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NURS122 > Cardiac interactive lecture > Flashcards

Cardiac interactive lecture Flashcards

1
Q

what are 6 subjective s/s of heart issue

A

chest pain/coughing (water retention)
dyspnea
palpitations
syncope - rapid drop in HR/BP
weight gain/edema (pitting)
paroxysmal nocturnal dyspnea (PND)

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2
Q

what is paroxysmal nocturnal dyspnea

A

SOB after 1-2 hrs of sleep relieved by sitting up typically

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3
Q

what is syncope

A

orthostatic hypotension of changes in 20-30 mmHg in BP
acute drop in BP/HR

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4
Q

objective s/s of heart issue

A

BP -> JVD
chest shape/sounds
HR/pulses
extremities

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5
Q

what is precordial movement

A

point of maximal pulse visible in intercostal space 5 midclavicular line

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6
Q

functions of cholesterol

A

cell membranes
vit. D formation
hormones
bile acids for digesting fat
energy

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7
Q

what is healthy amount of total cholesterol

A

less than 200

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8
Q

what is healthy amount of LDL

A

less than 100

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9
Q

what is healthy amount of HDL

A

greater than 60

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10
Q

what is bad amount of total cholesterol

A

above 240

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11
Q

what is bad amount of LDL

A

above 160

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12
Q

what is bad amount of HDL

A

greater than 40-50 depends on F/M

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13
Q

function of triglycerides

A

energy used between meals

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14
Q

what is good amount of triglycerides

A

around 150

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15
Q

what is bad amount of triglycerides

A

above 200

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16
Q

where are triglycerides found in

A

fatty foods
refined foods
simple sugar foods
alcohol

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17
Q

things to change to lower triglycerides

A

exercise
avoid sugars/refined carbs
lose weight
limit alcohol

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18
Q

significance of C-reactive protein

A

liver produced when inflammation in body or infection/injury

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19
Q

good amount of C-reactive protein and bad

A

less than 1mg/L good and
more than 3 mg/L bad

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20
Q

what does fasting lipoprotein profile test do and how to do it

A

tests total cholesterol, HDL, LDL, triglycerides
after fasting for 9-12 hours blood test

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21
Q

what is the 1st cardiac enzyme to test and what’s the normal level

A

troponin less than 0.04
released from myocardium injury
hx of heart issue <3 pt lives with high troponin

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22
Q

how frequently are troponin levels tested

A

q6hrs

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23
Q

what does Creatinine kinase - MB test and normal level

A

enzyme found when there damage to the heart
less than 5% is ideal

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24
Q

what does myoglobin test

A

damage to skeletal muscle tissue but not specific to the heart

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25
how does WBC change based on heart issues
inflammation - pericarditis, myocarditis, endocarditis so increase in WBC (4,500 - 11,000)
26
how does RBC change based on heart issues
increase in dehydration (HCT) increase in decreased tissue perfusion decreased in anemia decrease in rheumatic heart dx, endocarditis
27
electrolytes that are related to cardiac
K, Ca &P , Mg
28
hyperkalemia causes
increase width of QRS asystole -> MI
29
hypokalemia
digoxin toxicity
30
normal potassium level
3.5-5.3
31
hypercalcemia hypocalcemia
hyper: prolonged QT, dysrhythmias hypo: AV blocks, cardiac arrest
32
hypermagnesium hypomagensium
hyper: bradycardia, low BP, weakness hypo: pts going through withdrawl, drinks alcohol regularly ventricular tachycardia, V.fib, lots of arrhythmias
33
prothrombin time normals
10-15s normal 25-30s increased bleed
34
international normalized ration normals for high risk of clots uses typically
1.0 2.5-3.5 for those at risk for clots, they'll bleed easier used for warfarin (Coumadin)
35
normal PTT, APTT time when is it used how often taken
PTT: 25-35secs normal; 60-70secs increased bleed APTT: 30-40 secs used when pt on heparin, lovenox, enoxaparin q6hrs
36
what to monitor and do during invasive catheter insertion/stent procedure
cath lab w/ mostly radial access or femoral, dye infusion - warm hot flush feeling monitor dysrhythmias, vitals, pain
37
what to monitor post surg
re-occlusion, pain, position 5 P's - pain, pallor, pulse, paresthesia, paralysis
38
where to find all the valves when auscultating
aortic 2nd right pulmonary 2nd left tricuspid 4th left mitral 5th left
39
equation for CO
CO = SV (stroke volume) x HR SV typically sound using ultrasound
40
what does CVP (central venous pressure) measure
if too much blood going into heart which is bad
41
what does PAWP (pulmonary artery wedge pressure) measure
edema
42
what does cardiac index tell you
how much blood pumped per min
43
purpose of ADH vs. Aldosterone
ADH - hold fluids Aldosterone - hold Na & H2O, release K
44
purpose of ANP & BNP
released by heart to decrease BP increases Na & H2O output increase vasodilation
45
what is considered sustained hypertension
over 140/90
46
normal BP
120/80
47
elevated BP
120-139 over 80-90
48
HTN stage 1
140-159 over 90-99
49
HTN stage 2
160+ over 100+
50
hyypertensive crisis number
180+ over 110+
51
what is the first sign of hypertension
headache
52
complications HTN can lead to
MI/stroke aneurysm HF weakened/narrowed vessels in kidneys messed up optical blood vessels metabolic syndrome
53
what is metabolic syndrome
HTN, obesity, increased unhealthy lipids, diabetes the more it checks off the higher chance of dying
54
equation for BP
BP = CO x SVR (systemic vascular resistance)
55
what does essential/idiopathic hypertension mean
no known cause primary hypertension
56
what is primary HTN at risk for
CAD, stroke
57
how often to check BP for hypertensive crisis
q 2-3 mins
58
what medications to give for hypertensive crisis
vasodilators: nitroprusside, nitroglycerin, hydralazine labetalol
59
what are modifiable factors that increases chance of CAD
smoking, diet, diabetes, metabolic syndrome, stress use of stimulants like cocaine or amphetamines that increase BP rapidly
60
what meds to give for those at risk of CAD
81mg/day aspirin Plavix if aspirin not tolerated
61
what is given for blood clot (thrombus)
IV TPA within 6 hrs of onset symptoms ideally within 30mins at ER
62
S/S of PVD
warm legs edema irregularly shaped sores dull pain NOT sharp yellow/brown ankles
63
S/S of PAD
absent pulse, no leg hair/shinny round, red sores toes and feet pale or with black eschar sharp pain in calves
64
causes for aneurysms
atherosclerosis, trauma, congenital
65
when is surgery considered for aneurysms
if greater than 5cm in diameter or 0.5cm growth/yr
66
most common type of aneurysm
AAA abdominal
67
infrarenal vs. pseudoaneurysm in abdomin
infrarenal: below kidneys pseudoaneurysm: enlargement of outer layer caused by prior surgery or trauma
68
dissection aneurysm
tearing of new false lumen along aorta blood vessel wall
69
fusiform vs. saccular aneurysm
fusiform: all around vessel saccular: pouch like bulge on side
70
infrarenal/suprarenal/juxtarenal meaning
infra: below kidneys supra: above kidneys juxtarenal: arteries in kidneys
71
S/S of AAA
often none back/epigastric pain, pulsatile mass @ umbilicus, cardiovascular collapse, hypotension/shock, weak pulses, N&V, hoarseness
72
S/S of aneurysm rupture
sudden intense abdominal/back pain with "tearing" sensation tachycardia with hypotension
73
what test to use for finding aneurysm
CT with contrast to see location, false lumens, dissections, and size
74
treatment of aneurysm
endovascular grafting (EVAR) similar to stent
75
Allen's test
make first so blood flow out of hands press on arteries on wrist open fist to assess blood flow
76
what does HTN leads to?
AABC acronym A: atherosclerosis A: aneurysms B: broken kidneys, eyes, & heart C: clots: PE, CVA, MI
77
what can cause HTN?
SODA: S - stress, sedentary lifestyle, stimulants O: obesity, oral contraceptives D: diet in high Na & cholesterol; Diabetes, HF, Hyperlipidemia A: african men & age over 50
78
first symptoms for hypertension
ABC A: achy head B: blurred vision (retinopathy) C: chest pain (angina)
79
hypertensive urgency vs. hypertensive crisis
urgency if BP over 180/120 crisis if BP is high as well as end organ damage
80
what are the steps to treat HTN urgency/crisis
BCDE: B - beta blockers C - CCBs D - dilators i.e. nitroglycerin E - transfer from ER to ICU
81
Tests for PAD or PVD
doppler ultrasound D-dimer test (0.5< clot) raise toe & if pain in calf could mean clot ABI pressure between arm and leg (1> bad)
82
elevate or put down legs between PAD vs. PVD
PAD is leg down PVD is elevated legs
83
what is sharp pain in calf from PAD called
intermittent claudication unrelieved at rest
84
most important symptoms to address with PAD/PVD
pain & paresthesia could mean decreased circulation & O2
85
what's the condition called when a pt goes under anesthesia and reacts to it that causes HTN and can result in death
malignant hypertension

NURS122 (28 decks)

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