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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
Q

how does WBC change based on heart issues

A

inflammation - pericarditis, myocarditis, endocarditis
so increase in WBC (4,500 - 11,000)

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26
Q

how does RBC change based on heart issues

A

increase in dehydration (HCT)
increase in decreased tissue perfusion
decreased in anemia
decrease in rheumatic heart dx, endocarditis

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27
Q

electrolytes that are related to cardiac

A

K, Ca &P , Mg

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28
Q

hyperkalemia causes

A

increase width of QRS asystole -> MI

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29
Q

hypokalemia

A

digoxin toxicity

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30
Q

normal potassium level

A

3.5-5.3

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31
Q

hypercalcemia
hypocalcemia

A

hyper: prolonged QT, dysrhythmias

hypo: AV blocks, cardiac arrest

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32
Q

hypermagnesium

hypomagensium

A

hyper: bradycardia, low BP, weakness

hypo: pts going through withdrawl, drinks alcohol regularly
ventricular tachycardia, V.fib, lots of arrhythmias

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33
Q

prothrombin time normals

A

10-15s normal
25-30s increased bleed

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34
Q

international normalized ration
normals
for high risk of clots
uses typically

A

1.0
2.5-3.5 for those at risk for clots, they’ll bleed easier
used for warfarin (Coumadin)

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35
Q

normal PTT, APTT time
when is it used
how often taken

A

PTT: 25-35secs normal; 60-70secs increased bleed
APTT: 30-40 secs
used when pt on heparin, lovenox, enoxaparin
q6hrs

36
Q

what to monitor and do during invasive catheter insertion/stent procedure

A

cath lab w/ mostly radial access or femoral,
dye infusion - warm hot flush feeling
monitor dysrhythmias, vitals, pain

37
Q

what to monitor post surg

A

re-occlusion, pain, position
5 P’s - pain, pallor, pulse, paresthesia, paralysis

38
Q

where to find all the valves when auscultating

A

aortic 2nd right
pulmonary 2nd left
tricuspid 4th left
mitral 5th left

39
Q

equation for CO

A

CO = SV (stroke volume) x HR
SV typically sound using ultrasound

40
Q

what does CVP (central venous pressure) measure

A

if too much blood going into heart which is bad

41
Q

what does PAWP (pulmonary artery wedge pressure) measure

A

edema

42
Q

what does cardiac index tell you

A

how much blood pumped per min

43
Q

purpose of ADH vs. Aldosterone

A

ADH - hold fluids
Aldosterone - hold Na & H2O, release K

44
Q

purpose of ANP & BNP

A

released by heart to decrease BP
increases Na & H2O output
increase vasodilation

45
Q

what is considered sustained hypertension

A

over 140/90

46
Q

normal BP

A

120/80

47
Q

elevated BP

A

120-139 over
80-90

48
Q

HTN stage 1

A

140-159 over
90-99

49
Q

HTN stage 2

A

160+ over
100+

50
Q

hyypertensive crisis number

A

180+ over
110+

51
Q

what is the first sign of hypertension

A

headache

52
Q

complications HTN can lead to

A

MI/stroke
aneurysm
HF
weakened/narrowed vessels in kidneys
messed up optical blood vessels
metabolic syndrome

53
Q

what is metabolic syndrome

A

HTN, obesity, increased unhealthy lipids, diabetes
the more it checks off the higher chance of dying

54
Q

equation for BP

A

BP = CO x SVR (systemic vascular resistance)

55
Q

what does essential/idiopathic hypertension mean

A

no known cause
primary hypertension

56
Q

what is primary HTN at risk for

A

CAD, stroke

57
Q

how often to check BP for hypertensive crisis

A

q 2-3 mins

58
Q

what medications to give for hypertensive crisis

A

vasodilators:
nitroprusside, nitroglycerin, hydralazine
labetalol

59
Q

what are modifiable factors that increases chance of CAD

A

smoking, diet, diabetes, metabolic syndrome, stress
use of stimulants like cocaine or amphetamines that increase BP rapidly

60
Q

what meds to give for those at risk of CAD

A

81mg/day aspirin
Plavix if aspirin not tolerated

61
Q

what is given for blood clot (thrombus)

A

IV TPA within 6 hrs of onset symptoms
ideally within 30mins at ER

62
Q

S/S of PVD

A

warm legs
edema
irregularly shaped sores
dull pain NOT sharp
yellow/brown ankles

63
Q

S/S of PAD

A

absent pulse, no leg hair/shinny
round, red sores
toes and feet pale or with black eschar
sharp pain in calves

64
Q

causes for aneurysms

A

atherosclerosis, trauma, congenital

65
Q

when is surgery considered for aneurysms

A

if greater than 5cm in diameter or 0.5cm growth/yr

66
Q

most common type of aneurysm

A

AAA
abdominal

67
Q

infrarenal vs. pseudoaneurysm in abdomin

A

infrarenal: below kidneys
pseudoaneurysm: enlargement of outer layer caused by prior surgery or trauma

68
Q

dissection aneurysm

A

tearing of new false lumen along aorta blood vessel wall

69
Q

fusiform vs. saccular aneurysm

A

fusiform: all around vessel
saccular: pouch like bulge on side

70
Q

infrarenal/suprarenal/juxtarenal meaning

A

infra: below kidneys
supra: above kidneys
juxtarenal: arteries in kidneys

71
Q

S/S of AAA

A

often none
back/epigastric pain, pulsatile mass @ umbilicus, cardiovascular collapse, hypotension/shock, weak pulses, N&V, hoarseness

72
Q

S/S of aneurysm rupture

A

sudden intense abdominal/back pain with “tearing” sensation
tachycardia with hypotension

73
Q

what test to use for finding aneurysm

A

CT with contrast to see location, false lumens, dissections, and size

74
Q

treatment of aneurysm

A

endovascular grafting (EVAR) similar to stent

75
Q

Allen’s test

A

make first so blood flow out of hands
press on arteries on wrist
open fist to assess blood flow

76
Q

what does HTN leads to?

A

AABC acronym
A: atherosclerosis
A: aneurysms
B: broken kidneys, eyes, & heart
C: clots: PE, CVA, MI

77
Q

what can cause HTN?

A

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
Q

first symptoms for hypertension

A

ABC
A: achy head
B: blurred vision (retinopathy)
C: chest pain (angina)

79
Q

hypertensive urgency vs. hypertensive crisis

A

urgency if BP over 180/120
crisis if BP is high as well as end organ damage

80
Q

what are the steps to treat HTN urgency/crisis

A

BCDE:
B - beta blockers
C - CCBs
D - dilators i.e. nitroglycerin
E - transfer from ER to ICU

81
Q

Tests for PAD or PVD

A

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
Q

elevate or put down legs between PAD vs. PVD

A

PAD is leg down
PVD is elevated legs

83
Q

what is sharp pain in calf from PAD called

A

intermittent claudication unrelieved at rest

84
Q

most important symptoms to address with PAD/PVD

A

pain & paresthesia could mean decreased circulation & O2

85
Q

what’s the condition called when a pt goes under anesthesia and reacts to it that causes HTN and can result in death

A

malignant hypertension

NURS122 (28 decks)

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