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Cardio Sem 2 > Cardio Exam 3 > Flashcards

Cardio Exam 3 Flashcards

1
Q

EKG lead locations

A

V1 - 4th intercostal space to the right of the sternum
V2 - 4th intercostal space to the left of the sternum
V3 - directly between V2 & V4
V4 - 5th intercostal space at midclavicular line
V5 - level with V4 @ left anterior axillary line
V6 - level with V5 @ left midaxillary line (under the armpit

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2
Q

electrical impulses generates heart beat and is affected by which electrolytes

A

sodium, potassium, magnesium, calcium

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3
Q

normal rate of SA node

A

60-100 BPM

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4
Q

Normal rate of AV node

A

40-60 BPM

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5
Q

Normal rate of bundle of his

A

20-40 BPM

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6
Q

cardiac conduction system pathway

A

SA -> interatrial -> internodal bundles ->AV -> bundle of his -> purkinje

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7
Q

what EKG finding is indicative of SA node firing? What does it mean? How should they look?

A

P-wave

atrial depolarization

rounded

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8
Q

PR interval

What could it indicate if it’s prolonged?

A

time it takes for impulse to travel from SA node to AV node

a block

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9
Q

Normal PR interval

A

0.12 - 0.20

3-5 small squares

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10
Q

QRS complex

A

ventricular depolarization and atrial repolarization

time for electrical impulse to travel from AV node through ventricles

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11
Q

Normal QRS complex

A
  1. 06-0.10

1. 5-2.5 little boxes

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12
Q

T-wave

A

follows the QRS complex

ventricular repolarization (resting state)

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13
Q

ST segment

A

time from completion of contraction to recovery

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14
Q

how to calculate HR from EKG

A

count number of complexes in a 6 second strip x10

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15
Q

Normal sinus rhythm EKG

A 
regularity of rhythm
HR
P wave (present for every QRS)
PR interval
QRS interval
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16
Q

Cardio-selective beta blockers

A

MANBABE

metoprolol, metoprolol ER, atenolol, nebivolol, bisoprolol, acebutolol, betaxolol, esmolol

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17
Q

non-cardioselective beta blockers

A

propranolol, nadolol, labetalol, carvedilol, sotalol

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18
Q

causes of premature atrial contraction

A

hypoxia, cigarette smoking, heart failure, electrolyte imbalances, caffeine, alcohol, meds, fatigue, anxiety, stress

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19
Q

what is atrial fibrillation

A

electrical impulses initiated randomly from ectopic sites = atria quiver

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20
Q

is a PAC intermittent or continuous?

A

can be both

constant = increased risk for emboli

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21
Q

Afib RVR

A

(unstable Afib)

ventricular HR >100

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22
Q

Afib s/sx

A

hypotension, dizziness, pulse deficit, chest pain, palpitations, fatigue

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23
Q

Afib treatments

A 
anticoags (warfarin, eliquis, xarelto)
control rate and rhythm (BB, CCB, Dig)
cardioversion
cardiac ablation
surgery
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24
Q

digoxin functions

A

strengthen ventricular contraction, decreases conduction through the SA and AV node

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25
digoxin normal range
0.5-2.0
26
s/sx digoxin toxicity
N/V/D, arrhythmias, vision changes, decreased appetie, confusion
27
what do you monitor while on digoxin
potassium (hypokalemia increases dig toxicity) calcium (hypercalcemia increases risk for dig toxicity) magnesium (hypomagnesemia increases for dig toxicity)
28
nursing implications for digoxin
monitor apical pulse for 1 full minute hold if <60 bpm monitor EKG during IV administration and 6hr after each dose
29
A flutter a-flutter risks
coordinated electrical activity in the atria not every atrial impulse goes into the ventricle sawtooth pattern no PR interval risk = incomplete contraction -> blood stasis -> risk for stroke/embolism
30
A-flutter EKG
rhythm = atria is regular, ventricles could be regular or irregular HR: atrial 250-350 bpm, ventricle depends on the underlying rhythm P-waves: rapid coordinated, sawtooth pattern PR interval: unable to determine QRS: less then or equal to 0.1
31
PVC
premature ventricular contraction | very common
32
ventricular tachycardia
ventricles become the pacemaker instead of the SA node
33
V-tach ekg
``` rhythm: regular HR: 150-250 Pwaves: absent PR interval: unable to determine QRS: >0.1, wide, bizarre looking ```
34
Vtach treatment with a pulse
synchronized cardioversion ICD (intracardiac defib) ablation meds: lidocaine, adenosine, beta blocker, amiodarone, diltiazem
35
vtach treatment w/o pulse
CPR Defibrillate meds: epi, lidocaine, amiodarone
36
v-fib
ventricles quivering with no discernable waves no pulse present
37
causes of v-fib
hyperkalemia, hypomagnesemia, CAD, MI, electrocution, VTACH
38
vfib treatments
CPR -> epinephrine, amiodarone, lidocaine
39
what is arteriosclerosis
thickening, loss of elasticity, and calcification of arterial walls (part of aging process)
40
what is atherosclerosis
formation of plaque within arterial wall -> injury to endothelial cells -> growth of muscle cells which secrete collagen and fibrous proteins -> lipids platelets, and clotting factors accumulate
41
diagnosing atherosclerosis
lipid panel, c-reactive protein, blood glucose levels
42
lipid profile normal ranges
total cholesterol: <200 triglycerides: <150 (critical: >400) LDL: <100 HDL: >45 men, >55 women
43
c-reactive protein
1.0-3.0 >3.0 = low grade inflammation can indicate if something else is causing blockage
44
blood glucose levels
elevated levels can increase the risk for atherosclerosis
45
atherosclerosis therapeutic measurements
DASH diet, smoking cessation, exercise, low-dose aspirin, statins ** statins may take up 4-6 weeks
46
what is angina
chest pain due to ischemia
47
Stable angina
occurs in a pattern familiar to patient, only lasts a few minutes, goes away with rest/nitro
48
unstable angina
increases unpredictably in frequency occurs at rest and/or during sleep NOT RELIEVED BY MEDS OR REST treat as an emergency
49
prinzmetal angina
aka variant or vasospastic caused by coronary artery spasms cyclical pattern lasts longer than stable
50
microvascular angina
spasms in walls of tiniest arteries | pain may be more severe
51
angina treatment
nitroglycerin
52
things to know about nitro
dilates arteries = reduced workload assess BP and pain (hold if BP is low) given sublingual = faster absorption (acts in 1-2 minutes, lasts 30-40 minutes) 1 Q5min x3
53
nitro side effects
hypotension, headache
54
STEMI
ST Elevation Myocardial Infarction: most serious, effects full thickness of heart necrosis has probably occured
55
NSTEMI
Non ST Elevation Myocardial Infarction: less serious, blockage is usually partial, can be reversed and necrosis can be avoided
56
which part of the heart is effected during an MI
depends on the effected coronary artery
57
how long does it take for an ischemic injury to result in necrosis
it may take hours, but can be prevented if caught in time
58
when should meds be given for MI
within the hour **time is muscle
59
necrosis can lead to scar tissue causing what
decreased muscle contraction and heart failure
60
S/sx of myocardial infarction
heaviness, pressure, tightness, burning, constriction, crushing pain (elephant sitting on my chest) fatigue, weakness, SOB, anxiety, SNS is activated (low BP, high HR, clammy and gray skin) N/V **pain may radiate!
61
MI diagnostic tests
troponin: <0.04 is normal myoglobin and CK-MB: not as sensitive - takes longer to elevate EKG: Look at ST segment magnesium and potassium: vital for heart function
62
MI treatments (surgeries)
Cardiac catheterization: balloon angioplasty, percutaneous coronary intervention (PCI) Coronary Artery Bypass Graft (CABG): vessel usually taken from the leg to bypass blockage
63
Post MI medications
``` beta blockers: metoprolol, Carvedilol ACE inhibitors: lisinopril, ramipril STATINS: crestor, lipitor antiplatelet: plavix, brilinta vasodilators: isosorbide mononitrate ```
64
Peripheral Arterial Disease (PAD)
narrowing of arteries that leads to occlusions or obstructions
65
which part of the body is usually effected by PAD
lower extremities
66
causes/risk factors for PAD
Any other cardiovascular disease
67
S/sx of PAD 60-75% of blockage
``` intermittent claudication paresthesia thin, shiny, and taut skin loss of hair on the lower legs diminished or absent pedal, popliteal, or femoral pulses pallor of extremity when elevated, reddish-purple when dependent cool skin thickened toenails dry, flaky, scaly skin decreased sensation pain at rest ```
68
PAD complications
atrophy of the skin and underlying muscles delayed healing = risk for infections, gangrene wound infection tissue necrosis arterial ulcers (defined borders, painless) amputation
69
aneurysms
balloon-like bulge in the vessel
70
types of aortic aneurysms
aortic arch, thoracic aorta, abdominal aorta (AAA)
71
normal diameter of the aorta? diameter of aorta that requires treatment
<3cm >5cm
72
Aortic aneurysm s/sx
Thoracic: asymptomatic, SOB, SP pain that radiates to back AAA: asymptomatic, pulsatile mass, bruit, back or flank pain, abdominal pain/feeling of fullness
73
aneurysm diagnostic tests
abdominal US, CT, MRI, Aortography (arteriogram)
74
aneurysm treatments
lifestyle changes: wt loss, diet, smoking cessation, decreased BP surgery: removal of dilated section - graft placed endovascular aneurysm repair (EVAR): catheter threaded through femoral artery to place stent
75
aortic aneurysm complications
aortic dissection rupture
76
aortic dissection
tear in the inner wall and blood will pool between the inner and outer wall = increased risk for rupture
77
rupture
``` #1 complication into retroperitoneal space - can tamponade surrounding structures into thoracic or abdominal cavity - blood can compress lungs, heart, or abdominal organs -> massive hemorrhage = death ```
78
aortic dissection
tear -> blood between inner and middle layer -> systolic pulsation increases pressure on damaged area -> further dissection -> may occlude major branches of aorta

Cardio Sem 2 (3 decks)

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