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NCLEX YOU GOT THIS! > Cardiac YOU GOT THIS! > Flashcards

Cardiac YOU GOT THIS! Flashcards

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1
Q

permanent ventricular pacemaker

A

pts with permanent pacemaker should be assessed for both electrical capture and mechanical capture best method for mechanical capture is either auscultation of apical or palpation of femoral… assess for pulse deficit

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2
Q

atrial pacing

A

pacer spikes precede P waves

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3
Q

ventricular pacing

A

pacer spikes precede QRS complexes

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4
Q

IV potassium

A

NEVER ADMINISTERED BY GRAVITY D/T risk for lethal arrhythmias if administered too quickly

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5
Q

triple-lumen peripherally inserted central catheter

A

indicated for administration of noxious meds (parenteral nutrition, chemotherapy), long-term IV therapy or in clients with poor venous access

  • dresing change every 48 HOURS with a gauze dress or 7 days with a transparent semipermeable dressing (biopatch) or immediately if dressing is loose/torn, soiled or damp
  • all infusing meds (EXCEPT VASOPRESSORS) must be paused before drawing blood
  • scrub hub 10-15 seconds
  • dressings that no longer occlude the insertion site must be changed immediately, loose corners reinforced by tape
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6
Q

Thoracic aortic aneurysm

A

can put pressure on the esophagus and cause dysphagia this may indicate aneurysm has increased in size

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7
Q

atropine uses

A

“death rattle” noisy rattling with breathing in dying client, can help manage airway secretions

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8
Q

decreased cardiac output

A 
decreased perfusion to the body 
decreased LOC
wet lung sounds
SOB
cold and clammy 
decr UOP
weak peripheral pulses
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9
Q

widened QRS wave

A

often seen in PVCs, electrolyte imbalances and drug toxicity

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10
Q

treatment for sinus brady

A

correct underlying cause

may be d/t CCB, beta blockers, amiodarone
vagal stim
lower metabolic needs

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11
Q

causes of sinus tachy

A 
stress
some meds like epi, illicit drugs, stimulants
heart failure
cardiac tamponade 
hyperthyroidism
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12
Q

causes and treatment of v-tach

A 
causes 
myocardial ischemia/infarction
electrolyte imbalances
digoxin toxicity 
stimulats

treatment:
stable w a pulse: o2, antidysrhythmias (amiodarone), synchronized cardioversion
unstable without a pulse: cpr, possible intubation, drug therapy (epinephrine, vasopressin, amiodarone)

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13
Q

causes and treatment for vfib

A

causes
cardiac injury, medication toxicity, electrolyte imbalances, untreated ventricular tachy
treatment
CPR, o2, defib, possible intubation, drug therapy (vasoconstrictors like epi, antiarrhythmic like amoidaraon, lidocaine and then possibly magnesium)

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14
Q

a fib causes and treatment

A

causes
open heart surgery, heart failure, copd, htn, ischemic heart disease
tx of stable pt: o2, drug therapy (neta blockers, ccb, digoxin, amiodarone, anticoagulant therapy)
tx of unstable pt: o2, cardioversion

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15
Q

QRS depolarization

A

ventricular

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16
Q

p wave

A

atrial

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17
Q

p waves in the form of a saw tooth wave

A

atrial flutter

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18
Q

chaotic p wave patterns

A

a-fib

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19
Q

chaotic QRS complexes

A

v-fib

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20
Q

bizarre QRS complexes

A

v-tach

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21
Q

periodic wide bizarre QRS complexes

A

PVCs

22
Q

PVCs

A 
typically low priority 
moderate priority when:
6 or more PVCs in a minute 
more than 6 PVCs in a row 
R on T phenomenon (PVC falls on a T wave)

**PVCs after MI is common, low priority

23
Q

lethal arrhythmias

A

HIGH PRIORITY

  • asystole
  • v-fib
  • both either low or no CO… little to no brain perfusion –> confusion and death
24
Q

potentially lethal cardiac arrhythmia

A

v-tach

HAS CO! means they have a pulse

25
Q

treatment of PVCs and v-tach

A

ventricular - lidocaine

amiodarone

26
Q

supraventricular arrhythmias

A 
atrial arrhythmias 
treat w ABCDs
adenocard (adenosine) - fast IV push (push in less than 8 seconds and 20 ml NS flush right after... go into asystole for 30 seconds)
Beta-blockers 
CCBs
Digitalis (digoxin), Lanoxin
27
Q

side effects of beta blockers and CCB

A

HEADACHE

HYPOTENSION

28
Q

Treatment for asystole

A

epinephrine and atropine

29
Q

normal CO

A

4-8 L/min

30
Q

normal CVP

A

2-8 mmHg

31
Q

electrical conduction of the heart

A 
SA NODE
AV NODE
BUNDLE OF HIS
BUNDLE BRANCES
PURKINJE FIBERS
32
Q

S4 sounds indicate

A

late diastole and high atrial pressure

- forcing blood into a stiff ventricle

33
Q

PVCs causes

A 
early premature conduction of QRS complex 
causes:
HF
MI 
Drug toxicity 
caffeine, tobacco, alc
stress or pain 
incr workload on heart (exercise, fever, hypervolemia, HF, tachy)
34
Q

tx of PVCS

A

tx based on underlying cause

  • o2
  • decr caffeine intake
  • correct electrolyte imbalance
  • discontinue/adjust drug causing toxicity
  • decr stress or pain
35
Q

chest pain w pvcs

A

NOTIFY HCP

36
Q

Causes of asystole

A 
MI
HF
electrolyte imbalances 
severe acidosis 
cardiac tamponade 
cocaine OD
37
Q

tx for asystole

A

HIGH QUALITY CPR, rate 100-120, depth 2-2.4 in

38
Q

atrial flutter causes

A 
cad 
htn 
hf
valvular disease 
hyperthyrodism 
chronic lung disease 
pulmonary embolism 
cardiomyopathy
39
Q

tx of atrial flutter

A

drug therapy:
CCB
antiarrhythmics
anticoagulants ** risk for clots w atrial flutter d/t blood pooling**

unstable pt: CARDIOVERSION, synchronized shock

40
Q

Left sided HF

DROWNING

A 
pulmonary symptoms!!!!
Dyspnea 
rales (crackles)
orthopnea
weakness/fatigue
noctural paroxysmal dyspnea
incr hr, uop, s3 gallop
nagging cough (frothy, blood tinged sputum)
gaining weight (2-3 lb a day)
41
Q

right sided HF

SWELLING

A 
venous symptoms!!!
swelling of legs/hands
weight gain
edema - pitting
large neck veins (JVD)
lethargy/fatigue
irregular HR
nocturia 
girth (ascites)

** also hepatomegaly, splenomegaly, anorexia

42
Q

diagnosis HF

A

bnp
chest x-ray
echocardiogram (looks at EF, back flow, valve problems)

43
Q

CAD s/s

A

ischemia –> angina pectoris (chest pain w activity, SOB, fatigued)

44
Q

CAD diagnosis and tx

A

diagnosis

  • blood test and lipoprotein profile
  • ECG - assess for changes in ST segments or T waves

tx

  • diet, exercise, stress modifications
  • coronary stent/angioplasty
  • CABG
  • *exercise goal: moderate=75 mins, vigorous = 150 mins**
45
Q

PVD tx

A
  • deoxygenated blood can’t get back up to the heart, pooling in extremities
  • venous stasis ulcers
  • elevate legs

MEDS: aspirin, clopidogrel, statins
SURGERY: angioplasty, CABG, endarterectomy

**USE DOPPLER OR ABI TO DX

46
Q

PAD tx

A

narrow artery where o2 blood can’t get to the distal extremities

  • ischemia and necrosis of extremities
  • sharp pain gets worse at night = rest pain
  • intermittent claudication
  • gangrene
  • DANGLE ARTERIES

TX

  • daily skin care w moisturizer
  • stop smoking
  • avoid tight clothing
  • NO HEATING PADS
  • VASODILATORS, ANTIPLATELETS
47
Q

angina pectoris drug therapy

A

nitrates
ccb
bb
antiplatelet/anticoag

48
Q

nitrates

A

vasodilators
decrease ischemia, decr pain
usually sublingual

49
Q

s/s of MI in women

A

fatigue
shoulder blade discomfort
SOB

50
Q

TX of MI IMMEDIATE

MONA!

A

morphine
o2
nitro
aspirin

51
Q

troponin level after mi

A

> 0.4

can remain elevated for as long as 3 weeks

52
Q

Cardiac tamponade

A

Life threatening
Muffled or distant heart tones
Hypotension
JVD

NCLEX YOU GOT THIS! (14 decks)

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