Cardiac Lecture Flashcards
Diuretics
make you pee, and get rid of a lot of the extra fluid, pee of water, decrease blood pressure
- water follows salt
Prepare mannitol vial
Mannitol is an IV only medication
- Need to warm the vial (swirl between palms) to dissolve crystals, do not inject crystals
Regular potassium levels
3.5 - 5.0
- Hypo below 3.5
- Hyper above 5.0
Cardiac arrest occurs around 8-9
When giving potassium chloride (pills)
Give with a full glass of water, make sure to give it slowly
What does potassium do in terms of the heart?
disrupts the electrical activity
helps maintain normal fluid in cells (KIS)
What does magnesium do in terms of the heart?
lower mag leads to dysrhythmias
mag deals with contractibility
Magnesium Ranges
1.3 - 2.1 mg/dl
What can beta blockers “block”
signs of hypoglycemia, pt wont be tachy or tremor as much
beta 1 - heart (one heart)
beta 2 receptors - lungs, skeletal, liver
Heart Block
electrical impulses are off and don’t go towards the bottom of your heart
1st
2nd
3rd - most deadly
ACE vs ARB
They are cousins patients should only be on one! (-pril + -sartan)
ace, -pril: lowers production of substance that narrows vessels
arb, -sartan: reduces the action of the substance
ACE vs ARB for diabetics
Diabetics should use ACES, will help with the kidney
aCe=tiCs
Angiodemia due to ACE
Starts as jaw pain (anticipate), treat pt with EPI and never use drug again
Calcium and relation to the heart
muscle contraction cannot occur and the vessel will dilate
being on Dig and it’s effects on potassium (K+)
increases the chance of toxicicity, use the same receptor
Serum levels for digoxin
.5 to 2.0 ng/ml
lower levels used for treating HF, higher levels for treating a fib
Hold dig when?
- heartrate is below 60
- serum levels .5-2.0 ng/ml
- having vision issues
Angina Pectoris
sudden pain beneath the sternum
Nitro patches
To prevent tolerance patch in put on in AM and removed in PM.
ALWAYS date and sign patches, chart application and removal
Pt must be weaned off this therapy
Low density lipoproteins
“bad” cholesterol, greatest contributor to coronary heart disease (CHD)
- deli meats, fried foods, processed food, pizza, burger, icecreams
High-density lipoproteins
“good” cholesterol
-high fiber fruit, fish, beans, whole grains, olive oil
Purpose of cholesterol
component of all cells, systhesises hormones and bile salts
Cholesterol Screening + Values (Total, HDL, LDL, TGs)
Every 5 years for adults over the age of 20
Total: 125-200 mg/dl
HDL: >40 mg/dl men + >50 mg/dl for women
–higher is better
LDL: <100 mg/dl
Triglycerides TG: <150 mg/dl
Treatment of high cholesterol
first line: diet, weight control, exercise and smoking cessation
one lifestyle change at a time and baby steps
Anticoagulants
prevent formation of clots and inhibit their circulation
Antiplatelets
prevent platelet formation (prevent and stop bleeding, form clots)
Thrombolytics
attack and dissolve existing blood clots
May not use heparins after what
After surgery of eyes, brain, spinal cord and lumbar punctures
What is important to monitor after starting heparins
aPTT - activated partial thromboplastin time every 6 hours
normal: 20-35 (non treated)
INR Values
1.3-2.0 pretreatment
2.0-3.0 treated
how fast your blood clots
Platelets Life
7-10 days
clopidogrel effects platelet formation for its entire life cycle
In trauma what happens physiologically with the cells
The cells swell and they will burst. Releasing KIS, the potassium levels will rise, can lead to cardiac arrest. Anticipating it for trauma pts
When potassium is high
- infuse glucose and insulin to drive the potassium into the cells
- give them an enema
- infuse sodium bicarb
- put on dialysis
foods high in potassium
prunes, avocado, carrots, potatoes, broccoli, cantaloupe and salt substitutes