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Ashland > Cardio (333E2) > Flashcards

Cardio (333E2) Flashcards

1
Q

afterload

A

The pressure the ventricles must work against to pump blood out of the heart (opens semilunar valves) affected by vascular resistance, increases w/ vasocon, aortic stenosis & pulmonary htn

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2
Q

cardiac output (CO) equation

A

CO (ml/min) = stroke volume (systolic-diastolic) x heart rate (beats/min)

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3
Q

ejection fraction (%)

A

the % of blood pumped out of left ventricle with each contraction

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4
Q

hypertension

A

high blood pressure, pressure in arteries is higher than it should be (prolong changes make up & causes damage)

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5
Q

hypotension

A

SBP <90 mm/hg (do not only treat number bc some pt trend low)

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6
Q

infarction/necrosis

A

complete cut off of blood and oxygen to an area of the body

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7
Q

ischemia

A

blood flow (& oxygen) is restricted or reduced to an area in the body

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8
Q

myocardial contractility

A

how hard the heart contracts regardless of the stretch factor

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9
Q

orthostatic hypotension

A

upon standing, blood pressure drops (safety hazard, dizziness) blood pools, in healthy person no pooling

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10
Q

preload

A

The amount the ventricles stretch at the end of diastole (the amount of fluid in the ventricle) aka end diastolic volume -> increased preload increases SV which increases CO

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11
Q

pulmonary embolism

A
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12
Q

pulsus alternans

A

regular rhythm but strength of pulse varies with each beat (possible etiology = heart failure)

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13
Q

stroke

A
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14
Q

stroke volume

A

the amount of blood that is ejected from the left ventricle (into the body) every time it pumps in mL

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15
Q

venous thromboembolism

A
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16
Q

perfusion

A

passage of fluid through the circulatory system or lymphatic system to an organ or tissue (w/o this, tissues die bc O2 cannot get where it is needed)

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17
Q

if low perfusion to the brain, what are some symptoms

A

dizziness, might pass out, confused

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18
Q

if low perfusion to the toes, what are some symptoms

A

pale, weak pulses, sluggish cap refill

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19
Q

cardiac output

A

volume of blood pumped by the heart in one minute

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20
Q

what is the indirect measure of cardiac output

A

blood pressure (& heart rate)

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21
Q

what might alter cardiac output

A

-change in heart rate (in or de)
-decrease of stroke volume
-myocardial contractility
ex: meds, disease processes, activity

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22
Q

if stroke volume lowers, what will heart rate do in attempt to maintain cardiac output

A

heart rate will increase (a compensatory mechanism)

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23
Q

classifications of ejection fraction

A

-normal: 50-70%% [comfy during activity]
-borderline: 41-49% [pos symp during activity]
-heart failure: <40% [pos symp at rest]

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24
Q

what is the power house chamber of the heart

A

the left ventricle

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25
Q

diastole means & example in left ventricle relating to ejection fraction

A

relaxation ; when the left vent is in diastole it might have 100ml of blood sitting in it and if 50ml are pumped out on contraction, the EF is 50%

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26
Q

when would someone get a heart transplant

A

when their ejection fraction is incompatible to life

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27
Q

blood pressure

A

force exerted by the blood against the blood vessel walls (must be adequate to maintain perfusion during rest & activity)

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28
Q

pulse pressure

A

the difference between systolic and diastolic BP, usually about 1/3 of sbp (ex: 120-80 = pp of 40)

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29
Q

high pulse pressure might indicate

A

-atherosclerosis (hardening of arteries)
-exercise

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30
Q

low pulse pressure might indicate

A

-severe heart failure
-hypovolemia (fluid volume deficit)

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31
Q

CAB for CPR

A

compression (hard &fast - always first), airway, breathing

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32
Q

there will be a question on CPR

A

know numbers, rate, depth, do’s & dont’s of chest recoil, tilting the airway for adults

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33
Q

when is CPR needed

A

when someone doesn’t have a pulse or respiration

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34
Q

common perfusion concerns

A

-hypertension (decreased profu)
-hypotension
-hyperlipidemia
-venous thromboembolism

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35
Q

htn causes adverse affects of the arterial walls which causes what

A

increased peripheral vascular resistance

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36
Q

peripheral vascular resistance

A

the amount of effect that the heart has to overcome in order to get the blood out of the heart into the periphery (increased prolong will cause heart failure)

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37
Q

decreased profusion to the heart ; brain ; kidneys ; legs will cause

A

a heart attack ; a stroke ; kidney failure ; lose legs

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38
Q

BP categories

A

-normal: 120/80
-elevated: 120-129/<80
-HTN 1: 130-139 or 80-89
-HTN 2: 140+ or 90+
-HTN crisis: >180 and/or >120

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39
Q

factors influencing blood pressure

A

-age
-stress (sympathetic res)
-ethnicity (AA & hispanics)
-genetics
-gender (after puberty higher in males, after menopause higher in females)
-daily variation
-medications
-activity
-weight
-smoking (vasoconstriction, smaller)

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40
Q

daily variation of BP

A

lower at rest
-midnight-3am lowest
-slow rise until 6am
-surge when you wake up
-10am - 6pm BP is at the highest

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41
Q

HTN risk factors - modifiable

A

-DM (choose to control)
-elevated serum lipids (alter diet & ~meds)
-excessive Na intake (H2o follows Na, limit)
-obesity (diet & lifestyle)
-sedentary lifestyle (move)
-stress (manage)
-tobacco use (stop)
-alcohol use (decrease)

42
Q

HTN risk factors - non modifiable

A

-family hx
-race/ethnicity
-increasing age
-gender
-CKD
-Obstructive SA

43
Q

hypertension is a “” killer

A

“silent”, pts are usually asym until severe

44
Q

how to diagnose HTN

A

average of 2 or more readings on at least 2 subsequent health care visits is above 120/80 (also maybe ekg or chest x ray)

45
Q

HTN symptoms

A

dizziness, headache, heart palpitation, nosebleed, short breath, anger, reddened face, visual problems, fatigue, insomnia, sore knee, raised temp

46
Q

complications of htn

A

-CVD
-MI (heart attack)
-heart failure
-stroke
-peripheral vascular disease
-renal disease
retinal disease

47
Q

nursing care - blood pressure readings for someone w/ htn

A

pt rest for 5 mins, wait 1 minute in between readings, do both arms, record highest reading, observe patterns/baseline

48
Q

nursing intervention goals of pt w/ htn

A

prevent heart disease, stroke or renal disease

49
Q

nursing care for htn

A

assist w/ changing risk factors, heart healthy diet, wt reduction if needed, balance rest & activity, stop smoking, mgn meds, monitor BP, collab w/ provider & dietitian, pt ed

50
Q

pt education for HTN

A

-bp screening program (have a cuff? can they use the cuff? when to hold meds? when to notify PCP? how to record?)
-discuss risks
-how to manage
-lifestyle modification
-proper nutrition & exercise
-stress mgt
-drug therapy ed

51
Q

when to seek immediate care for htn

A
  • BP >180/110
  • severe headache
  • dyspnea or chest pain
    -dizziness, numbness, weakness
    -loss of vision
    -difficulty speaking
    -nose bleeds
    -severe anxiety
    -unresponsive
52
Q

lifestyle modifications for htn

A

-mgn blood pressure
-control cholesterol
-reduce blood sugar
-get active , lose wt
-stop smoking
-limit alc
-stress modification

53
Q

dash diet

A
  • 6 to 8 serving whole grains /d
  • 4 to 5 serving /d of fruits
  • 4 to 5 serving /d of veggies
  • 2 to 3 servings /d of low fat dairy
  • 4 to 5 serving /w of legumes
  • <6 servings /d lean meat & fish
  • <5 servings /w of sweets
  • 2 to 3 servings/d fats & oils
    -limit salt
54
Q

why are we concerned about hypotension

A

low perfusion to organs

55
Q

causes of hypotension

A

-dilation of arteries
-loss of blood volume (dehy, bleeds, weak heart)
-failure of heart muscle to pump

56
Q

symptoms low hypotension

A

-pale, modeled clammy skin
-light headedness, dizziness (syncope), confusion
-blurred vision
-chest pain (angina)
-increased HR
-decreased urine output
-nausea / vomiting

57
Q

treatment of hypotension

A

treat the cause
-if vasodilation: find things to increase resistance of vasculature (give meds)
-if loss of blood volume: supplement perfusion insider the intravascular space (IV fluids)
-if failure to pump: may give meds to increase contractility of the heart

58
Q

nursing implementation of hypotension

A

-monitor VS more frequently
-assess for symptoms
-interventions for treatment of cause
-consider adding more salt to diet
-drink water or IVF
-wear compression hose
-meds

59
Q

what type of people get orthostatic hypotension

A

-w/ who don’t have very high blood volume
-elderly
-people who have been immobilized / bedrest
-pregnant women

60
Q

diagnosis of orthostatic hypotension

A

-SBP: decrease of 20mmHg or more
-DBP: decrease of 10mmHg or more
-same symptoms as hypotension
when you go from lying to standing

61
Q

how to check for orthostatic hypotension

A

-measure BP & HR supine, sitting & standing
-measure BP within 3 mins of position changes
-monitor BP, pulse & symptoms
-CDC: 5mins after lying down, 1 min after standing, 3 mins after standing

62
Q

nursing care for orthostatic hypotension

A

-change position slowly
-dangle feet at bedside
-do not cross legs
-early ambulation
-if immobile, balance rest & activity
-perform isometric exercises (squeezing rubber ball)
-wear compression (venous return
-prevent falls

63
Q

what are lipids

A

-cholesterol & triglycerides
-made by liver and consumed in diet from animal sources

64
Q

what is the most common fat in the body

A

triglycerides, body makes it and we consume it

65
Q

hyperlipidemia diagnostic tests

A

-start at 20, test every 4-6 years until 40 and then assess every 10 unless risk factors
-needs to be fasting (9-12 hrs)

66
Q

desired chol, LDL, & HDL levels (serum lipid profile)

A

-chol: <200mg/dL
-LDL: <130 mg/dL
-HDL: >45 (M), >55mg/dL (F)

67
Q

nursing care for hyperlipidemia

A

check, change, control
-be active
-diet mods
-healthy wt
-limit smoking & alc
-lipid lowering therapy

68
Q

dietary modifications for hyperlipidemia

A

-reduce sat & trans fat
-increase complex carbs (WG, F/V) & fiber
-limit cholesterol
-limit alc & simple sugar (esp for high tags)
-eat fatty fish weekly + omega 3s

69
Q

foods high in omega 3s

A

soybean oils, canola, walnuts, flax seeds

70
Q

DVT + PE =

A

VTE

71
Q

a pulmonary embolism enters the heart on which side?

A

right side and then gets pumped into the lung

72
Q

what is a VTE

A

obstruction of a blood vessel by a blood clot that has become dislodged from another site (usually legs) in the circulation

73
Q

who is at risk for a VTE

A

-someone with venous stasis (the blood isn’t moving back to your heart from your legs)
-person w/ hyper coagulability
-endothelial damage
-hx of DVT
-diabetes

74
Q

what causes venous stasis

A

obesity, immobility, surgery, pregnancy, anyone with thickened blood (hyper-coagulability)

75
Q

what causes endothelial damage

A

-some kinds of IV fluids / having an IV site
-certain drugs / drug abuse
-fractures & dislocations

76
Q

signs & symptoms of VTE

A

-localized redness, tenderness, swelling over vein sites
-warm, tenderness firmness of muscle in calf
-calf pain when ambulating
-usually unilateral pain

77
Q

assessment for DVT

A

usually redness will not show due to depth & early phases wont be swollen
-palpate legs and ask/watch about pain

78
Q

VTE diagnosis

A

-obtain hx
-physical assessment
-vascular ultrasound studies (only reliable tool to detect)

79
Q

Nursing care for VTE

A

-assess for symptoms
-measuring calf circumference
-calf tenderness/phlebitis check
-early ambulation/activity
-ted hose (expose tips of toes to check for profusion)
-SCDs (compression machines)
-calf pumping

80
Q

VTE treatment

A

prevention is key
-anticoagulation
-thrombolytic
-IVC filter
-nursing interventions

81
Q

diagnostic tests related to cardiovascular system for fundamentals

A

-complete blood count (CBC) for hgb & hct
-fasting lipid panel for chol/tags/ldl/hdl
-chest x ray (fluid build up in lungs & heart size)
-electrocardiography (EKG)

82
Q

hemoglobin

A

the iron containing pigment of the red blood cells ; need it in order for the oxygen to travel on the rbc

83
Q

hemoglobin normal range

A

need to know for exam
14-18 (M), 12-16 (F)

84
Q

hematocrit

A

the percentage of total volume of that is made up of RBCs

85
Q

hematocrit normal range

A

need to know for exam
42-52% (M), 37-47% (F)

86
Q

electrocardiogram (EKG)

A

reflects the normal electrical conduction (we want it to be in normal sinus rhythm) a snap shot in time

87
Q

normal sinus rhythm

A

originates in the SA nodes, follows normal sequence through conduction system (means the ateria contracts, the ventricles contract, the rate is good and the heart is happy)

88
Q

the difference between EKG & telemetry

A

-EKG is a detailed snap shot in time
-telemetry is less detailed but is continuous

89
Q

what implies fluid volume excess

A

jugular venous distention more than 45 degrees

90
Q

S3

A

ventricular gallop “Ken-TUCK-y”

91
Q

S4

A

atrial gallop “TEN-nes-see”

92
Q

murmurs

A

-swishing sound
-within a valve

93
Q

click sounds in the heart

A

pt has mechanical valve

94
Q

rubbing heart sounds

A

rubbing of theh pericardial sac and it sounds scratchy

95
Q

peripheral vascular checks

A

feet tell you so much
-pain
-pulse (0-4+)
-pallor (pale)
-paresthesia (feeling)
-paralysis

96
Q

nursing implementation for the cardiovascular pt

A

-strict I&Os
-oxygen prn
-telemetry
-administer medications
-monitor labs
-implement heart healthy diet
-limit stress
-prevent thrombus formation

97
Q

nursing collaborations for the cardiovascular pt

A

cardio pul rehab, HCP, cardiologist, res therapy, code team/rapid, dietitian, PT, cardiac nurse navigators, support groups, social / cae mgt

98
Q

hypertension does what to cardiac output, peripheral resistance and hematocrit levels

A

increases them

99
Q

How to increase preload

A

IV fluids, stimulating SNS w/ meds (vasopressors) venous return to the heart

100
Q

How to decrease preload

A

Diuretics (pts usually in volume overload) , vasodilation

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