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TRA REFRESHER > CARDIO > Flashcards

CARDIO Flashcards

1
Q

A hollow muscular organ that resembles like a closed fist?

A

Heart

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2
Q

Where is the heart located?

A

Middle of the mediastinum

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3
Q

The heart weighs approximately ______.

A

300-400 grams

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4
Q

It is the largest chamber of the heart.

A

Left Ventricle

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5
Q
  • Located between right ventricle and pulmonary artery.
  • semilunar valve
A

Pulmonic valve

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6
Q
  • located between the left atrium and left ventricle
  • atrioventricular valve
A

Bicuspid/Mitral valve

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7
Q
  • located between right atrium and right ventricle
  • atrioventricular valve
A

Tricuspid valve

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8
Q
  • located between left ventricle and aorta
  • semilunar valve
A

Aortic valve

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9
Q

middle/muscular layer of the heart

A

Myocardium

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10
Q

innermost layer of the heart

A

Endocardium

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11
Q

outermost layer of the heart

A

Epicardium

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12
Q

Sac the surrounds and protect the heart

A

Pericardium

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13
Q

Which inner pericardial layer also forms a part of the wall?

A

Visceral pericardium

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14
Q

The outer layer of the pericardium

A

Parietal pericardium

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15
Q

A buildup of excess fluid in the sac that surrounds the heart:

A

Pericardial sac

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16
Q

To prevent friction the amount of fluid in the pericardial sac is ______.

A

5-20 ml

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17
Q

Modifiable Risk Factors

A
  • Stress
  • Diet
  • Exercise
  • Smoking & Alcohol
  • HPN
  • Obesity
  • Lifestyle/Behavior
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18
Q

Non – Modifiable Risk Factors

A
  • Age
  • Sex
  • Race
  • Family history
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19
Q

Physical examination of the heart: IPPA

A
  • Inspection
  • Palpation
  • Percussion
  • Auscultation
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20
Q

Electrical conductivity of the heart:

A

Conduction system

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21
Q

Upon inspection the skin color of the patient is?

A

Pallor, Cyanotic

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22
Q

Upon inspection the respirations of the patient is?

A

Dyspnea

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23
Q

Upon inspection what do you expect to assess in the peripheral edema of the patient?

A

Venous insufficiency

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24
Q

Upon inspection what do you expect to assess in the neck vein of the patient?

A

Venous congestion

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25
Q

Normal cardiac percussion:

A

Dullness (thudlike sound)

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26
Q

Normal heart sounds are ____, and ____.

A

S1 (“lubb”) and S2 (“dubb”)

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27
Q

Auscultated upon closure of AV valve (TV & BV)

A

S1 (“lubb”)

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28
Q

Auscultated upon closure of semilunar valve (PV & AV)

A

S2 (“dubb”)

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29
Q

This heart sound is considered normal in children, young adult, and pregnant women

A

S3 (ventricular gallop)

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30
Q

Hearing this heart sound in older adult indicate an early indication for CHF?

A

S3 (ventricular gallop)

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31
Q

Heart sound that is abnormal in all ages and present in CHF

A

S4 (atrial gallop)

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32
Q

Dyspnea on Exertion

A

DOB r/t activity

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33
Q

DOB in lying position

A

Orthopnea

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34
Q

DOB upon sleep onset

A

Paroxysmal nocturnal dyspnea

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35
Q

Elevated RBCs suggest _______.

A

Hypoxia

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36
Q

Elevated WBCs may indicate ______.

A

Infections, heart disease, or MI

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37
Q

3 Cardiac Enzymes:

A
  • Aspartate Aminotransferase (AST)
  • Dehydrogenase (LDH)
  • Creatinine Phosphokinase (CK-MB)
38
Q

Cardiac enzyme produce by liver

A

Aspartate Aminotransferase (AST)

39
Q

Cardiac enzyme produce by skeletal muscle

A

Lactic Dehydrogenase (LDH)

40
Q

Most cardiac specific enzyme

A

Creatinine Phosphokinase (CK-MB)

41
Q
  • most important, most indicative
  • protein found in myocardial cells; reliable critical markers of myocardial injury
A

Troponin I

42
Q

Normal value of Troponin I:

A

0-0.04 mg/ml

43
Q

Troponin I remains elevated for as long as _______.

A

2 weeks

44
Q
  • protein found in cardiac & skeletal muscle
  • Not very specific (negative result can rule out MI)
A

Myoglobin

45
Q

Records electrical activity of the heart

A

Electrocardiogram (ECG)

46
Q

Atrial depolarization

A

P wave

47
Q

Ventricular Depolarization

A

QRS Complex

48
Q

Ventricular Repolarization

A

T wave

49
Q
  • Transient chest pain caused by insufficient blood flow to the myocardium resulting in myocardial ischemia
  • fancy name for chest pain
A

Angina Pectoris

50
Q

What causes Angina Pectoris?

A
  • Atherosclerosis plaques obstruction
  • HPN
  • DM (viscous blood) insufficient blood flow
51
Q

Pain manifestation of Angina Pectoris SAVERS

A

Substernal (below the sternum)
Anterior chest (pericordial)
Vague: radiates➡️jaw, neck,back,L shoulders both arms
Exertion: related
Relieved by Rest & NTG
Short-duration (>30mins)

52
Q

Precipitating Events of Angina Pectoris 4 E’s

A

Exertion: NO vigorous exercise
Emotions: excitement; sexual activity
Eating heavy meal
Environment: cold exposure

53
Q

Direct Vasodilators (Nitrates)
- directly relax smooth muscles of blood vessels = vasodilation

A
  • Nitroglycerine
  • ISMN (Isosorbide Mononitrate)
  • ISDN (Isosorbide Dinitrate)
54
Q

Beta-Blockers
- blocks SNS that slows HR and lower BP
- “-olol” “Bolol”

A
  • Nitroglycerine
  • ISMN (Isosorbide Mononitrate)
  • ISDN (Isosorbide Dinitrate)
55
Q

Calcium - Channel blockers
- indirect vasodilators
- “dipine” “Cdipine”

A
  • Nifedipine (Procardia)
  • Amlodipine (Norvasc) tablet
  • Nicardipine (Cardene) IV
56
Q

drug of choice for pain relief

A

Nitroglycerine Therapy

57
Q

Direction in taking Nitroglycerine Therapy:

A

Take maximum of 3 doses at 5 mins interval; if not relieved call physician

58
Q

Nitroglycerine Therapy indication of potency: ____________________ under the tongue when taken sublingually

A

burning/stinging

59
Q

Nitroglycerine Therapy dry of mouth inhibit absorption. As nurse what will you offer?

A

Offers sips of water prior admission

60
Q

You are educating pt. under nitroglycerine therapy he/she should avoid?

A
  • Alcohol prevent Hypotension
61
Q

You are educating pt. under nitroglycerine therapy how will he/she would rise from bed?

A

Gradual change of position
R: prevent Orthostatic hypotension

62
Q

Pt. under nitroglycerine therapy should Always carry _____ in pocket

A

3 tabs
Instruction: take 1 tablet before exercise

63
Q

Nitroglycerine tablet are destroyed by heat, light or moisture.How to store nitroglycerine tablet?

A
  • cool, dry place
  • used dark/amber colored air tight container
  • do not store in refrigerator
64
Q

How often will the pt. change his/her nitroglycerine tablet stock?

A

Change stock every 3 mons

65
Q

What are the side effects of nitroglycerine therapy?

A

headache, flushed face, dizziness, faintness, tachycardia
- common: during 1st few doses
- instruct to: do not discontinue medication

66
Q

Beta-Blocker Therapy

A

⬇️HR and ⬇️BP

67
Q

Prior the admission of Beta-Blockers, what will you assess first?

A

Assess HR and BP
R: If mababa WITH HOLD

68
Q

To prevent GI upset while taking Beta-Blockers it should be taken with?

A. Without meals
B. With meals

A

B. With meals

69
Q

Beta- Blockers were contraindicated with _______.

A

Propanolol (Inderal)

70
Q

Why beta-blockers contraindicated in asthma?

A

cause bronchoconstriction

71
Q

Why beta-blockers contraindicated in DM patients?

A

cause hypoglycemia

72
Q

Antidote for BB poisoning:

A

Glucagon

73
Q

Calcium Channel Blocker

A

Prior admission assess HR and BP

74
Q

Calcium channel blockers causes **food delay absorption:

A

Empty stomach
- early morning upon waking
- 1hr prior meal
- 2hrs after meal

75
Q

Antidote for CCB poisoning:

A

Calcium gluconate

76
Q

Formation of localized necrotic areas within the myocardium

A

Myocardial Infarction (Heart Attack)

77
Q

Most common site of MI:

A

Left ventricle

78
Q

What causes MI?

A
  • Coronary occlusion
  • Cessation of blood supply
79
Q

3 Types of Coronary occlusion?

A
  • Atherosclerosis: fat accumulation
  • Thrombosis: clot formation
  • Embolisms: dislodged/foreigner
80
Q

A classification of MI **necrosis “endocardium”

A

Subendocardial

81
Q

A classification of MI **patchy areas myocardium”

A

Intramural

82
Q

A classification of MI **from endo to epicardium “

A

Transmural

83
Q

Pain manifestion of MI?

A
  • crushing, severe pain
  • radiating arms, neck and back
  • not relieved by rest and nitroglycerine
  • lasting >30 mins
84
Q

MI’s universal sign of distress in pain:

A

Levine’s Sign

85
Q

MI ECG:

A
  • STEMI – ST segment elevation MI (Deadliest!)
  • NSTEMI – Non ST segment elevation
86
Q

MI Laboratories:

A
  • increased Cardiac Enzymes: AST, LDH, CK-MB
  • elevated Troponin levels: most definitive finding for MI
87
Q

MI’s Management: MONA

A

Morphine: Opioid Analgesic - DOC for pain relief in MI
Oxygen Therapy by cannula: Increase myocardial O2 supply
Nitroglycerine: for vasodilation
Aspirin (ASA): Antiplatelet

88
Q

Oxygen therapy by cannula, Why in cannula?

A

Stop feeling of suffocation “6 lpm”

89
Q

_______ commode; ________ bed pan

A

use commode; avoid bed pan
Ratio: Valsalva Maneuver

90
Q

Reiterate the use of stool softener to avoid straining.
what would be the diet of MI patients:

A
  • LSLF: low salt, low fat
  • SFF: small frequent feeding
91
Q

What are the complications of MI?

A
  • Dysarthria: most common PVC
  • Cardiac arrest: “premature ventricular contraction”

TRA REFRESHER (8 decks)

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