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Cardio Random Flashcards

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0
Q

Alpha blocker -(minipress)

A

it often causes severe hypotension after the first dose so Patients should be advised to take the first dose before bedtime to avoid syncope, dizziness, or lightheadedness

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1
Q

Beta -1 & 2 receptors locations

A

Beta 1 found mostly n the heart

Beta 2 found n the bronchi , arteries and uterus

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2
Q

Apical pulse

A

Palpated at the fifth intercostal space on the left midclavicular line. Also known as the point of maximal impulse(PMI)

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3
Q

Electrolyte imbalances are common causes of

A

ventricular tachycardia and hypo magnesium, hypokalemia, and hyperkalemia

So should obtain serum levels of potassium and calcium

Calcium imbalances may cause QT and ST changes

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4
Q

Pitting edema description

A

1+= barely detectable impression, immediate rebound.

2+= slight indentation, 15 seconds to rebound

3+= deep indentation, 30 seconds to rebound

4+= greater than 30 seconds to rebound

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5
Q

Digoxin (Lanoxin) has which effects on hemodynamics

A

Digoxin has a positive inotropic effect and a negative chronotropic effect, producing increase contractility and cardiac output while decreasing the heart rate. So it increases BP & decreases HR

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6
Q

Thromboangiitis obliterans

A

Inflammation and thrombosis of the vessels of the hand and feet. It is strongly associated with smoking

Usually treated with vasodilators and sometimes bypass surgery

Smoking is the number one risk factor. The patient should quit smoking entirely in order to slow the progression of the disease

The patient should keep extremities warm. Cold temperatures can cause vasoconstriction and worsen symptoms

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7
Q

Procainamide

A

Is antiarrhythmic used for both ventricular and atrial arrhythmia. The nurse should assess the patient’s vital signs, particularly blood pressure and heart rate before a ministry any antiarrhythmic

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8
Q

Elevated potassium levels cause

A

Lethal arrhythmias! The nurse should access the patient’s EKG immediately

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9
Q

Nitroglycerin infusion should be administered

A

A glass bottle because most plastics absorbs the Drug diminishing its potency and effectiveness

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10
Q

A measures to relieve claudication

A

Avoid smoking because smoking cessation prevent symptoms of claudication and also reduces progression of the disease

Warm compress are recommended to promote circulation

Discomfort can be relieved with rest, as exercise will aggrevate get the legs

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11
Q

Clopidogrel ( Plavix)

A

is an anti platelet med used in the prevention of vascular ischemic events and during and acute myocardial infarction

Unlike aspirin, this med reduces platelet aggregation by inhibiting the ADP pathway of platelets and doesn’t not affect prostaglandin metabolism

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12
Q

Major risk factors for coronary heart disease (CAD)are

A

Diabetes
Smoking
Increase in LDL levels
Hypertension

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13
Q

Pericarditis S&S

A 
Chest pain
Fever 
Leukocytosis
Pericardial friction rub
ST-segment elevation
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14
Q

Chest pain is a symptom of

A

Myocardial infraction

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15
Q

Edema and low urine output are associated with

A

Heart failure

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16
Q

Spironolactone(Aldactone) can cause

A

Is a potassium sparing diuretic that can calls hyperkalemia potentially resulting in cardiac arrhythmias

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17
Q

Hypokalemia is associated with Loop diuretics

A

Hypokalemia is associated with Loop diuretics

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18
Q

PTCA

A

During a PTCA a balloon tipped catheter is inserted into the Femoral or radial and is advanced artery into the coronary arteries. Then the balloon is inflated to compress the atheromatous plaque against the walls of the vessel, resulting in a patent vessel

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19
Q

After a cardiac catheterization using the femoral artery,

A

the patient should remain on flat bed rest and be reminded not to flex or move the affected extremity. Doing so may result in hemorrhage or arterial occlusion

Fluids are encouraged after any procedure that uses contrast dye. After a cardiac catheterization, the patient must keep the affected extremity straight, so the nurse can’t place the patient in reverse Trendelenburg to facilitate drinking

Assessing the motor functions of the patients foot is important to confirm adequate perfusion

Medications should be resume to treat all other diseases and conditions

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20
Q

Endocarditis risk factors

A

Artificial valves,
dental procedures
IV drug use
immunosuppressive

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21
Q

Weber test

A

Is a screening tool for conductive hearing loss

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22
Q

Romberg’s test

A

Evaluates proprioception

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23
Q

Tinel’s sign

A

Is used to determine median nerve damage in carpal tunnel syndrome

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24
Q

Isolated PVCs

A

Are not life-threatening but should be monitored closely for other rhythm changes

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25
Q

Life threatening arrhythmias are

A

Ventricular fibrillation

ventricular tachycardia

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26
Q

Claudication

A

Refers to pain in the leg muscle after small amount of physical activity. It is caused by poor circulation to the extremity

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27
Q

Raynaud’s phenomenon

A

A vasosplastic disorder that compromises blood flow to the extremities

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28
Q

Lazarus syndrome

A

Is the spontaneous return of circulation after failed attempts at resuscitation

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29
Q

Atropine

A

An Anti-chlorogenic medication that may cause

urinary retention 
dry mouth 
dry eyes 
tachycardia 
dilated pupils 
blurry vision 
constipation
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30
Q

Peripheral Vascular disease (PVD)

A

Leads to compromised blood flow to the extremities. Regular exercise is a great way to improve circulation and Collateral blood flow!!

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31
Q

Endocarditis S&S

A 
Fever
Malaise
Murmur
Weight loss 
Splinter hemorrhages
Osler's nodes

Infective endocarditis mostly commonly occur in
IV DRUG USER
AT THE VALVE SURGERY
AFTER DENTAL PROCEDURES

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32
Q

Splinter hemorrhages

A

Are tiny clots that run vertically under the fingernails

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33
Q

Osler’s nodes

A

Are painful subcutaneous lesions in the distal fingers

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34
Q

Charcoal

A

Only use if large amounts of the drug are still in the stomach

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35
Q

Digibind

A

Is an antidote use for digitalis Toxicity by binding to digoxin in the blood. This is only use with unstable patients or doing a severe overdose

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36
Q

A stable patient with drug toxicity

A

For a stable patient the best treatment is to wait for the patient’s body to excrete the drug metabolites and treat the symptoms ss needed. Symptoms include arrhythmia and nausea

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37
Q

Pulmonary edema

A

Elevating the patient legs with increased venous return to rapidly this could overload the heart and worsen the patient’s condition

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38
Q

Cardiac catheterization

A

The patient may feel warmth, flushing, a flattering feeling, palpitations or a desire to cough. The symptoms are from the injection of dye catheter passage

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39
Q

Right-sided heart failure signs and symptoms

A

Peripheral edema
ascites
jugular vein distention
Hepatomegaly

The symptoms are caused by a diminished ability of the right ventricle to pump blood. This causes blood to pool in the extremities, abdomen, Neck, and living

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40
Q

Left-sided symptoms S&S

A

Dry cough
Crackles
Cyanosis

Left-sided symptoms r caused by a diminished ability of the left ventricle to pump blood. This leads to pooling in the pulmonary circulation causing pulmonary edema

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41
Q

ARBs May be beneficial for patients who cannot tolerate the adverse effects of which class of medications

A

Ace inhibitors are often not tolerated due to the dry cough that many patients experience. ARBs provides a similar mechanism of action without the dry cough

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42
Q

Deep vein thrombosis (DVT) S&S

A

Pain In the calf
Redness
Swelling
Heart signs

Having the pt ambulate or massaging the calf would dislodge thrombosis and create an embolus

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43
Q

Atropine is contraindicated in patients with

A

angle closure glaucoma because it would increase optic pressure

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44
Q

Intra-aortic ballon pump

A

Inflates during the diastole to increase perfusion ito the coronary arteries and deflates During systole to decrease afterload

The timed inflation and deflation contribute to

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45
Q

Digoxin toxicity

A 
Cardiac arrhythmias 
Nausea
Vomiting 
Diarrhea
Visual disturbance
Headache
Lethargy
Irritability
Abdominal cramps
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46
Q

Austin Flint murmur

A

Is best heard over the apex of the heart. It’s describe is a low pitch and rumbling and can be heard during mid-late diastole

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47
Q

Pulmonic stenosis

A

Second in the coastal space, left sternal border is the best location for hearing

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48
Q

Aortic stenosis

A

Second intercostal space, right sternal border is the best location for hearing

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49
Q

Failure to capture

A

Is when the pacer fires a signal, but the heart does not respond with a beat. This is often caused by pacer lead migration on the epicardium .

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50
Q

Failure to pace

A

Is when the pacer fail to fire a signal when it should. This often leads to bradycardia and hypotension because the heart cannot beat at the same rate as a pacer

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51
Q

Failure to sense

A

Is when the pacer cannot sense the heartbeat, leading to poorly timed firing by the pacer!

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52
Q

Asystole

A

Is the absence of a heart rate

53
Q

Angina pectoris

A

Caused by increased oxygen demand and decreased oxygen supply to the heart! When activity cardiac output increases. Without an adequate oxygen supply to the heart, ischemia and pain develop

Usually self-limiting often last for only 10-15minute

Patient may have chest pain related to eating (heartburn) and breathing(pleurisy ) but this is generally not relate to angina pectoris.

54
Q

What food should a pt way while taking -Furosemide (Lasix)

A

The pt should be instructed to consume foods high in potassium due to furosemide’s potassium-wasting effect

Foods high in potassium include
Spinach
Potatoes 
Beans
Raisins
Tomatoes
Bananas
Squash
Dried apricots
55
Q

Colestipol (Colestid)

A

A bile acid sequestrants commonly cause constipation and can be used to treat diarrhea associated with bile acid malabsorption

Bile acid sequestrants bind to bile in the GI tract and can be used safely in a pt with active liver disease

56
Q

Myocardial infarction. Interventions

A

Administration of nitroglycerin and morphine
Placement of a cardiac monitor
Administration of 2-4L of oxygen and I.V. Catheter insertion

High levels of oxygen should only be administered if specifically ordered by the physician

57
Q

Hypertension symptoms

A

Headache
Tinnitus
Blurred vision
Dizziness

58
Q

Diltiazem (Cardizem)

A

Is a nondihydropyridine calcium channel blocker user in treatment of arrhythmias

59
Q

Nitroglycerin

A

A vasodilator , leading to a reduction in blood pressure. It’s strong venodilating effects cause a decrease in preload leading to a decrease in cardiac output. This causes a reflex response by sympathtic nervous system increasing heart rate in order to maintain cardiac output

60
Q

Corrugated’s pulse

A

Is a bounding and forceful pulse with a rapid rise and fall. This associated with increase stroke volume and decrease in peripheral resistance !

Commonly found in aortic regurgitation and often leads to a widening pulse pressure.

61
Q

Pulse tardus

A

Is a weak pulse with a slow upstroke and prolonged peak. It is seen in aortic stenosis

A weak, threads pulse is a sign of low blood pressure or reduced cardiac output.

62
Q

Abdominal aortic aneurysm (AAA)

A

Worsening pain in the back and abdomen may indicate that the aneurysm is pressing against the lumbar nerve root!

Hypotension and tachycardia expected with AAA extension

63
Q

CholecystItis S&S

A

Right upper quadrant pain that worsens with palpitations

64
Q

Implantable cardioverter-defibrillator (ICD)

A

We will not harm a person touching the patient. The shock may be felt but the charge is not high enough to cause harm

A.m. alarm will sound if the patient is near a magnetic field that may deactivate the device

Contact with the patient should not be avoided

65
Q

Hypertension risk factor

A 
High salt and fat intake
Obesity
Stress
Alcohol consumption
Inactivity 
caffeine
Vitamin D deficiency
66
Q

Secondary hypertension risk factors

A 
Renal disease 
Cushing's syndrome 
hyperthyroidism
Hyperaldosteronism
Pheochromocytoma
Hormonal contraceptives 
diabetes
67
Q

Raynaud’s disease

A

Characterizes by intermittent vasospastic attacks. These acute attacks are often precipitated by stress, cold, caffeine, smoking!!

68
Q

Alcohol and extreme heat cause

A

Vasodilation

69
Q

Normal cardiac output

A

4-8L per min

70
Q

Low heart rate or low blood pressure indicates

A

Poor cardiac output

71
Q

Cardiogenic shock results in

A

In adequate circulation of blood due to failure of the heart to pump effectively

Manifestations of reduce circulation include 
tachycardia 
hypotension 
weak and Thready pulse
decrease in urinary output 
cool and clammy skin
72
Q

Prinzmetal’s and Angina also known as variant angina

A

Is characterized by cyclic chest pain. It is caused by vasospasms leading to narrowing of the coronary arteries

73
Q

What is a contraindications for intra-aortic ballon pump (IABP)

A

Absolute contraindicates to IABP include significant aortic regurgitation and aortic dissection

74
Q

Which of the following common symptoms resolve spontaneously with Coronary artery bypass graft (CABG)

A

Depression is common after undergoing a CABG. It usually resolves within several weeks and does not generally require medical intervention

Edema after a CABG may indicate heart failure

Dizziness may signal a decrease in cardiac output. This is an abnormal findings and requires immediate attention

75
Q

During the early stages of heart failure which ‘specific compensatory mechanism occurs

A

Hypotension stimulates the baroreceptors to decrease sympathetic activity(as blood pressure falls, baroreceptors of the carotid and aorta are stimulated. This causes a release of Catecholmines resulting in vasoconstriction increased heart rate)

76
Q

Niacin ( Niaspan)

A

Is a water-soluble vitamin that decrease lipoprotein and triglyceride synthesis. Common side effects include flushing of the face and neck, rash, diarrhea, cough, pruritus, nausea and vomiting, hypotension, hyperglycemia

77
Q

Echocardiogram

A

The echocardiogram is painless and will record images of your heart

78
Q

Abdominal aortic aneurysm (AAA) common sites

A

90% of AAAs occur below the renal arteries

79
Q

Small boxes on EKG represent what

A
  1. 04 sec on the horizontal axis(time) and 1mm on the vertical axis(voltage)
  2. 04 sec x 4 boxes= 0.16sec
80
Q

Hepatojugular reflex test

A

Is used to measure jugular vein distention

The nurse places the pt head at 45degrees and firmly presses the right upper quadrant or center of the abdomen for 10-60

If there is a sustained rise in the jugular vein, then the result is positive

81
Q

Malignant hypertension or hypertension crisis

A

Is most commonly caused by untreated hypertension

Less coming causes include 
abrupt discontinuation of antihypertensive medication i
illicit drug use 
certain prescription drugs 
neoplasms
Glomerulonephritis
Pheochromocytoma
82
Q

Mitral stenosis complication

A

Mitral stenosis impedes blood flow in the left side of the heart. This creates fluid and pressure builds in the pulmonary circulation, causing pulmonary hypertension

Other complications of my mitral stenosis includes
edema
right-sided heart failure hand
reduced cardiac output

Myocardial infraction is likely if the patient has underlying coronary artery disease

Fluid overload of the pulmonary circulation can impaired gas exchange potentially leading to respiratory acidosis

83
Q

Which abnormal heart sounds is associated with myocardial infarction

A

Pericardial fraction rub often occurs within one week of having a myocardial infarction due to inflammation of pericardial sac It sounds like squeaky leather

84
Q

Myocardial infarction

A

Cardiac arrhythmias are the most common complication associated with a myocardial infarction. They frequently cause disability and death.

Hearty failure and cardiogenic shock are known complications of a myocardial infarction, but they are not as common as arrhythmias

85
Q

Myocardial infarction pain

A

Usually lasts longer than 30mins radiates to the left arm and shoulder and requires morphine for relief.

Angina pain usually caused by activity or excretion radiates to the left arm and is relieved by nitroglycerin

86
Q

Cardiac arrhythmias tornadoes de pointes

A

tornadoes de pointes is a type of ventricular tachycardia is often caused by hypomagnesemia. The nurse should prepare to administer magnesium sulfate

Diltiazem and amigos stone can be used with ventricular arrhythmias but tornadoes de pointes is first treated with magnesium sulfate

87
Q

Nitroglycerin transdermal patch

A

Application sites for nitroglycerin transdermal patches must be rotated every application to Prevent skin irritation sensitization

Nitroglycerin patches must be applied for 12-14 hours followed by 10 to 12 hour nitrate free period to avoid developing tolerance

The preferred site for nitroglycerin patch is the chest. It must be dry cleaned and hairless. Avoid placing the patch on irritated sites or areas with cuts

88
Q

After undergoing a cardiac catheterization the nurse should

A

The insertion site usually the femoral artery should be checked frequently for signs of bleeding or hematoma formation ! The insertion site is at risk for bleeding due to the high pressure of the femoral artery and the large diameter of the catheter

Fluids should be encouraged to flush out the dye used during the procedure

89
Q

Most commonly used indicator for poor peripheral circulation

A

The ankle brachial index is the blood pressure ratio between the lower legs and arms. Blood pressure in the lower legs is normally higher than arm. A ratio 1.0 indicate peripheral vascular disease

Peripheral pulses are not a good indicator of peripheral vascular disease

90
Q

Allen test

A

Used to asses blood supply to the hand

91
Q

Cardiac stress test

A

used to measure the hearts ability to respond to stress

92
Q

Defibrillate for a pt with a ventricular fibrillation

A

Ventricular fibrillation is not shockable when the synchronizer is turn on.

93
Q

Premature ventricular contractions ( PVCs)

A

Are wide bizarre QRS complexes in the absence of P waves . There is generally a pause that follows the PVC

94
Q

Ezetimibe ( zetia)

A

inhibits absorption of cholesterol and is often combine with a strain .

Use to treat hyperlipidemia

95
Q

Sublingual Nitroglycerin should be place ?

A

Sublingual mess should be place on the mucosa below the tongue on the floor of the mouth. The superior to the sublingual gland

96
Q

Troponin-I

A

Is highly specific for cardiac muscle necrosis and us the most accurate lab test for myocardial infraction

97
Q

Varicose veins

A

Results from a genetic predisposition that results in less elastic veins

Sclerotheraphy is user to treat varicose veins it is not a cure

Varicose veins r more common n women

98
Q

During a myocardial infraction pain

A

During a myocardial infraction pain is usually felt n the left shoulder, arm , neck, jaw

99
Q

What should the nurse do if the client shows symptoms of Myocardial infraction

A

When a patient has symptoms of a myocardial infarction the nurse should administer oxygen to increase myocardial oxygen supply

Telemetry will help diagnose an MRI because of changes in the EKG. Vital signs should be check before administering nitroglycerin

So administer oxygen via nasal cannula, initiating the telemetry, check vital signs, administer nitroglycerin

100
Q

How do you determine inadequate stroke volume

A

Use pulse deficit

Pulse deficit is when the apical pulse is greater then the radial pulse. This is due to a low stroke volume in which most blood flow is not reaching the periphery

A narrow pulse pressure is expected with a low stroke volume. A narrow pulse pressure is when the difference between the systolic and diastolic pressure is less then 25% of the systolic value

Corrida pulse is associated with increased stroke volume and peripheral resistance

101
Q

Serum CK-MB levels

A

start to elevate 4 to 6hrs after the onset of chest pain. Levels usually peak around 12 to 18 hours after onset of chest pain

102
Q

Which of the following drugs can prevent a common side effect of nitroglycerin

A

Acetaminophen (Tylenol ) headaches are a common side effect of nitroglycerin. The nurse make Acetaminophen to prevent or treat headaches caused by nitrates

103
Q

Preload is decreased by

A

Conditions that reduce circulation volume or venous return this includes hemorrhage,sepsis and anaphylaxis

104
Q

Ventricular depolarization is represented by

A

The QRS complex

105
Q

Ventricular reporter Repolarization is represented by

A

The T wave

106
Q

Atrial Repolarization is

A

Is hidden within the QRS complex and cannot be distinguished

107
Q

Angioplasty of the iliac artery

A

After an angioplasty of the iliac artery bleeding may develop accumulate in the retroperitonal space. Measuring a abdominal girth is the best way to assess blue accumulation

108
Q

Pericarditis interventions

A

Pericarditis is inflammation of the percardium caused by infections autoimmune disorders and trauma

Pain related to pericarditis worsens while in a lying position

Instructing the patient to lean forward will pull the heart away from the Lungs, preventing pericardial irritation caused by the lungs

109
Q

Aspirin

A

Is a cyclooxygenase(COX) inhibitor that interferes with platelet aggregation

Heparin inactivates clotting factors

Coumadin ( Warfarin) blocks vitamin K synthesis

Nitrates promote coronary vasodilation

110
Q

Hydrochlorothiazide

A

Is a thiazides diuretic that is used to treat hypertension and edema

Common  side effects include
Hypokalemia
Hyperuricemia
Glucose intolerance
Hypotension
Hyperlipidemia
111
Q

Chronic congestive heart failure results from

A 
Infections
Arrhythmias 
Hypertension
Anemia
Hyperthyroidism 
Inadequate diet
Meds such as NSAIDs
112
Q

Proteinuria & albuminuria r early inductors of

A

Renal injury often causes by hypertension

113
Q

Which lab results is the goal of treatment for this patient taking Coumadin (Warfarin)

A

Patient taking Coumadin for atrial fibrillation need to maintain an INR between 2 and 3 ( normal is 0.9-1-2) to reduce the risk of emboli formation

114
Q

Foods a pt with CHF should avoid r

A

Pt with CHF should avoid foods high in sodium.

Monitoring sodium intake is an important part of ongoing treatment for CHF

115
Q

ACE inhibitors lower blood pressure thru

A

ACE inhibitors block the actions of aldosterone and angiotensin II

Aldosterone is responsible for sodium and water retention in the kidneys. Angiotensin II causes potent vasoconstriction

116
Q

DVT

A

Bed rest is not advised. Ambulation is encourage to reduce complications and promote recovery.

Interventions
Heat
Pain meds
Elevation of the leg

117
Q

Atropine

A

Is the only drug listed that used for symptomatic bradycardia

118
Q

Epinephrine

A

Is used for ventricular fibrillation, flutter and unstable tachycardia

119
Q

Dopamine

A

Is used to maintain adequate blood pressure during shock and to maintain kidney perfusion

120
Q

Dobutamine

A

Is used to increase cardiac output in heart failure.

121
Q

What can interact with the effects of Coumadin ( Warfarin)

A

Dark leafy green vegetables r high n vitamin K and will reduce the effects of warfarin. However the patient should maintain a consistent intake of vitamin K to prevent adverse reactions of warfarin particularly bleeding

122
Q

Sign and symptoms of low cardiac output

A 
Hypotension
Dizziness
Weakness
Fatigue
Shortness of breath
Syncope
123
Q

Raynaud’s disease( phenomenon)

A

Is vasospastic disorder affectioning the hands and feet. It leads to impaired perfusion

S&S
diminished peripheral pulses, 
palor
Numbness in the extremities
Brittle finger nails
Thin skin
Cyanosis

Vasospasms generally occur due to exposure to cold or stress

124
Q

Myocarditis

A

Is inflammation of the myocardium or the heart muscle of the heart

125
Q

Pericarditis

A

Is inflammation of the outermost layer if the heart

126
Q

Endocarditis

A

Is the inflammation of the innermost layer of the heart

127
Q

Valvular disease

A

Affects the hearts valves

128
Q

IVC filters

A

Is a vascular used to trap emboli floating in vena cava. It helps prevent pulmonary emboli.

129
Q

Signs of cardiac tamponade

A 
Muffle heart sounds
Tachycardia 
Hypotension
Jugular vein distention
Paradoxical pulse

Cardiac tamponade occur when fluids fills the pericardial space, causing an increase in pressure . As pressure increases around the heart, less blood enters the ventricles this results in decreased stroke volume.

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