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Cardiology > Cardiac Test #2 > Flashcards

Cardiac Test #2 Flashcards

1
Q

What is CHF?

A 
• Congestive Heart Failure
• Inability of  heart to pump effectively
• Syndrome that gets worse over time
• Long term dx- lifetime but manageable 
• Back flow of bld in pulmonary or 
  systemic system
• Development of compensatory
   mechanisms
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2
Q

What is left-sided heart failure?

A
  • Blood backs up into lungs bc bld in lt side of heart come from the lungs
  • The heart not giving the kidneys enough bld to do its job
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3
Q

What does left-sided heart failure cause?

A 
• Pulmonary edema 
           Cough            
           Dyspnea            
           Orthopnea           
           Crackles
• Impaired Kidney function
• Cerebral Anoxia
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4
Q

What is Dyspnea?

A

• labored breathing that occurs because of low O2

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5
Q

What is Orthopnea?

A
  • Labored breathing that occurs when laying flat.

* Relieved by sitting up or leaning over bedside table

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6
Q

What is BUN?

A
  • Blood Urea Nitrogen (a blood test)

* Measures kidney function (urine waste)

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7
Q

What is Cerebral Anoxia?

A

• Lack of 02 to the brain

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8
Q

What is right-sided heart failure?

A

• Blood backs up into extremeties ex edema in feet

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9
Q

What does right-sided heart failure cause?

A
  • Dependent edema
  • Weight gain
  • Liver and GI tract complications
  • Frequent urination at night
  • JVD
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10
Q

What is dependent edema?

A
  • means dependent on gravity.

* fluid accumulates in lower extremities ie ankles and feet

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11
Q

What causes weight gain?

A

Fluid retention

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12
Q

What is JVD?

A
  • Jugular Vein Distention

* Major symptom of heart dz

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13
Q

What is cor pulmonale?

A
  • Right sided heart failure
  • Enlargement of rt ventricle due to ↑BP in lungs
  • Caused by chronic lung dz ex COPD
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14
Q

How is CHF diagnosed?

A
  • BUN/ Creatinine bld test
  • BNP bld test
  • Thyroid bld test
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15
Q

What is BNP?

A

> Brain Natriuretic Peptide

• Hormone produced in response to over stretching of the ventricles

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16
Q

What is a low sodium diet?

A
  • Tx of CHF
  • Limit of sodium to approx 2.5 Gm/day
  • Avoiding ↑ sodium foods
  • Some pts restricted to 2 Gm/day
  • Be aware of other sources of sodium in foods
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17
Q

What is allowed on a low sodium diet?

A
  • Salt substitute

* Ex Mrs Dash

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18
Q

What must be considered when choosing a salt substitute?

A

• Remember some salt substitutes are high in potassium

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19
Q

What foods are high in sodium?

A
  • Salted pretzels
  • Salted popcorn
  • Ham
  • Salami
  • Cheese
  • Can vegs
  • Ketchup
  • Olives
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20
Q

What does Digoxin do?

A
  • A diuretic
  • Slows & strengthens heart contractions
  • Increase cardiac output by allowing heart to fill better
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21
Q

What are nrsg considerations for a pt on Digoxin?

A
  • Check heart rate before giving

* Apical rate must b> 60 bpm

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22
Q

What are signs of Digoxin toxicity?

A
  • Bradycardia
  • Arrhythmias
  • Abdominal pain, N/V, anorexia
  • Visual problems (halo)
  • Low potassium levels
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23
Q

Why do the elderly run a risk for developing digoxin toxicity?

A
  • Have slower metabolism so digoxin takes a longer time to pass thru system (liver)
  • Low potassium level makes risk for toxicity ↑ (bc of taking diuretics)
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24
Q

What is the generic name for Lasix?

A

Furosemide

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25
Q

What does Lasix do?

A
  • Inhibits reabsorption of sodium & chloride from loop of Henle & distal renal tubule.
  • ↑ renal excretion of water, sodium, chloride, magnesium, potassium, & calcium.
  • ↓ BP
  • Main effect: fluid loss
  • Diuresis-act of kidneys filtering out & making future urine
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26
Q

What are lab values for Potassium?

A

• 3.6-5.0 MMOL/L

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27
Q

What are lab values for Sodium?

A

• 137-145 MMOL/L

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28
Q

What are complications if Potassium is too high?

A
  • Hyperkalemia

* Wh leads to arrhythmias

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29
Q

What are complications if Potassium is too low?

A
  • Hypokalemia

* Wh leads to arrhythmias

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30
Q

What is Raynaud’s Dz?

A

• A problem involving artery blood flow

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31
Q

What does Raynaud’s Dz do?

A

• Vasospasm and constriction usually in the hands

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32
Q

What are S&S of Raynaud’s Dz?

A
  • skin of hands and nailbeds get pale or cyanotic from lack of circulation
  • very painful
33
Q

What brings on an attack of Raynaud’s Dz?

A
  • When skin is exposed to cold temps

* Prolonged exposure to vibrations such as jackhammers – drills etc.

34
Q

What is Tx for Raynaud’s

A
  • avoid triggers (jackhammers – drills etc)
  • wear gloves
  • May need to take Calcium Channel Blockers for vasodilatation effect
35
Q

What is Rheumatic heart Dz?

A

• It is a consequence of rheumatic fever which develops after repetitive consequences of strep throat.

36
Q

What does Rheumatic Dz cause?

A

• It causes the valves of the heart to become calcified and not work properly

37
Q

What parts do Rheumatic Dx affect?

A

• The heart valves

38
Q

What is Endocarditis?

A
  • Inflammation of the inner lining of the heart
  • Bacteria enters the bld stream & settles in the inner lining of the heart (colonies)
  • Primarily affects the heart valves-they become calcified and do not work properly
39
Q

Who is at risk for Endocarditis?

A
  • People who already have heart valve abnormalities such as rheumatic hrt dz.
  • Have mitral valve prolapse
  • Have had a valve replacement
  • IV drug users
40
Q

What are symptoms of Endocarditis?

A
  • Intermittent low grade fever
  • fatigue
  • wt loss
  • pain in joints
  • little bleeds under fingernails
41
Q

What is Tx for Endocarditis?

A
  • IV antibiotics

* Usually need for 4-6 weeks

42
Q

What is an Aneurysm?

A
  • a bulging – weakened, outpouching of an arterial wall
  • tends to enlarge over time
  • Most common is AAA (abdominal Aortic Aneurysm)
43
Q

What are varicose veins?

A
  • Abnormally dilated veins

* Secondary to incompetent valves

44
Q

What causes vericose veins?

A
  • Occupational
  • Obesity
  • Pregnancy
  • Hereditary
45
Q

What to do to keep varicose veins from getting worse?

A
  • Promote venous return
  • Elevate legs
  • Use non restrictive clothing
  • Leg exercises
  • Losing weight
  • Avoid long periods of standing
  • AE hose (compression stocking)
46
Q

What are Txs for varicose veins?

A
  • Sclerotherapy-injection of solution into the affected vein
  • Laser surgeries-energy heats up vein and collapses it
  • Vein ablation-use of hot tipped catheter (like laser technique)
47
Q

What is Thrombophlebitis?

A
  • Thrombophlebitis is inflam of vein (usually extremity, especially legs)
  • occurs in response to a blood clot in the vessel
  • When it occurs in a vein near the surface of the skin, it is known as superficial thrombophlebitis, a minor disorder commonly identified by a red, tender vein.
48
Q

What is DVT?

A
  • Deep Vein Thrombosis
  • An abnormal blood clot development in a VEIN (not an artery)
  • Usually in the legs
  • Clot obstructs blood flow in the vein
49
Q

What is a thrombus?

A

• A clot that is stationary-fixed in place

50
Q

What is an embolus?

A
  • Clot that breaks free from the thrombus

* Floats around in the bld stream

51
Q

What are symptoms of DVT?

A
  • pain
  • swelling
  • warmth
  • discoloration/mottled skin
52
Q

How can DVT be avoided?

A
  • be active – moving
  • leg exercises if bed-bound
  • stop smoking
  • weight loss
  • If traveling get out of seat qhr or q 2 hrs
  • stay hydrated
  • Compression stockings
53
Q

What are basic Tx for DVT?

A
  • Elevate extremity on pillows
  • Apply heat to the area-moist heat is best
  • Medications-heparin and Coumadin
54
Q

What are the do’s and don’ts in the care of a pt w/DVT?

A
  • Do not massage the are-may cause part of the thrombus to break off
  • Do check lab values and for bld in stools
55
Q

What does Coumadin do?

A

• Coumadin/Warfarin helps to pevent blood clots from forming or from getting bigger, but it does not dissolve blood clots

56
Q

What are the risks of Coumadin to the pt?

A
  • Abnormal bleeding
  • paralysis
  • pink or brown urine
  • sudden shortness of breath
  • unexplained bruising
  • unusual pain or swelling
57
Q

What does Heparin do?

A
  • helps to keep blood flowing smoothly and from clotting by making a certain natural substance in your body (anti-clotting protein) work better.
  • An anticoagulant-prevents formation of clots
  • Does not break down existing clots
58
Q

What are the risks of Heparin to a pt?

A
  • sudden numbness or weakness, especially on one side of the body;
  • sudden severe headache, confusion, problems w/vision, speech, or balance;
  • chest pain, sudden cough, wheezing, rapid breathing, fast heart rate;
  • pain, swelling, warmth, or redness in one or both legs;
  • trouble breathing
  • fever, chills, runny nose, or watery eyes.
  • Abnormal bleeding
59
Q

what is the relationship btw a PTT test and Heparin?

A
  • Partial thromboplastin time (PTT) a blood test that looks at how long it takes for blood to clot. It can help tell if you have bleeding or clotting problems.
  • Done to check the clotting time for pts on heparin
60
Q

What is the relationship btw PT/INR test and Coumadin?

A
  • The PT and INR are used to monitor the effectiveness of the anticoagulant warfarin (COUMADIN)
  • Checking the clotting time for pts on Coumadin
61
Q

What is HTN?

A
  • hypertension
  • a persistent elevation of blood pressure (not just one time reading)
  • Medical dx
62
Q

What is essential HTN?

A
  • When there is no identifiable cause of ↑ BP
  • This type of ↑ BP, called essential hypertension or primary hypertension
  • tends to develop gradually over many years
63
Q

What is secondary HTN?

A
  • ↑BP caused by an underlying condition

* When another known cause like kidney dz is responsible for the HTN.

64
Q

What are the risks factors for HTN?

A
  • Older age
  • Race/ethnicity (Afr Amer)
  • Family hx/genetics (immediate family member with elevated BP before age 60)
  • Overweight (body mass >25)
  • Diet (salt sensitive – high fat)
  • Smoking
  • Alcohol (excessive use can elev BP)
  • Lack of exercise
  • DIabetes (leads to atherosclerosis)
  • Stress
65
Q

Whare are possible findings on a physical exam for HTN?

A
  • enlarged thyroid
  • distended neck veins
  • bruits in the carotid arteries
  • Clubbing of fingers
  • Edema in lower extremities
  • Retina changes
66
Q

What are standard Txs for HTN?

A
  • Limit alcohol
  • Stop smoking
  • Reduce caffeine intake
  • Reduce stress
  • Exercise
  • Weight control
  • Reduce sodium intake
  • Monitor BP regularly
  • DASH diet
67
Q

What is the DASH diet?

A
  • Dietary Approach to Stop Hypertension
  • Low in saturated fats and cholesterol
  • Whole grains
  • Fruits
  • Vegetables
  • Low-fat dairy products
68
Q

What medications are given for HTN?

A
  • Diuretics
  • Beta Blockers
  • Calcium Channel Blockers
  • ACE inhibitors
69
Q

What are general side effects of antihypertensive medications?

A
  • dizziness
  • Orthostatic hypertension
  • Annoying cough
70
Q

What are “lol’s”?

A

• Beta blockers

71
Q

What are “pine’s?

A

• Calcium Channel blockers

72
Q

What are “prils”

A

• ACE Inhibitors

73
Q

What are statins?

A

• Cholesterol lowering

74
Q

What are some Diuretics?(3)

A
  • Thiazides – (HCTZ)
  • Loop diuretics – Lasix
  • Potassium sparing – Aldactone
75
Q

Name some Beta blockers (3)

A
  • Atenolol (Tenormin)
  • Metoprolol (Lopressor)
  • Propranolol (Inderal)
76
Q

Name some Calcium Channel Blockers (2)

A
  • Amlodipine (Norvasc)

* Nifedipine (Procardia)

77
Q

Name some ACE Inhibitors (2)

A
  • Enalapril (Vasotec)

* Lisinopril (Zestril)

78
Q

How can you tell a med category by looking at the generic name?

A
  • Beta Blockers-“lol’s”
  • Calcium Channel Blockers-“pines”
  • ACE inhibitors-“prils”
  • Cholesterol meds-“statins”
79
Q

Who is gonna ROCK this Cardio test?

A

I AM ! ! ! !

Cardiology (3 decks)

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