Brainscape's Knowledge GenomeTM

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


See full index

HAPS > Cardiac - powerpoint > Flashcards

Cardiac - powerpoint Flashcards

1
Q

atrioventricular (AV) valves

A

tricuspid

mitral (aka bicuspid)

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

semilunar valves

A

pulmonic

aortic

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

systole

A

contraction of the ventricles

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

S1

A 
lub
onset of systole
closure of the mitral and tricuspid valves
aka closure of AV vales
louder at the apex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

diastole

A

Diastole- relaxation of the ventricle

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

S2

A

dub
onset of diastole = closure of aortic and pulmonic valves
Louder at the base

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

blood flow through the heart

A 
R. Atrium >
Tricuspid valve >
Right ventricle >
Pulmonic valve >
Pulmonary artery >
Lungs >
Pumonary veins >
Left atrium > 
Mitral valve > 
Left ventricle>
Aortic valve>
Aorta
> BODY
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

3 major coronary arteries

A

Left Anterior Descending artery
Left Circumflex artery
Right Coronary artery

**Coronary arteries receive their blood supply from the aorta and supply blood to the myocardium.

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

automaticity

A

Ability of pacemaker cells to initiate an impulse spontaneously and repetitively
The conduction tissue area with the highest rate of automaticity assumes the role of pacemaker, normally the SA node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

contractibility

A

The ability to respond to this impulse with pump action.

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

sympathetic nervous system

A

Increase heart rate, speed of conduction and vigor of contraction

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

parasympathetic nervous system

A

Decrease rate of firing of the SA node, speed of conduction and force of contraction

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

subjective info questions

A 
chest pain
dyspnea
orthopnea
cough
fatigue
cyanosis, pallor
edema
nocturia
past cardiac Hx
family cardiac Hx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

auscultating the carotids

A

Auscultate each carotid arteries for the presence of a bruit with your bell
This swishing sound indicates turbulence therefore… none should be present
If it is present, the patient is at risk for TIA, CVA.
It is present if the lumen is occluded by ½. After the lumen is 100% occluded, the bruit will disappear.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

measuring JVP

A

Place one ruler vertically at the sternal angle.
Locate the pulsation and place another ruler at the level of the pulsation.
Line up the two rulers as a T.
Measure JVP at the level where the horizontal ruler intersects the vertical ruler.
Ideally the measurement should be less than 2 cm

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

palpating chest

A

Palpate over the valve areas for thrills
Thrills are vibratory sensations caused by the heart and felt on the body surface
Thrills are indicative of turbulent blood flow
Check for thrills over the apex, base, and left sternal border

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

diaphragm use on stethascope

A 
Diaphragm = used for high pitched sounds
S1 and S2
Murmurs 
Bell = low pitched sounds
S3 and S4
Murmurs 
Bruits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

S3

A

loudest at APEX additional sound “KENTUCKY”
Can be physiologic (normal) or pathologic (abnormal).
Physiologic S3 is heard in children and young adults
May last to age 40 in women.
Also called a ventricular gallop indicates decreased compliance of ventricles and indicative of heart failure

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

S4

A

S4- comes before S1 and is called an atrial gallop = and sounds like “TENNESSEE”
May indicate Right ventricular hypertrophy, CHF, coronary artery disease, hypertension.

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

murmurs

A

Sound produced by turbulence of abnormal blood flow through a valve
When listening for murmurs:
Determine the timing in the cardiac cycle
Do they occur in systole? (heard between S1 and S2)
Do they occur in diastole? (heard between S2 and S1)

MAIN CAUSES
Stenotic valve
Regurgitant or insufficient valve
Abnormal passage between heart chambers

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

pericardial friction rub

A

Produced by inflammation (Pericarditis)
Heard best at apex and along left sternal border
Lean patient forward
Sounds like sand paper rubbing together

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

infants

A

Heart rate may range from 100 to 180 beats per minute immediately after birth
Infants normally have wide fluctuations with activity, from 170 bpm or more with crying or being active to 70 to 90 bpm with sleeping
Rapid rates make it more challenging to evaluate heart sounds
Expect heart sounds to be louder in infants than in adults because of infant’s thinner chest wall.
Murmurs in immediate newborn period do not necessarily indicate congenital heart disease
Murmurs are relatively common in first 2 to 3 days because of fetal shunt closure
These murmurs are usually grade I or II
They are systolic and accompany no other signs of cardiac disease, and they disappear in 2 to 3 days
On the other hand, absence of a murmur in immediate newborn period does not ensure a perfect heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

SA node

-normal heart rate

A

60-100

normal pacemaker of the heart

24
Q

AV node

A 
– Receives electrical impulse from SA
node
– Delays impulse before conduction
– Enables atrial contraction to be
completed before ventricles contract
– Can become the pacemaker
25
Q

purkinje fibers

A

Conduct impulse to ventricular muscle
cells
– Cause ventricular depolarization and
contraction

26
Q

In cardiac cycle, what is P wave

A

atrial depolarization

27
Q

QRS complex

A

ventricular depolarization

P wave and QRS wave follow each other

28
Q

T wave

A

ventricular repolarization

(resting state of the heart)

29
Q

small and large boxes on strip

A

Each small square represents 0.04 seconds

Each large square (surrounds 5 small squares) = 0.20 seconds

30
Q

Reading a strip

-what are the steps

A 
First determine the rate
rhythm analysis
analyze the p waves
measure the PR interval
QRS duration
31
Q

ways to count the rate

A

count the number of complexes in 6 seconds of time
and multiply by 10.
This will equal beats per minute.
This is usually used for irregular rhythms

OR for regular rates:
1500 divided by the number of small squares
between complexes (R-R)

Count the number of big blocks between
complexes (R-R) and divide that into 300

32
Q

PR interval

A

• Measure the P-R interval from the
beginning of the P wave to the R wave

(normally 0.12 to 0.20 seconds)

• This measures the electrical impulse through the atria and the delay that normally occurs at the AV node

33
Q

QRS duration

A

normally 0.4 - 0.10

represents ventricular depolarization

34
Q

What is NSR

A
  • Rhythm is regular
  • Rate is 60-100
  • P waves are rounded and come before each QRS and all look alike
  • PR interval is between 0.12-0.20 seconds
  • QRS interval is less than 0.10 seconds
35
Q

Bradycardia - what is it

A
  • Slower than normal heart rate.
  • The beat is originating from the SA node.
  • The rhythm is regular, the rate is less than 60,
  • P waves are smooth and regular, QRS .06-.10
  • It’s just like a Normal Sinus rhythm, But SLOW.
  • There are no symptoms unless it’s so slow that cardiac output is reduced.
36
Q

Tachycardia - what is it

A

• heart rate greater than 100 BPM originating from the SA node.
•Rate is regular, P waves are regular and rounded, PR interval .12-
.20, QRS is .06-.10
•It’s the same as Normal Sinus Rhythm, but FAST.
•If the heart rate is rapid for a long period, the patient may
experience angina or dyspnea.
•Patient’s with a heart history, can not tolerate tachycardia asmuch as a healthier person!

37
Q

PAC - what is it

A
  • “Early Beat” The atria fires an impulse due to irritability and a premature beat results.
  • The impulse does not always originate from the SA node. The rate has irregularities.
  • P wave often look different or it may be buried in the T wave
38
Q

PAC - causes and treatment

A 
• Possible causes
– Stress
– Fatigue
– Anxiety
– Inflammation
– Infection
– Caffeine/nicotine/alcohol
  • Treatment is aimed at the cause
  • Usually no symptoms but the patient will feel palpitations
  • Medications used are anti-dysrhythmic medications
39
Q

Supraventricular tachycardia

A

Occurs with rapid stimulation of atria at a rate of 100-280
P waves may not be visible
Depending on whether it is sustained or not sustained will
determine if the patient is symptomatic or not.

40
Q

Atrial Fibrillation

  • what is it
  • causes
  • treatment
A
  • An atrial rate of 350-500 can occur.
  • The AV node blocks most impulses so the ventricular rate is much lower than the atrial rate.
  • There is no definable P waves because the atria are fibrillating or quivering.
  • There is an increased risk of thrombus formation which can result in stroke due to the heart dilation and blood pooling.
  • You can usually tell if the patient has this as their pulse is irregular and thready.

• Cardioversion or medications are usually indicated.

• A Fib occurs with patients who have HTN, heart failure, CAD, have had TIA’s or strokes
• As it progresses, cardiac output can decrease as much as 20%-30%
• Treatment includes anti-dysrhythmic meds
such as beta blockers, digoxin, cardizem or amiodarone.
• Anticoagulants are given due to the increased risk for emboli

41
Q

PVCs - what is it

A

• These dysrhythmias originate in the ventricles from
an ectopic focus (ectopic = a site other than the SA node).
• The ventricles are irritable and fire prematurely,
before the SA node normally would. The result is a
widened strange looking QRS complex.
– Unifocal PVC: originated from the same place in the
ventricle. The odd shaped QRS complexes look the same.
– Multifocal PVC: originates several different places in the
ventricle. The odd shaped QRS all look different.
• Now look back at the next slide and you can see the
two different types.

Bigeminy: every other beat is a PVC
Trigeminy: every 3rd beat is a PVC
Couplet: there is a pair of PVC’s
PVC’s can be felt by the patient and are usually caused by to
much caffeine, nicotine or alcohol.
42
Q

PVCs

- nursing interventions

A
  • Make special concerns with patients who are having PVC’s and have a history/or current issue of MI’s as this could potentially progress to life threatening ventricular tachycardia or ventricular fibrillation.
  • Palpate the peripheral pulses during an episode to ensure adequate perfusion.
43
Q

Ventricular tachycardia

- what is it

A

When there are 3 or more PVC’s in a row. The ventricles
become the pacemaker of the heart.
Is it serious?? Depends on how long it lasts.
Intermittant is less than 15 seconds
Sustained is longer than 15-30 seconds

44
Q

V Tach

- treatment

A

• V Tach can cause cardiac arrest
• Assess the patient’s airway, breathing, circulation, LOC, and oxygen level.
• Administer oxygen, and administer meds as ordered such as
– Amiodarone, lidocaine, or mag sulfate

45
Q

Ventricular Fibrillation

- what is it

A

When many ectopic ventricular foci fire at the same time. Ventricular activity is chaotic with no definite waves. Because of the chaos, there is NO contraction.
There is no cardiac output or pulse. This is fatal if not ended within 3-5 minutes

46
Q

V Fib

- treatment

A

• The patient will become faint, lose consciousness, pulseless, and apneic.
• There are no heart sounds
• Seizures can occur and the pupils become fixed and dilated
• Defibrillation is REQUIRED
• Medications included with defibrillation are:
– Vasopressin, epinephrine, amiodarone,
lidocaine, mag sulfate

47
Q

Systole

  • what is it
  • treatment
A

THIS is a full cardiac ARREST
Treatment indicated is:
Epinephrine and atropine…no shocking

48
Q

First degree AV block

A
  • PRI greater than 0.20
  • Rhythm remains regular
  • Marital problems start
49
Q

Second degree AV block

A
  • Progressive lengthening of PRI until one P wave is not conducted through to the ventricles
  • Separation of the couple begins
50
Q

third degree AV block

A
  • No conduction of atrial impulses
  • Atria and ventricles beat independently and P:QRS have no sequential relation
  • Now Divorced
51
Q

Cardioversion

A

• Used for dysrhythmias that do not respond to drug
therapy.
• The pads are placed where you would listen to S1 and S2
• The patient is sedated and the shocks start with a range of 25-50 joules.
• If successful the SA node will regain control of the heart
• A consent is required and the patient is sedated.
• Assess the cardiac response after the first synch has been delivered
• Turn oxygen back on if it had been turned off.

52
Q

Defibrillation

A

It delivers an electrical shock to reset the hearts rhythm.
• Indicated in V-Fib or pulseless V-tach
• Pads are placed on the patients chest to prevent burning and promote the conduction of the electrical charge.
• The pads are placed where you would listen to S1 and S2.
• A total of 3 shocks can be initially given starting at 100
joules, -200-300-360

53
Q

nursing interventions during defibrillation/ CODE

A
  • Oropharyngeal airway
  • Manual resuscitation with mask is attached to flowmeter and set at 15 liters
  • Maintain airway and ventilation with chin lift position
  • 2 large bore IV lines are needed
  • Set up suction, incase the patient vomits
  • Check pulses during compressions and without compressions
  • Check blood pressures and pupils every few minutes
  • Any responses and actions need to be recorded
  • Continue CPR until physician terminates
54
Q

Apex- where is it

A

5th intercostal space

55
Q

where will you hear a murmur

A

Erbs point

56
Q

ectopic means:

A

a site other than the SA node

HAPS (4 decks)

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