Cardio #1 Flashcards
What is the Endocardium?
a. innermost layer of heart
b. line inside of heart
What is the Myocardium?
a. middle muscular layer
b. Thickest part
d. Does all the work
What is the Peri/epicardium?
a. outermost part of heart
b. Protective covering
What are the major vessels of the heart?
a. Aorta: Main Street
b. Superior vena cava
c. Inferior vena cava
d. Pulmonary artery
e. Pulmonary vein
What are the chambers of the heart?
a. Rt atrium
b. Lt atrium
c. Rt ventricle
d. Lt ventricle
What are the valves of the heart?
a. Aortic semilunar valve
b. Pulmonary semilunar valve
c. Tricuspid valve
d. Bicuspid valve
How does blood flow thru chambers of the heart?
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
What might indicate Risk for heart Dz?
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
What are notable cardiovascular assessment findings?
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
What is the SA node and what does it do?
a. pace maker of the heart
b. Sends elec impulse 60-90 X/ per min,
c. heart muscle contracts in response to
elec impulse
What does the AV node do?
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
What is Ectopic focus?
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
What is an EKG?
electro cardiogram: wh leaves a tracing of heart activity that can be graphed in a timely fashion.
Define EKG paper
a. graph paper made up of small & larger
heavy, lined squares. 300 dark
lines per minute
How to calculate heart-rate w/EKG?
estimated by counting dark lines btw each beat then dividing into 300
ex 7 (spaces) into 300=42 beats per minWhat happens in a P-wave?
SA node fires off and atriums depolarize or contracts
What happens in a QRS-complex?
ventricles depolarizing or contracting
What happens in a T-wave?
ventricles re-polarizes. The heart is preparing to receive next electrical impulse
What is a PR interval?
the delay created by the AV node
What is PT (prothrombin time?
coagulation test for pts on Coumadin
What is PTT (partial thromboplastin time?
coagulation test for pts on heparin
What is INR (international normalized ratio?
companion to the PT test
Why are hemoglobin/hematocrit tests done?
to check for anemia
What is LDL?
bad cholesterol
What is HDL?
good cholesterol
How to monitor cholesterol?
Doing lipid studies
What is troponin?
a. proteins released by the damaged heart
muscles.
b. Elevated after heart attack
Why are cardiac enzymes monitored?
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
What are normal values for Hemoglobin?
a. F=12.0-16.0
b. M=14.0-18.0
What are normal values for Hematocrit?
a. F=36.0-47.0
b. M=40.0-54.0
What are normal cholesterol values?
150-200 mg/dL
Why is a Chest X-Ray used?
a. to detect cardiomyopathy (heart
enlargement)
b. To detect fluid in lungs due to heart
congestion
What is an echocardiogram?
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
What is a Holster Monitor?
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
What considerations are needed for pre-angiography?
a. should know if pt is allergic to iodine or
shellfish
b. contrast dye iodine based can cause
reactions
c. Pt must be NPO X8hrsWhat Nrsg care is given post coronary angiography (cardiac cath)?
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)
What are Nursing responsibilities for a pt on Heparin or Coumadin?
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
What are common symptoms of newborn with a congenital heart defect?
a. heart murmur
b. SOB
c. paleness
d. failure to gain wt
e. fast heart rate
f. seating when feeding
g. cyanotic
What is Ventrical Septal Defect (VSD)?
a. Allows good O2 blood to mix w/ poor O2
blood
b. Most common defect
c. AKA Hole in Heart
What are S&S of Ventricular Septal Defect?
a. SOB
b. Pale or Cyanotic
c. Failure to gain wt d. Elev HR
e. Sweating while feeding
f. Heart murmur
What are Tx for Ventrical Septal Defect?
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
What is Atrial Septal Defect/Patent Foramen Ovale?
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
What are S&S Atrial Septal Defect/Patent Foramen Ovale?
Same as VSD but less severe
What is Tx for Atrial Septal Defect/Patent Foramen Ovale?
a. similar to VSD
b. patch via heart cath NOT open heart
What is Patent Ductus Arteriosus?
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 & femalesWhat is Tx for Patent Ductus Arteriosus?
a. May close on its own
b. NSAIDS – blocks hormones that keep it
open
c. Angioplasty - @ 1 year old
What is Coarctation of the Aorta?
a. Narrowing of the Aorta
b. less blood out to body – heart needs to
work harder
What are S&S for Coarctation of Aorta?
a. Pale – but not cyanotic
b. Dyspnea
c. No stamina for activity
What is Tx for Coarctation of Aorta?
Need surgical repair
Describe transposition of Great Vessels?
a. Aorta & Pulmonary Artery are reversed b. blood goes from heart to body – heart to
body does not pick up O2
What are S&S for Transposition of Great Vessels?
a. Very Cyanotic
b. Poor feeding
What is Tx for Transposition of Great Vessels?
a. Must have surgery to repair
b. Must keep fetal openings patent until
surgery performed
What is Tetralogy of Fallot?
4 issues all at once!
- VSD (ventrical septal defect)
- Overriding Aorta
- Pulmonary Stenosis (narrowing) 4. R ventrical hypertrophy
What are S&S of Tetralogy of Fallot?
a. Murmur
b. Cyanotic
c. Syncope
d. d. CHILD SQUATS FREQ
What is Tx for Tetralogy of Fallot?
Must have surgery
What is Atrial Fibrillation (A Fib)?
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 efficientlyWhat are Tx for A Fib?
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
What are risks for Pt w/ A Fib?
a. May lead to clot formation in heart
chambers
b. Stroke
c. Pulmonary Embolism
d. MIWhat is Cardioversion?
a. synchronized shock to organize the
hearts electrical activity
b. Timed w/EKG
c. Gets heart beating back to normal if in
active A FIBWhy might a pt w/A Fib need a blood thinner?
a. To prevent clot formation
b. to prevent stroke
What is heart block?
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
What is 1st degree heart block?
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 dealWhat is 2nd degree heart block?
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
What is 3rd degree heart block?
a. None of the atrial “impulses” get to the
ventricles
c. atriums and ventricles work
independently (these are etopic foci)
What do pacemakers do?
Artificially stimulate the heart to beat by sending an electrical charge
What does “demand mode” mean regarding pacemakers?
generates an impulse if heart rate drops below a preset rate (as needed)
What instructions are given to Pt w/pacemaker?
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
