Cardio 1 Flashcards
Rhythm originates from Sinoatrial Node;
Atrial & Ventricular rates are
60-100 b/m
Multiple rapid Impulses form many Foci Depolarize in the Atria in a Totally Disorganized Manner at a Rate of 350-600 times/min
Atrial Fibrillation
Atria Quiver, Can lead to formation of Thrombi
Atrial Fibrillation
No definitive P -Wave, only fibrillatory waves before each QRS
Atrial Fibrillation
Oxygen, Anticoagulants (risk of emboli), cardiac meds to control ventricular rhythm & assist in maintenance of CO, Cardioversion, meds to control dysrhythmia.
Atrial Fibrillation
Early Ventricular Complexes result from Increased Irritability of the Ventricles
PVCs
Premature Ventricular Contractions
Can occur in repetitive patterns: bigeminy (q other Hbeat), trigeminy (q 3rd Hbeat), quadrigeminy (q 4rth Hbeat); Or Unifocal (Upward/Downward deflection), Multifocal (diff shapes, impulses in different sites)
PVCs
Premature Ventricular Contractions
Evaluate SpO2 to assess for Hypoxemia
Can cause PVCs
administer O2
Hypokalemia
Can cause PVCs
Repetitive Firing of an Irritable Ventricular Ectopic focus at a rate of 140-250 bpm
VT
Ventricular Tachycardia
May present as a Paroxysm of 3 self-limiting beats or more or may be a sustained rhythm
VT
Ventricular Tachycardia
Can lead to Cardiac Arrest
VT
Ventricular Tachycardia
- oxygen
2. antidysrhythmics
Stable / sustained VT (Pulse, no S/S of < CO)
- oxygen
- antidysrhythmics
- Synchronized Cardioversion (unstable)
- Cough Cardiopulmonary Resuscitation (CPR), cough hard q 1-3 sec
Unstable/ VT (Pulse, S/S of <CO)
Defibrillation & CPR
Pulseless w/ VT
Impulses from many irritable foci in Ventricles fire in disorganized manner; chaotic rapid rhythm in which ventricles quiver & there is no Cardiac Output
VF
Ventricular Fibrillation
Fatal if not successfully terminated within 3-5 min; absent Pulse, BP, RR, H-Sounds
VF
Ventricular Fibrillation
- CPR
- O2
- AntiDysrhythmic therapy
VF
Ventricular Fibrillation
Induce vagal stimulation of Cardiac Conduction System & are used to Terminate Supraventricular Tachydysrhythmias
Vagal Maneuvers
bear down or induce gag reflex to stimulate vagal response; Monitor HR, Rhythm, BP, Aspiration Precautions
valsalva maneuver
Synchronized Countershock to Convert an Undesirable rhythm to a stable rhythm
Cardioversion
for stable tachydysrhythmias resistant to medical therapies or an Emergent procedure for hemodynamically Unstable ventricular or supraventricular tachydysrhythmias
Cardioversion
Asynchronous countershock used to terminate Pulseless Ventricular Tachycardia (VT) or VF
Defibrillation
resume CPR, 5 Cycles or 2 min, shock as necessary if VF or pulseless VT continues
Temporary or Permanent Device that Provides Electrical Stimulation & Maintains the HR when the Client’s Intrinsic Pacemaker fails to Provide a Perfusing Rhythm
Pacemakers
Internal Pulse generator, Surgically Implanted in subQ pocket below Clavicle
Permanent Pacemakers
Leads passed transvenously via cephalic or Subclavian vein to Endocardium on R side of Heart; Post-op limitation of arm movement on operative side required to prevent lead wire dislodgement
Permanent Pacemakers
Single-Chambered : lead wire placed in chamber to be paced.
Dual-Chambered: lead wires placed in both R Atrium & Ventricle
Permanent Pacemakers
Biventricular pacing of ventricles allows for synchronized depolarization & is used for moderate to severe HF to improve CO
Permanent Pacemakers
causes decreased perfusion of myocardial tissue & inadequate myocardial oxygen supply; leads to: HypErtension, Angina, Dysrhythmias, MI, HF, & Death
CAD
Narrowing/ Obstruction of one or more coronary arteries from atherosclerosis (accumulation of lipid-containing plaque in arteries)
CAD
More than one artery supplying a muscle w/ blood, normally present in coronary arteries & older adults
Collateral Circulatio
symptoms occur when coronary artery is occluded to the point that inadequate blood supply to muscle occurs, causing ischemia
CAD
goal of tx is to alter atherosclerotic progression
CAD
- Chest Pain
- Palpitations
- Dyspnea
- Syncope
- Cough/ Hemoptysis (spitting up blood)
- Excessive Fatigue
CAD
ECG (Electrocardiogram) shows: ST-segment Depression &/or T-wave Inversion
Ischemia from reduced blood flow in CAD
ECG (Electrocardiogram) shows: ST-segment Elevation, followed by T-Wave Inversion & Abnormal Q-Wave
Infarction
in CAD/ ischemia/ infarction, this provides definitive source for diagnosis; shows presence of atherosclerotic lesions
Cardia Catheterization
elevated Blood Lipid Levels
CAD
Low calorie, sodium, cholest., fat diet ++ Fiber
CAD
to compress plaque against wall of artery & dilate vessel (CAD + Angina)
PTCA (percutaneous transluminal coronary angioplasty
to vaporize plaque (CAD + Angina)
laser angioplasty
to Remove plaque from artery (in CAD + Angina)
Atherectomy
to prevent artery from closing & prevent restenosis (in CAD + Angina)
Vascular stent (bare metal or drug-eluting)
to Improve blood flow to Myocardial Tissue at risk for ischemia or infarction b/of occluded artery (in CAD + Angina)
Coronary Artery Bypass Grafting
to Dilate coronary arteries & Decrease Preload & Afterload
Nitrates
CAD + Angina
to Dilate coronary arteries & Reduce Vasospasm
Calcium Channel Blockers
CAD + Angina
to reduce development of Atherosclerotic plaques
Cholesterol-Lowering medications
CAD + Angina
to reduce BP in Hypertensive individuals
B-Blockers
CAD + Angina
