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exam 2 > Cardiac notes > Flashcards

Cardiac notes Flashcards

1
Q

Inotropic

A

increase or decrease contractility

digoxin: positive inotropic (stronger)

most meds : negative inotropic (depress contractility

watch for CHF because not pumping blood out

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2
Q

Dromotropic

A

conduction system (impulses)

positive : increased conduction

most meds : interfere with conduction

treat tachy arrythmias

drugs have potential for blocks

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3
Q

chronotropic

A

rate @ SA node

stimulate SA node

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4
Q

women

A

have weird angina

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5
Q

diagnostic evaluation procedure

A

ECG

troponin

cardiac enzymes

isoenzymes

myoglobulin

WBC

Sed rate

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6
Q

CK

A

creatinine kinase

goes up fast then decreases

best for determining early MI

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7
Q

Isoenzymes

A

CKMB (MB means heart)

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8
Q

WBC

A

increases because of inflammatory response to attack on heart

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9
Q

sed rate

A

stays increased for awhile

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10
Q

ECG changes

A

Q - does not go back to normal

ST elecated

T wave inversion

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11
Q

emergency management of MI

A

O2

2 IV’s

ECG

nitro/asprin/morphine

bloodwork/x-rays (enlarged heart)

assess antiplatelet/anticoagulation?thrombolytics

beta blockers/ antidysrhythmics

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12
Q

thrombolytics

A

TPA

4-6 hours after start of chest pain (asap pre-damage)

TPA goes to where its needed

side effects: hemorrhage/anemia

hypotension/fever

bronchospasm/anaphyaxis

periorbital swelling/itching/uticaria/headache

dysrhythmias

can cause another clot when a large clot is broken up

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13
Q

Heart failure

A

right side -fluid backup

left side - pulmonary

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14
Q

systolic ventricular dysfunction

A

not enough blood ejection

foward failure

decrease cardiac output -fluid backs up

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15
Q

diastolic ventricular dysfunction

A

left ventricule cant relax enough to accumulate blood to pump out

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16
Q

right vs. left side heart failure

A

arteries Left

veins right

rt. failure can be caused by left failure

rt ventricular MI

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17
Q

high output failure

A

cardiac ouput can be ok

increase metabolic demands on heart

hyperthyroid

septecemia

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18
Q

what diagnoses Heart Failure

A

BNP

from fluid in ventricles

chest xray

echocardiogram

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19
Q

diltiazem (cardizem)

A

calcium channel blocker

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20
Q

metoprolol (lopressor)

A

beta blcoker

21
Q

atenolol (tenormin)

A

beta blocker

22
Q

Nifedipine (procardia)

A

calcium channel blocker

23
Q

timolol (betimol)

A

beta blocker

24
Q

amlodipine (norvasc)

A

calcium channel blocker

25
Q

the condition of having a reduced clood supply to myocardial cells is call

A

myocardial ischemia

26
Q

by causing venodilation, nitrates reduce the amount of blood returning to the heart thus decreaseing

A

cardiac output

27
Q

which of the following is true regarding the effect of atenolol (tenormin) on the heart

A

it selectively blocks beta receptors

28
Q

the primary mechanism of calcium channel blockers

A

reducing cardiac workload

29
Q

what agent has the ability to inhibit the transport of calcium ions into myocardial cells and relaxes both coronary and peripheral blood vessels

A

diltiazem (cardizem)

30
Q

what are the goals for pharmacotherapy of acute MI

A

restore blood supply to the damaged myocardium as quickly as possible

prevent associated dysrhythmias with antidysrhythmics

reduce post- MI mortality with aspirin and ACE inhibitors

31
Q

in treating MI the function of thrombolytic therapy is to

A

restore blood supply to the damaged myocardium

32
Q

the primary risk during thrombolytic therapy is

A

excessive bleeding

33
Q

following an acute MI , metoprolol (lopressor) is infused slowly until

A

a target heart rate of 60-90 beats perminute is reached

34
Q

opiods such as morphine sulfate are sometimes administered to patients with MI to

A

reduce acute pain associated with MI

35
Q

the nurse should administer aspirin as soon as possible following an suspected MI in order to

A

reduce post MI mortality

36
Q

patients at high risk for stroke are often treated with

A

antihypertensives

37
Q

a drug that blocks impulses from the parasympathetic nervous system is known as

A

cholinergic blocker

38
Q

which cardiac enzyme would the nurse expect to elevate first ina client diagnosed with an MI

A

Troponin

39
Q

along with persistent, crushing chest pain, which signs/symptoms would make the nurse suspect that the client is experiencing an MI

A

diaphoresis and cool clammy skin

40
Q

The client diagnosed with rule out myocardial infarction is experiencing chest pain while walking to the bathroom. Which action should the nurse implement first

A

have the client sit down immediately.

41
Q

The nurse caring for a patient diagnosed with MI who is experiencing chest pain. what interventions should the nurse implement

A

administer aspirin

apply O2

42
Q

The patient who had an MI is admitted to the telemetry unit from ICU. which referel is most appropriate for the patient

A

cardiac rehab

43
Q

patient is day one post-op coronary artery bypass sugery. the client complains of chest pain. which intervention should the nurse implement first

A

assess the clients chest dressings and vital signs

44
Q

patient diagnosed with MI is 6 hours post right femoral percutaneous transluminal coronary angioplasty, which assessment data would require immediate attention by the nurse

A

complains of numbness in right foot

45
Q

the ICU nurse is assessing the client who is 12 hours post MI. The nurse assesses an S3 heart sound. Which intervention should the nurse implement

A

notify the health care provider immediately

46
Q

The nurse is administering a calcium channel blocker to the client diagnosed with a MI. Which assessment data would cause the nurse to question administering this medication

A

the clients bood pressure is 90/62

47
Q

The client diagnosed with MI is on bedrest. The CNA is encouraging the client to move the legs. Which action should the nurse implement

A

praise the CNA for encouraging the client to move his legs

48
Q

The client diagnosed with a MI asks the nurse “why do I have to rest and take it easy? My chest doesn’t hurt anymore” Which statement would be the nurse’s best response

A

your heart is damaged and needs abou four to six weeks to heal

49
Q

The client has just returned from a cardiac catheterization. Which assessment data would warrant immediate intervention from the nurse

A

the client refuses to keep the leg straight.

exam 2 (9 decks)

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