations
  10. crackles
  11. angina
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

valvular disease questions

A
  1. medical hx
  2. smoke / drink / illicit drugs
  3. meds
  4. family hx
  5. social hx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

valvular disease drugs

A

most seen with COCAINE USE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

valvular disease assessment

A

vitals
pain assessment
breath sounds
heart sounds
vascular assessment
activity tolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

valvular disease test

A

EKG
CBC
CXR
CMP
cardiac enzymes
TEE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

valvular disease meds

A

beta blockers
ACE inhibitors
ARBS
anticoagulants
nitroglycerin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

valvular disease education

A
  1. medication
  2. low sodium / caffeine
  3. s/s of HF
  4. daily weights
  5. bleeding precautions
  6. follow up

-prophylactic ABX for dental procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

daily weight education

A

use same scale and check at same time everyday

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

carotid artery disease

A

wall thickening , plaque formation , progressive narrowing of carotid artery

-no s/s until almost completely occluded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

carotid artery disease modifiable risk

A

smoking
HTN
DM
dyslipidemia
sedentary lifestyle
obesity
ineffective stress management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

carotid artery disease nonmodifiable risk

A

age
gender
ethnicity
family hx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

coronary artery disease pts have high risk of developing ….

A

carotid artery disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

carotid artery disease s/s

A

symptoms resembling TIA
weakness
dizziness
loss of coordination
slurred speech
facial droop
vision problems
HA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

carotid artery disease test

A
  1. carotid duplex ultrasonography
  2. computed tomography angiogram
  3. CTA / MRI / MRA
  4. carotid angiography
  5. cardiac echo
  6. heart cath
  7. EKG
  8. CBC
  9. lipid profile
  10. CMP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

carotid artery disease med

A
  1. antiplatelets
  2. antihypertensive
  3. satins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

carotid artery disease BP

A

needs to be below 140 / 90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

carotid artery disease major sign

A

BRUIT when listening over side of neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

carotid artery disease education

A

s/s of stroke
medication
lifestyle change
limit alcohol
DASH diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

heart failure

A

inadequate pumping / filling of heart and cannot meet oxygenation needs of tissues

59
Q

HF classifications

A

based off of ejection fraction

60
Q

left sided HF

A

weakened contraction –> poor peripheral perfusion

-backflow of blood accumulating fluid in lungs

61
Q

left sided HF s/s

A

SOB
orthopnea
fatigue
weight gain
poor color
tachypnea
blood tinged sputum
CRACKLES
S3 , S4 GALLOP

62
Q

right sided HF

A

inability of R side of heart to pump blood to pulmonary vasculature

63
Q

right sided HF s/s

A

JVD
generalized edema
hepatomegaly
ascites
loss of appetite
n/v
increased abdominal girth

64
Q

HF primary test

A
  1. CXR!!!
  2. EKG
  3. CMP
  4. CBC
  5. cardiac enzymes
  6. ABGs
  7. BNP and NT-pro BNP
65
Q

BNP

A

biomarkers elevated due to overstretching of ventricles

66
Q

lactic acidosis

A

reduction of blood flow throughout the body

-formed as by-product of ANAEROBIC METABOLISM
-lead to cell death and organ failure

67
Q

dysrhythmias and HF

A

these are and adverse effect of HF , a-fib is the MOST COMMON

68
Q

ischemic cardiomyopathy

A

secondary to MI

69
Q

nonischemic cardiomyopathy

A

dilated cardiomyopathy
hypertrophic cardiomyopathy
restrictive

70
Q

rapid intubation

A
  1. induction agents
    -ketamine
    -fentanyl
    -propofol
    -etomidate
    -midazolam
  2. neuromuscular blockers
    -vecuronium
    -succinycholine
71
Q

cardiomyopathy meds

A

beta blocker
diruetics
nitroglycerin
heparin drip
morphine
digoxin

72
Q

digoxin consideration

A

DO NOT given when HR < 60

73
Q

shocking joules

A

120 - 200

74
Q

post shock meds

A

atropine
dopamine OR
norepinephrine OR
epinephrine

75
Q

cardiogenic shock

A

happens from diminished CO , ventricular dysfunction initiates compensatory mechanisms

-initially stabilize pt but later cause deterioration as O2 demands increase

76
Q

intra-aortic balloon pump

A

used to increase myocardial oxygen supply and demand

-used in major occlusion of coronary artery and low ejection fraction

77
Q

AICD

A

recommended for pts with < 30% ejection fraction and high risk for lethal dysrhythmias

78
Q

post cardiogenic shock meds

A
  1. beta blockers
  2. ACE inhibitors
  3. nitroglycerin
  4. digoxin
  5. ARBS
  6. ARNIs
  7. inodilators
  8. vasodilators
  9. diuretics
79
Q

cardiomyopathy / HF education

A
  1. management
  2. oxygen use
  3. rest / pace activity
  4. fall precaution
  5. FACES
  6. daily weight
  7. no smoking
  8. reduce sodium
  9. cardiac rehab
  10. potassium rich foods
80
Q

potassium rich foods

A

banana
orange juice

81
Q

weight concerns

A

> 2.5 lbs in a day
5lbs in a week

82
Q

FACES for HF

A

fatigue
activity limitation
cough / congestion
edema
SOB

83
Q

shock

A

life threatening syndrome occurs when circulatory system is unable to supply O2

84
Q

aneurysm dissection s/s

A

chest , back , flank pain
tearing or ripping feeling
sweating
n/v
faintness
tachycardia
pain gets progressively worse
BP can vary from one limb to another

85
Q

aneurysm questions

A
  1. onset of pain
  2. description of pain
  3. severity of pain
  4. pain radiation
  5. medical hx
  6. family hx
  7. peripheral sensation
  8. smoking
  9. n/v
  10. trauma
86
Q

aneurysm risks

A

SMOKING
family hx
male
atherosclerosis
HTN
high cholesterol
CAD
genetic disorders : Marfan’s syndrome

87
Q

aortic dissection

A

sudden tear in aortic intima creating false lumen where blood can enter aortic wall

88
Q

aneurysm labs

A

CBC
lipids
coagulation
cardiac enzymes
EKG
CT abd with contrast
abd US / TEE

89
Q

aneurysm pre -surgery

A

blood type and crossmatch
two large IVs
O2
IV fluids

90
Q

hypovolemic shock

A

rapid fluid loss resulting in poor circulation volume

-r/t ruptured AAA

91
Q

hypovolemic shock intervention

A

prepare for ventilation
cardiac monitor
ABGs
rapid fluid / blood transfusion
hemodynamic monitor
foley
repeat CBC
lactate level

92
Q

hypovolemic shock meds

A

dobutamine
dopamine
epinephrine / norepinephrine / phenylepinephrine
vasopressin

93
Q

distributive shock

A

result of diseased state such as
-sepsis
-anaphylaxis

94
Q

anaphylaxis

A

give EPINEPHRINE
then ANTIHISTAMINE

95
Q

arterial line

A

transducer must be in line with midpoint of R atrium

-can give wrong reading if too high or low

96
Q

obstructive shock

A

caused by mechanical barrier to ventricular filling / emptying

-tension pneumothorax
-cardiac tamponade

97
Q

central venous catheter advantage

A

CVP and ScvO2 monitor
monitor preload
volume resuscitation
frequent blood draws
long term IV abx
parenteral nutrition
transvenous pacemaker insertion

98
Q

what is done before an arterial line insertion

A

allen’s test

99
Q

CVP reading

A

can indicate low volume states or high volume

100
Q

hypovolemic shock values

A
  1. decreased CO
  2. decreased CVP
  3. decreased PCWP / PAOP
  4. decreased central venous oxygenation
  5. decreased mixed venous oxygenation
  6. increased systemic vascular resistance
  7. decrease MAP
  8. hypotension and tachycardia
101
Q

shock interventions

A
  1. vitals
  2. hemodynamic reading
  3. neuro status
  4. monitor UO
  5. skin color and temp
  6. ABGs
  7. venous O2 sat
  8. H and H
  9. metabolic profile
  10. lactic acid
  11. IV fluids
102
Q

anaerobic metabolism

A

cells use anaerobic (without O2) pathway to produce energy
-blood is more acidic
-leads to cell death

103
Q

ARDS

A

leading cause of sepsis

104
Q

sepsis

A

life-threatening organ dysfunction caused by a deregulated host response to infection

105
Q

septic shock

A

occurs when circulatory and metabolic abnormalities are profound

106
Q

sepsis and septic shock complications

A

MODS and DIC

107
Q

DIC

A

widespread clotting

108
Q

MODS

A

involves two or more organ systems not working

-initial organ is typically the lungs
-GI / hepatic / renal follow

109
Q

sepsis tx

A

treat underlying cause ( IV abx)
maximize O2
IV fluids
blood products

110
Q

DIC diagnosis

A

based off of clinical picture of cyanosis and ischemia plus labs

111
Q

DIC tx

A

treat underlying cause
maximize O2
volume replacement
-NS
-blood
-plasma
-FFP
-replacement clotting factors

112
Q

swan catheter

A

measures L heart preload or amount
-can also draw venous oxygen samples

113
Q

CVP low

A

hypovolemia
peripheral vasodilation

114
Q

CVP low tx

A

fluid bolus
vasopresser

115
Q

CVP high

A

R heart failure
tension pneumothorax
HTN
pericardial tamponade

116
Q

CVP high tx

A

inotropic or vasodilator therapy

117
Q

PA high

A

pulmonary hypertension
R sided HF

118
Q

PA high tx

A

inotropic and vasodilator
diuretics

119
Q

Pulmonary capillary wedge pressure (PCWP)

A

high :
-HTN
-cardiogenic shock
-hypoxia
-ARDS

120
Q

PCWP high tx

A

inotropic and vasodilator therapy
diuretics

121
Q

low CO

A

MI , all shock forms
-except early septic shock

122
Q

low CO tx

A

fluid bolus
inotropic therapy
treat MI cause

123
Q

CO high

A

septic shock (early)
hypervolemia
hyperthermia

124
Q

CO high tx

A

only if concerned

125
Q

systemic vascular resistance (SVR) low

A

vasodilation
-distributive shock (anaphylaxis and sepsis)

126
Q

SVR low tx

A

fluid bolus
vasopressors
tx underlying cause

127
Q

SVR high

A

vasoconstriction
-hypovolemia
-hypotension
-cardiogenic shock

128
Q

SVR high tx

A

vasodilators

129
Q

pulmonary vascular resistance high

A

HTN

130
Q

PVR high tx

A

vasodilators

131
Q

mixed venous O2 low

A

increased oxygen needs of tissue
low CO
low hemoglobin
low O2

132
Q

SvO2 low tx

A

increase CO
increase oxygenation
increase hemoglobin

133
Q

lactate level

A

increased lactate and negative base are evidence of poor perfusion and cellular level

134
Q

sepsis bundle of care

A
  1. measure lactate
  2. obtain blood culture
  3. administer abx
  4. administer NS
  5. administer vasopressors if BP unresponsive after fluids
135
Q

v-tach

A

pulseless = shock
pulse = cardioversion

136
Q

v-fib

A

always shock , start CPR without pads

137
Q

cannot feel pulse in carotid

A

feel for femoral pulse

138
Q

R heart cath

A

go into vein , looking at R heart pressure
-valve disorders, ejection fraction

139
Q

L heart cath

A

femoral or radial entrance
-MI or angioplasty

140
Q

cardiogenic shock

A

forms from high wedge pressure

141
Q

ARDS cannot happen without….

A

acute respiratory failure because it creates scar tissue

142
Q

pts with this HF are at high risk for blood clots

A

R sided HF

143
Q

R and L sided HF

A

both create extra strain can go into v-fib
-VERY COMMON

Critical Care (15 decks)

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