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Cardiology > Cardio #1 > Flashcards

Cardio #1 Flashcards

1
Q

What is the Endocardium?

A

a. innermost layer of heart

b. line inside of heart

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2
Q

What is the Myocardium?

A

a. middle muscular layer
b. Thickest part
d. Does all the work

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3
Q

What is the Peri/epicardium?

A

a. outermost part of heart

b. Protective covering

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4
Q

What are the major vessels of the heart?

A

a. Aorta: Main Street
b. Superior vena cava
c. Inferior vena cava
d. Pulmonary artery
e. Pulmonary vein

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5
Q

What are the chambers of the heart?

A

a. Rt atrium
b. Lt atrium
c. Rt ventricle
d. Lt ventricle

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6
Q

What are the valves of the heart?

A

a. Aortic semilunar valve
b. Pulmonary semilunar valve
c. Tricuspid valve
d. Bicuspid valve

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7
Q

How does blood flow thru chambers of the heart?

A 
Into rt atrium-------
tricuspid valve-------
rt ventricle------
pulmonary semilunar valve------
Pulmonary artery-------
capillaries in lung-------
pulmonary veins------
lt atrium-------
Bicuspid (mitral) valve-------
lt ventricle-------
aortic semilunar valve-------
aorta
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8
Q

What might indicate Risk for heart Dz?

A

a. chief complaint: reason pt came to see
doc ex chest pain, SOB, tiredness
b. past medical hx: stressed, meds, past
surgeries, existing conditions
c. medications
d. family hx: has the pt or anyone in his/her
family ever had a heart attack, any heart
disease in immediate family
e. social hx: smoking, drinking

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9
Q

What are notable cardiovascular assessment findings?

A

a. LOC due to > O2 to brain - meds - DM -
altered BP - head injury - UTI - hrt issues
dizzy -
b. pallor/cyanosis
c. Clubbing/fingers(long term poor gasexch)
d. slow capillary refill
e. JVD-bld pooling - veins well/distend CHF)
f. assess all pulses
g. extremities - color - mvmt - sensitivity
h. pitting edema
i. Homan’s sign (ck for DVT)
j. hrt sounds (lub dub)
k. VS
l. EKG

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10
Q

What is the SA node and what does it do?

A

a. pace maker of the heart
b. Sends elec impulse 60-90 X/ per min,
c. heart muscle contracts in response to
elec impulse

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11
Q

What does the AV node do?

A

a. picks up impulse from the SA node
b. Causes delay then sends impulse to
ventricles (bundle of HIS, purkinje fibers,
contractile heart muscle cells) &
ventricles contract

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12
Q

What is Ectopic focus?

A

a. area of irritability that depolarizes
prematurely
b. something besides SA node initiating
heart beat
c. causes premature heart beat
d. can occur in either atriums or ventricles
e. can be one area or multiple areas that all
fire off at once

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13
Q

What is an EKG?

A

electro cardiogram: wh leaves a tracing of heart activity that can be graphed in a timely fashion.

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14
Q

Define EKG paper

A

a. graph paper made up of small & larger
heavy, lined squares. 300 dark
lines per minute

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15
Q

How to calculate heart-rate w/EKG?

A 
estimated by counting dark lines btw each beat then dividing into 300
     ex 7 (spaces) into 300=42 beats per min
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16
Q

What happens in a P-wave?

A

SA node fires off and atriums depolarize or contracts

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17
Q

What happens in a QRS-complex?

A

ventricles depolarizing or contracting

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18
Q

What happens in a T-wave?

A

ventricles re-polarizes. The heart is preparing to receive next electrical impulse

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19
Q

What is a PR interval?

A

the delay created by the AV node

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20
Q

What is PT (prothrombin time?

A

coagulation test for pts on Coumadin

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21
Q

What is PTT (partial thromboplastin time?

A

coagulation test for pts on heparin

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22
Q

What is INR (international normalized ratio?

A

companion to the PT test

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23
Q

Why are hemoglobin/hematocrit tests done?

A

to check for anemia

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24
Q

What is LDL?

A

bad cholesterol

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25
Q

What is HDL?

A

good cholesterol

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26
Q

How to monitor cholesterol?

A

Doing lipid studies

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27
Q

What is troponin?

A

a. proteins released by the damaged heart
muscles.
b. Elevated after heart attack

28
Q

Why are cardiac enzymes monitored?

A

a. enzymes released by damaged heart
muscles.
b. Elevated after heart attack (CK, CK-
MB, CPK).
c. Tests are performed over time ex q6h x
4 times

29
Q

What are normal values for Hemoglobin?

A

a. F=12.0-16.0

b. M=14.0-18.0

30
Q

What are normal values for Hematocrit?

A

a. F=36.0-47.0

b. M=40.0-54.0

31
Q

What are normal cholesterol values?

A

150-200 mg/dL

32
Q

Why is a Chest X-Ray used?

A

a. to detect cardiomyopathy (heart
enlargement)
b. To detect fluid in lungs due to heart
congestion

33
Q

What is an echocardiogram?

A

a. ultrasound of heart
b. non-evasive procedure
c. visualize heart in motion,
d. check for clots & infection in heart
e. Assess valve fxn, direction of bld flow,
regurgitation, murmurs

34
Q

What is a Holster Monitor?

A

a. portable EKG recorder
b. worn 24-48 hrs
c. Keeps log of activities, no special activity
restrictions, have a normal day
d. no showers for pt/only sponge bath
e. monitor read by physician

35
Q

What considerations are needed for pre-angiography?

A 
a. should know if pt is allergic to iodine or 
    shellfish
b. contrast dye iodine based can cause
    reactions
c.  Pt must be NPO  X8hrs
36
Q

What Nrsg care is given post coronary angiography (cardiac cath)?

A

a. dressing is placed over puncture site
(groin)
b. pt needs to lay flat for several hrs
c. check for bleeding-there should be no
bleeding
d. assess pulses distal to puncture site
(pedal pulse)

37
Q

What are Nursing responsibilities for a pt on Heparin or Coumadin?

A

a. monitor for bleeding issues
b. head to toe assessments and laboratory
monitoring
c. know the potential side effects:
bleeding in gums, hematuria,
hemorrhage, thrombocytopenia, &
potential drug and food interactions

38
Q

What are common symptoms of newborn with a congenital heart defect?

A

a. heart murmur
b. SOB
c. paleness
d. failure to gain wt
e. fast heart rate
f. seating when feeding
g. cyanotic

39
Q

What is Ventrical Septal Defect (VSD)?

A

a. Allows good O2 blood to mix w/ poor O2
blood
b. Most common defect
c. AKA Hole in Heart

40
Q

What are S&S of Ventricular Septal Defect?

A

a. SOB
b. Pale or Cyanotic
c. Failure to gain wt d. Elev HR
e. Sweating while feeding
f. Heart murmur

41
Q

What are Tx for Ventrical Septal Defect?

A

a. May heal on its own
b. Digoxin – makes hrt beat faster
c. Surgical repair – “patch” open area by
open hrt or cardiac cath d. will need antibiotics for dental wrk e. must be on ASA or Coumadin

42
Q

What is Atrial Septal Defect/Patent Foramen Ovale?

A

a. Foramen Ovale suppose to close up after
birth
b. almost same as VSD
c. allows good O2 blood to mix w/poor Os
blood

43
Q

What are S&S Atrial Septal Defect/Patent Foramen Ovale?

A

Same as VSD but less severe

44
Q

What is Tx for Atrial Septal Defect/Patent Foramen Ovale?

A

a. similar to VSD

b. patch via heart cath NOT open heart

45
Q

What is Patent Ductus Arteriosus?

A 
a. Ductus Arteriosus suppose to close up 
    after birth  	
b. This is communication b/w aorta & 
    pulmonary artery 	
c. Similar to Septal defects  	
d. Common is premature births & females
46
Q

What is Tx for Patent Ductus Arteriosus?

A

a. May close on its own
b. NSAIDS – blocks hormones that keep it
open
c. Angioplasty - @ 1 year old

47
Q

What is Coarctation of the Aorta?

A

a. Narrowing of the Aorta
b. less blood out to body – heart needs to
work harder

48
Q

What are S&S for Coarctation of Aorta?

A

a. Pale – but not cyanotic
b. Dyspnea
c. No stamina for activity

49
Q

What is Tx for Coarctation of Aorta?

A

Need surgical repair

50
Q

Describe transposition of Great Vessels?

A

a. Aorta & Pulmonary Artery are reversed b. blood goes from heart to body – heart to
body does not pick up O2

51
Q

What are S&S for Transposition of Great Vessels?

A

a. Very Cyanotic

b. Poor feeding

52
Q

What is Tx for Transposition of Great Vessels?

A

a. Must have surgery to repair
b. Must keep fetal openings patent until
surgery performed

53
Q

What is Tetralogy of Fallot?

A

4 issues all at once!

  1. VSD (ventrical septal defect)
  2. Overriding Aorta
  3. Pulmonary Stenosis (narrowing) 4. R ventrical hypertrophy
54
Q

What are S&S of Tetralogy of Fallot?

A

a. Murmur
b. Cyanotic
c. Syncope
d. d. CHILD SQUATS FREQ

55
Q

What is Tx for Tetralogy of Fallot?

A

Must have surgery

56
Q

What is Atrial Fibrillation (A Fib)?

A 
a. When the Atriums are more like 
    “quivering” instead of contracting  		b. Most common arrhythmia  		
c. Multiple etopic foci   		
d. No true “P” waves   		
e. Hrt not pumping efficiently
57
Q

What are Tx for A Fib?

A

a. Amiodarone – Antiarrhytmic
b. Digoxin – cardiotonic –
slows/strengthens hrt
c. Atenolol – Beta blocker slows hrt d. Coumadin – anticoag
e. Cardioversion – gets hrt back to normal
rhythm
f. Ablation – destroy etopic foci

58
Q

What are risks for Pt w/ A Fib?

A 
a. May lead to clot formation in heart 
    chambers  		
b. Stroke  		
c. Pulmonary Embolism  		
d. MI
59
Q

What is Cardioversion?

A 
a. synchronized shock to organize the 
    hearts electrical activity  		
b. Timed w/EKG   		
c. Gets heart beating back to normal if in 
    active A FIB
60
Q

Why might a pt w/A Fib need a blood thinner?

A

a. To prevent clot formation

b. to prevent stroke

61
Q

What is heart block?

A

a. A problem with the AV node delay
b. “impulse” not getting to the ventricles in
timely manner or blocks it completely
c. delay is too long or erratic
d. Can lead to decreased cardiac output

62
Q

What is 1st degree heart block?

A 
a. All “impulses” reach the ventricles – just 
   slower than normal   		
b. every P wave followed by a QRS but a 
     little too long (PR interval)  		
c. no big deal
63
Q

What is 2nd degree heart block?

A

a. Some “impulses” get through to
ventricles – some don’t
b. Not every P wave followed by QRS c. Some long PR intervals – some normal

64
Q

What is 3rd degree heart block?

A

a. None of the atrial “impulses” get to the
ventricles
c. atriums and ventricles work
independently (these are etopic foci)

65
Q

What do pacemakers do?

A

Artificially stimulate the heart to beat by sending an electrical charge

66
Q

What does “demand mode” mean regarding pacemakers?

A

generates an impulse if heart rate drops below a preset rate (as needed)

67
Q

What instructions are given to Pt w/pacemaker?

A

a. pacemaker incision must be ck’d in one
wk after surgery
b. DO NOT life more than 10 lbs until see
by doc
c. DO NOT raise your arm above your head
for 1 mo
d. DO NOT shower for one wk (sponge
baths only)
e. DO NOT put lotion- power –ointment on
incision
f. DO NOT be in close contact w/ magnetic
fields such as airport security systems
transformers – welders stereo spkrs – Bingo wands MRI’s

Cardiology (3 decks)

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