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nclex MUST-KNOWs > CARDIO > Flashcards

CARDIO Flashcards

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1
Q

tetralogy of fallot (TOF)

A
  • “PROVe” = pulmonic stenosis, right hypertrophy, overriding aorta, ventricular septal defect (VSD)
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2
Q

overriding aorta

A

flat blocking aorta
- blue (cyanosis), LOW O2, tet/blue spells
- LOW blood flow = crying, stress, large meals, long breastfeeding
- small frequent meals + less stress!
- Tx: knee-to-chest, soothe/calm child (sucrose, sucking, swaddle, skin-to-skin), + surgery!

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2
Q

patent ductus arteriosus (PDA)

A

opening bw duct of arteries = bypasses utero lungs
- MACHINE-LIKE MURMUR
- normal in FIRST 3 days!
- abnormal = after 3 days (72 hrs) = Tx: NSAIDs or Acetaminophen (if pregnant)

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3
Q

coarctation of aorta (COA)

A

kinking / narrowing of aorta
- systolic murmur
- diminished / weak pulses
- different pulses (upper and lower extremities)
- more than 3 sec capillary refill
- Turner’s syndrome! = “WIBSS” = webbed/wide neck, infertile, breast buds, short stature, streak ovaries

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4
Q

transposition of great arteries (TGA)

A

ALPROSTADIL infusion!

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5
Q

heart sounds

A

“All People Enjoy Times Magazine”
- Aorta = R sternal border - 2nd ICS
- Pulmonic = L sternal border - 2nd ICS
- Erb’s Point = L sternal border - 3rd ICS
- Tricuspid = L sternal border - 4th ICS
- Mital = L sternal border - 5th ICS

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6
Q

heart circulation

A

SVC/IVF → R. atrium → tricuspid valve (TV) → R. ventricle → pulmonary valve (PV) → pulmonary arteries → LUNGS →
pulmonary veins → L. atrium → bicuspid valve (BV) → L. ventricle → aortic valve (AV) → aorta → BODY

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7
Q

LEFT-sided HF

A
  • L = LUNGS
  • ALL HF = LOW O2, pale/apllor, cold/clammy, LOW UO, LOW BP
  • LSHF = pulmonary edema, pink frothy sputum, crackles/rales, SOB, dyspnea, orthopnea (uncomfortable breathing when lying flat), cough, tachypnea
  • can lead to RSHF → LSHF + RSHF = Complete HF!
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8
Q

RIGHT-sided HF

A
  • R = rest of the body = NOT LUNGS
  • ALL HF = LOW O2, pale/apllor, cold/clammy, LOW UO, LOW BP
  • RSHF = ascites, JVD, edema, puffy face/cheeks, increased abdominal girth, hepatosplenomegaly, weight gain
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9
Q

COMPLETE HF

A

LSHF + RSHF
- ALL HF = LOW O2, pale/apllor, cold/clammy, LOW UO, LOW BP
- LSHF = pulmonary edema, pink frothy sputum, crackles/rales, SOB, dyspnea, orthopnea (uncomfortable breathing when lying flat), cough, tachypnea
- RSHF = ascites, JVD, edema, puffy face/cheeks, increased abdominal girth, hepatosplenomegaly, weight gain

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10
Q

confirming HF dx?

A

BNP!
- normal: < 100
- abnormal (HF): > 100

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11
Q

HF Treatment

A
  • Diuretics = (-ide) (-thizide) (-one) = take in AM!
    “DR BEEDS”
  • Diet = NO Na + IVF
  • Risk for falls (orthostatic hypotension)
  • BP + BNP (not elevated)
  • Elevate with pillows in HIGH-Fowlers
  • Exercise (cardiac rehab)
  • Daily weights (monitor I&O)
  • STOP SMOKING!
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12
Q

angina

A

chest pain
- stable = no tx
- unsatble = MONA (morphine, O2, nitroglycerin, aspirin)

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13
Q

CAD treatment

A
  1. Patient Education
  2. -Satins
  3. Nitrates
  4. Calcium Channel Blockers (-dipine)
  5. Stent
  6. CABG
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14
Q

-statins

A

Atorvastatin, Fluvastatin, Lovastatin
- increases HDL
- lowers LDL, triglycerides, total cholesterol
- check LFTs BEFORE
- SE: myopathy (rhabdomylysis)
- take in PM / BEDTIME!

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15
Q

nitrates

A

Nitroglycerin pacthes + Sublingual Nitroglycerin
- lowers BP!
- SE: headaches, flushing, orthostatic hypotension, fall risk
- sublingual Nitroglycerin = 1 patch every 5 min 3 times a day (call 911 if 1st pill does not work!)
- Nitroglycerin patches = 1 patch at a time for 12-14 hrs! (do not cut + fold patch when discarding)

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16
Q

calcium channel blockers (-dipine)

A

lowers BP!
- SE: orthostatic hypotension + peripheral edema!
- NEVER with -nafil drugs + GRAPEFRUIT!

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17
Q

PVD

A

ALL peripheral diseases!
- arteries, veins, lymph, extremities

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18
Q

PAD

A

artherosclerosis that slows/stops blood supply in periphery
- “PAD” = pale/pallor, absent/LOW HR, dry/clay/scaly skin
- cool + clammy
- peripheral neuropathy
- pAd = dAngle Arteries!
- NO elevating legs + NO compression socks!

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19
Q

venous insufficiency

A

insufficient vein
- risk factors: standing + obesity!
- bilateral peripheral edema = usually ankles and up
- ankles = ulcers, swollen, injury, discoloration (blue, dark brown)
- Venous inffuficiency = eleVate Veins!
- Elevate Legs + Compression socks!

20
Q

cardiac tamponade

A
  • Becks Triad (HIGH HR, LOW BP with narrow pulse pressure, muffled/distant heart tones)
  • Tx: pericardiocentesis!
21
Q

bacterial / infective endocarditis

A

inflammation of endocardium due to bacteria (inned lining of heart)
- #1 cause = IV drug use!
- Janeway lesions!
- can cause RSHF = JVD, puffy face, edema, ascites
- risk for PE!
- Tx: IV vancomycin, valve replacement + prophylactic antibiotics!

22
Q

MI

A

“substernal crushing”
“elephant sitting on my chest”
- Dx: PCI
-

23
Q

sinus BRADYCARDIA

A

< 60 bpm
- no symptoms = monitor!
- symptoms = trancutaneous pacing + IV atropine!

24
Q

sinus TACHYCARDIA

A

> 100 bpm
- Tx: beta-blockers (-olol)!

25
Q

atrial fibrillation (A. FIB)

A
  • “wavy” irregular, regular rhythm
  • Tx: ABCD (amiodarone, beta-blockers, CCB, digoxin)
26
Q

atrial flutter (A. FLUTTER)

A
  • “sawtooth”
  • Tx: ABCD (amiodarone, beta-blockers, CCB, digoxin)
27
Q

supraventricular tachycardia (SVT)

A
  • narrow QRS complex
  • stable = vagal stimulation/valsalva maneuver + IV Adenosine
  • not stable = CARDIVERSION (sync)!
28
Q

ventricular tachycardia (V. TACH)

A
  • no P wave
  • wide bizzare QRS complex
  • consecutive pattern!
  • has pulse = vagal stimulation + Amiodarone + Cardiversion
  • no pulse = DEFIB, CPR, Epinephrine!
29
Q

ventricular fibrillation (V. FIB)

A
  • chaotic rhythm with NO QRS complex
  • NO rhythm
  • NO consecutive pattern!
  • Tx: DEFIB (unsync) + Amiodarone
30
Q

TORSADES DE POINTES

A
  • W’s + M’s
  • prolonged QT interval
  • type of V. TACH!
  • hypoMAGnesemia
  • Tx: MAGNESIUM SULFATE!
31
Q

ASYSTOLE

A
  • “flatline”
  • NO QRS complexes
  • NO CO = NO DEFIB!
  • death in < 8 min
  • Tx: Epinephrine + CPR
32
Q

maternal EKG

A

< 5 contractions in 10-minutes
< 90 seconds
> 2 min frequency (2 rectangles)

33
Q

6+ contractions indicates?

A

uterine TACHYSYSTOLE
- Tx: STOP oxytocin + give IVF bolus/Terbutaline!

34
Q

> 90 sec contractions indicates?

A

TETANIC CONTRACTIONS! (abnormal)

35
Q

2 or 3 consecutive contractions indicates?

A

2 consecutive contractions = coupling
3 consecutive contractions = tripling
-Tx: L-lateral position + increase IVF!

36
Q

fetal HR

A

110 - 180 bpm

37
Q

variable decelerations

A

“VEAL CHOP MINE”
- cord compression
- move mom! = STOP oxytocin, knee-to-chest position, O2, terbutaline, notify MD, C-section, Amnioinfusion

38
Q

early decelerations

A

“VEAL CHOP MINE”
- head compression
- Intervention NOT needed!

39
Q

accelerations

A

“VEAL CHOP MINE”
- OK!
- NO interventions = Normal!

40
Q

late decelerations

A

“VEAL CHOP MINE”
- prolapsed cord!
- Execute actions ASAP! = “LION” = STOP oxytocin, L-lateral position, IV bolus (LR or NS), O2, Notify MD, C-section!

41
Q

NEVER give what drugs in HF?

A
  • NSAIDs
  • Ace-Inhibitors
  • Calcium Channel Blockers (-dipine)
42
Q

stents for CAD drug?

A

Clopidogrel + Aspirin!

43
Q

acute pericarditis drug?

A

NSAID + Colchicine!

44
Q

aoritc dissection drug?

A

beta-clockers = Labetolol!

45
Q

DIGOXIN

A
  • increases contractility of heart + decreases HF
  • 0.5 to 2.0
  • BEFORE administering = check HR for 1 min + BUN/creatinine!
  • DIG Toxicity = N/V/D (first), visual color distubances (halo/yellow vision), neuro/heart toxicity
  • maintain normal K+ values!
  • antidote: Digibind/Digifab/Digoxin immune fab
46
Q

HEPARIN (HEP)

A
  • anticoagulant
  • HEP = PTT = 1.5-2 times normal = 46-70 sec
  • antidote: Protamine sulfate
  • for DVT, VTE, strokes
  • abnormal SE: HIT (LOW platelets + starts bleeding fast!)
47
Q

WARFARIN

A
  • anticoagulant
  • PT/INR = 2-3 sec! (valve replacement = 2.5-3.5 sec)
  • antidote: Vitamin K!
  • for DVT, PE, A, Fib, stroke, TIAs, embolism
  • PO same time every day
  • C/I: pregnancy, vitamin E, NSAIDs, 4 G’s (ginger, garlic, ginko, ginseng)

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