Cardio 2 Flashcards

1
Q

chest pain resulting from Myocardial Ischemia caused by inadequate myocardial blood & oxygen supply (imbalance between O2 supply & Demand)

A

Angina

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2
Q

Causes: obstruction of coronary blood flow resulting from atherosclerosis, coronary artery spasm, or conditions increasing myocardial oxygen consumption

A

Angina

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3
Q

occurs w/ Activities that involve Exertion or Emotional Stress; Relieved w/ Rest or Nitroglycerin

A

Stable (Exertional Angina)

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4
Q

occurs w/ an Unpredictable degree of Exertion or Emotion & Increases in Occurrence, Duration, & Severity Over Time; Pain may not be relieved w/ Nitroglycerin

A

Unstable (PreInfarction Angina)

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5
Q

Chronic, Incapacitating & Unresponsive to Interventions

A

Intractable Angina

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6
Q

Acute Coronary Insufficiency; lasts >15-30 min; Worsening Cardiac Ischemia; Chest Pain days to weeks before an MI

A

PreInfarction Angina

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7
Q

Pain: develops slowly or quickly; mild-Moderate; Substernal, Crushing, Squeezing; may Radiate to Shoulders, Arms, Jaw, Neck, Back; Intensity unaffected by Inspiration/Expiration; lasts

A

Angina

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8
Q

Dsypnea
Pallor
Sweating

A

Angina

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9
Q

Palpitations & Tachycardia
Dizziness & Syncope
HypErTension
Digestive Disturbances

A

Angina

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10
Q

ECG: Normal readings during Rest w/ ST Depression or T-Wave Inversion during an Episode of Pain

A

Angina

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11
Q

Angina Stress Testing: Chest Pain/Changes in ECG or VS during Testing may Indicate

A

Ischemia

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12
Q

Findings are normal in Angina

A

Cardiac Enzyme & Troponin levels

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13
Q

provides definitive diagnoses by providing information about Patency of Coronary ARteries

A

Cardiac Catheterization (Angina)

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14
Q
  1. Asses Pain
  2. O2 by NC
  3. VS, continuous cardiac monitoring,
  4. Bed Rest/ semi-Fowler’s
  5. 12-lead ECG
  6. IV access
A

Nitroglycerin (Angina)

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15
Q

to Dilate Coronary Arteries, reduce O2 requirements of Myocardium, & relieve chest Pain

A

Nitroglycerin (Angina)

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16
Q

Antiplatelet meds to inhibit platelet aggregation & reduce risk of developing an Acute MI

A

Angina

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17
Q

occurs when myocardial Tissue is Abruptly & Severely Deprived from Oxygen; Ischemia can lead to Necrosis of Myocardial Tissue if blood flow is Not Restored.

A

MI

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18
Q

does not occur Instantly, Evolves over Several Hours; After 6 hrs, area appears blue & swollen; After 48 hrs, area turns gray w/ yellow streaks (as neutrophils invade tissue)

A

MI

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19
Q

Granulation Tissue forms

A

8-10 days after Infarction

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20
Q

over 2-3 months, Necrotic area develops into Scar tissue, permanently changing size & shape of ..

A

entire left ventricle (MI)

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21
Q

Atypical discomfort, SOB, Fatigue often present w/ NSTEMI (non-ST-elevation myocardial Infarction) or T-Wave Inversion

A

Women (Sx of MI)

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22
Q

SOB, pulmonary Edema, Dizziness, ALOC, dysrhythmia

A

Elderly (Sx of MI)

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23
Q

Atherosclerosis/ CAD/ Elevated Cholest. levels

A

MI risk factors

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24
Q

Smoking/ HTN/ Obesity/ Physical Inactivity

A

MI risk factors

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25
Impaired Glucose Tolerance, | Stress
MI risk factors
26
Troponin Creatine Kinase CK-MB isoenzyme Myoglobin
MI (labs)
27
elevated WBC (up to 20,000 cells/mm3)
appears on the second day after MI, lasting up to 1 week
28
ECG: T-wave Inversion & abnormal Q-WAVE (usually remain permanently)
+ STEMI (ST-Elevation MI) or NSTEMI (non-ST-Elevation MI)
29
T-wave Inversion, Abnormal , & STEMI/NSTEMI return to normal hours-days..
Abnormal Q-wave may remain permanently. in MI
30
Prescribed to Assess for ECG changes & Ischemia following an Acute Stage MI; evaluate for Medical therapy or identify who may need invasive therapy
Exercise Tolerance Test or Stress Test
31
to assess for Ischemia or Necrotic Muscle Tissue
Thallium Scans
32
used to Evaluate left Ventricular Function
Multigated Cardiac Blood Pool
33
to determine Extent & Location of Obstructions of Coronary Arteries
Cardiac Catheterization
34
``` Pain: Crushing or Substernal Pain. Radiate to Jaw, Back, Left-Arm. Occur without cause, primarily early morning. Lasts >30 min. ```
MI
35
Pain is Unrelieved by Rest or Nitroglycerin & is Relieved only by Opioids
MI
36
Nausea/Vomiting Diaphoresis Dyspnea
MI
37
Dysrhythmias Feelings of Fear & Anxiety Pallor, Cyanosis, Coolness of Extremities
MI
38
Dysrhythmias HF Pulmonary Edema
MI complications
39
Cardiogenic Shock Thrombophlebitis Pericarditis
MI complications
40
Mitral Valve Insufficiency Post Angina Ventricular Rupture
MI complications
41
combination of Pericarditis, Pericardial Effusion, Pleural Effusion; can occur weeks-months after MI
Dressler's Syndrome
42
Pain relief Increases Oxygen supply to Myocardium...A priority in managing pain for MI
Morphine (opioid)
43
1. Pain Description (crushing/substernal...) 2. O2 by NC 3. Pain (morphine, nitroglycerin) 4. VS, Cardiovascular Status, Cardiac monitoring 5. Bed Rest; semi-Fowler's (for comfort & tissue oxygenation) 6. IV access 7. 12-Lead ECG
MI (acute stage)
44
Antidysrhythmics | Thromobolytics (monitor for Bleeding)
MI (acute stage)
45
to slow HR & increase Myocardial Perfusion while Reducing the Force of Myocardial Contraction
B-Blocker MI (acute stage)
46
monitor for Cardiac Dysrhythmias (Tachycardia & PVCs)
MI (acute stage)
47
Assess distal peripheral pulses & skin temp; Cool Diaphoretic skin & diminished/ Absent pulses Indicates...
Poor Cardiac Output ; MI (acute stage)
48
I & O
MI (acute stage)
49
Assess RR & Breath Sounds; Crackles, Wheezing, or Dependent Edema
MI (acute stage) can lead to HF
50
after Acute MI stage, if Systolic Pressure <100 or 25 lower than previous reading after medications ...
lower HOB & Notify HCP
51
Bed Rest (24-36 hr). Prevent thrombus formation, Increase Mobility slowly. Monitor for complications.
After acute episode of MI
52
Inability of the heart to maintain adequate CO to Meet the metabolic demands of the Body because of impaired Pumping Ability
HF
53
Diminished CO results in inadequate Peripheral Tissue Perfusion. Pulmonary Edema can Occur.
HF
54
occurs suddenly
Acute HF
55
develops over time. | a person w/ HF can develop ...
an Acute Episode (HF)
56
most HF begins w/ ____, & progresses to failure of Both Ventricles
Left HF
57
Acute Pulmonary Edema (medical Emergency), results from
Left Ventricular Failure | HF
58
If not treated, person will die from suffocation because they are literally drowning in their own fluids
Pulmonary Edema | HF
59
an Inadequate Output of the Affected Ventricle causes Decreased Perfusion to Vital Organs
Forward Failure (HF)
60
Blood backs up behind the affected ventricle, causing Increased pressure in Atrium behind affected Ventricle
Backward Failure (HF)
61
not Enough CO is available to meet the demands of the body
Low-Output HF
62
occurs when a condition causes the heart to Work Harder to meet Demands of Body
High-Output HF
63
leads to problems w/ Contraction & Ejection of Blood
Systolic Failure (HF)
64
leads to problems w/ the Heart Relaxing & Filling w/ blood
Diastolic Failure (HF)
65
Act to Restore CO to near-normal levels; work initially, but eventually have a damaging effect on pump action
Compensatory Mechanisms
66
Compensatory mechanisms contribute to an Increase in Myocardial Oxygen consumption; when this occurs, Myocardial Reserve is Exhausted & Clinical Manifestations of develop.
of HF
67
Increased HR | Improved Stroke Volume
HF Compensatory Mechanisms
68
Arterial Vasoconstriction
HF Compensatory Mechanisms
69
Sodium & Water Retention
HF Compensatory Mechanisms
70
Myocardial Hypertrophy
HF Compensatory Mechanisms
71
Evident in Pulmonary system
Signs of Left Ventricular HF
72
Evident in Systemic Circulation
Signs of Right Ventricular HF
73
Dependent Edema (Legs & Sacrum)
Right-Sided HF
74
JVD
Right-Sided HF
75
Abdominal Distention
Right-Sided HF
76
Hepatomegaly
Right-Sided HF
77
Splenomegaly | Anorexia & Nausea
Right-Sided HF
78
Weight Gain
Right-Sided HF
79
Swelling of Fingers & Hands
Right-Sided HF
80
``` Increased BP (from Fluid Vol. Excess) or Decreased BP (from Pump Failure) ```
Right-Sided HF
81
Signs of Pulmonary Congestion
Left-Sided HF
82
Dyspnea | Tachypnea
Left-Sided HF
83
Crackles in Lungs
Left-Sided HF
84
Dry, Hacking Cough
Left-Sided HF
85
Paroxysmal Nocturnal Dyspnea
Left-Sided HF
86
``` Increased BP (from FVE) Decreased BP (from Pump Failure) ```
Left-Sided HF
87
Severe Dyspnea & Orthopnea
Acute Pulmonary Edema (HF)
88
Pallor | Tachycardia
Acute Pulmonary Edema (HF)
89
Expectoration of large amounts of blood-tinged frothy sputum
Acute Pulmonary Edema (HF)
90
Wheezing & Crackles | Gurgling respirations
Acute Pulmonary Edema (HF)
91
Acute Anxiety, Apprehension, Restlessness
Acute Pulmonary Edema (HF)
92
Profuse Sweating Cold, Clammy Skin Cyanosis
Acute Pulmonary Edema (HF)
93
Nasal Flaring Use of Accessory Muscles Tachypnea
Acute Pulmonary Edema (HF)
94
is evidenced by Muscle Cramps, Weakness, Dizziness, & Paresthesias
Hypocapnia in Acute Pulmonary Edema (HF)
95
High-Fowler's, w/ legs in a dependent position to reduce
Pulmonary Congestion & Relieve Edema; Acute Episode of HF
96
Oxygen w/ NC or Mask in high concentrations
to improve gas exchange and pulmonary function (goal of O2 Saturation 90%); Acute Episode of HF
97
Assess lung sounds. IV access Foley (to measure output accurately). Intubation or Ventilator support (if required)
Pulmonary Edema: Acute Episode of HF
98
In Pulmonary Edema (HF), this will eliminate accumulated fluid
Furosemide (rapid-acting diuretic)
99
In Pulmonary Edema (HF), this reduces venous return (preload), decreases anxiety, & also reduces the work of Breathing.
Morphine Sulfate
100
In Pulmonary Edema (HF), Cardiac Monitoring for
HR & Dysrhythmias
101
In Pulmonary Edema (HF),, Lung sounds are assessed for Crackles &
Decreased Breath Sounds/ Response to Tx (weight measurement also determines response to tx)
102
In Pulmonary Edema (HF), this increases Ventricular Contractility & Improves CO
Digoxin
103
Bronchodilators for severe Bronchospasm or Bronchoconstriction.
In Pulmonary Edema (HF)
104
Medications to facilitate myocardial Contractility & Enhance Stroke Volume.
In Pulmonary Edema (HF)
105
Vasodilators to reduce Afterload, Increase the capacity of Systemic Venous bed, & Decrease venous return to the Heart.
In Pulmonary Edema (HF)
106
``` Digoxin Diuretic Angiotensin-Converting Enzyme (ACE) inhibitors. Low-dose B-Blockers. Vasodilators. ```
Medication Regimen for HF (Pulmonary Edema)
107
Avoid: OTC med, Caffeine. Diet: Low-Sodium, fat, cholest. K rich foods (diuretics
x
108
Balance periods of Activity & Rest. | Avoid Isometric Activities (Increase pressure in the Heart).
x
109
Fluid Restriction (suck on hard candy to reduce thirst). Monitor weight daily. Report signs of Fluid Retention (edema/ weight gain)
x