Cardio unit exam Flashcards
40 y/o PT w/ history of coronary artery disease & recent mastectomy chief Complaint is chest discomfort. BP 80/54 P 120 R22
Cardiogenic shock
60 year old patient short of breath and cyanotic. Lung sounds reveal crackles and
you note accessory muscle use.
Left- sided heart failure
A 36 year old female has a chief complaint of chest pain. She is conscious & alert.
Her SPo2 is 93%. You should:
O2 NRM 15 LPM
A 36 year old female with a history of congenital heart defects is slow to respond.
She has pale, cool, and clammy skin. Vital signs are BP 68/30, P 128, R 26.
Cardiogenic Shock
a 42 year old female has a pulse and is breathing adequately after a single shock from the AED. in which position should you place her?
Recovery
a 42 year old male is unresponsive. he was found behind a restaurant and bystanders are unsure how long he has been there. what should you do?
check for a carotid pulse
a 45 year old female complains of weakness, shortness of breath, back pain, and pressure in her chest. what should you suspect?
myocardial infarction
A 48 year old male complains of 8/10 chest pain that radiates to his neck. Vital signs
are BP 112/78, P 60, R 18. The patient’s daily medications include Metoprolol, Cialis,
Transport rapidly in a position of comfort to the closest facility.
a 48 year old male suddenly becomes confused after taking nitro. he is sitting upright but is unable to follow your directions. what should you do?
place him in a supine position
A 48 year old patient complains of difficulty breathing. Patients history reveals an acute MI 8 months ago. Vital Signs are BP 144/88 P 110 R 24. Auscultations reveal crackles in the lung bases. You should suspect?
PULMONARY EDEMA
A 49 year old male with a history of heart problems complains of chest pressure and
shortness of breath. You should assist him in taking his prescribed nitroglycerin if he:
Complains of a headache and has a BP of 132/90
A 54 year old male complains of chest tightness after raking leaves for an hour. The
pain subsided after he rested and took two nitroglycerin tablets. He has had very similar
Angina pectoris
a 55 year old female’s skin is cool, clammy, and ashen. her level of consciousness begins to decrease and you can no longer palpate a radial pulse. what should you do?
assess her carotid pulse
a 56 year old male complains of epigastric pain that started an hour ago. he is diaphoretic and the pain is radiating to his left arm. what should you suspect
myocardial infraction
a 57 y/o Female chief complaint is chest pain and points to epigastric. You should.
Administer o2
a 57 year old male with chest pain needs assistance taking his medication. what should you do?
assess his vitals
a 61 year old male with chest pain took one does of nitro prior to your arrival. he has experienced relief. vitals: BP 88/44, P58, R22. what should you do?
- assist with the administration of aspirin
A 62 year old male has a chief complaint of chest pain and is lightheaded. BP 88/56
P 126 R 18. What is the best position?
Supine
A 64 year old patient tells you “I feel like I’m about to die”. You administer
nitroglycerin and oxygen and there is no relief of chest pain. Vitals are BP 90/66, P 60,
TRANSPORT IMMEDIATELY
A 65 year old male complains of weakness and indigestion from the morning. Vital
signs are BP 150/90 P 116 R 24
MI
A 66 year old Female called EMS for chest pain. Prior to calling she took 3 doses of her prescription sublingual nitroglycerin with no relief what should you do?
ADMINISTER OXYGEN
a 66 year old female complains of severe shortness of breath that started during the night. she denies chest pain. vitals: BP 180/92, P 110, R irregular, 24 with crackles. what is the most likely cause?
CHF
A 67 year old male with significant shortness of breath, chest pain, and nausea, is
ashen & clammy. Vital signs are BP 90/60 P 148 R 34. You should
- Place patient in supine
A 68 year old female with cardiac history complains of shortness of breath, auscultations reveal crackles bilaterally. you should suspect?
CHF
A 69 year old male is lying in his bed and complaining of chest pain. during your assessment he becomes unresponsive and pulseless. what should you do?
- MOVE HIM ONTO A HARD SURFACE
A 73 year old female has chest pain and shortness of breath with bilateral crackles.
Vitals are 80/40, P 112, and R 22. What is the most likely cause?
- CARDIOGENIC SHOCK
A 76 year old female is in tripod position. She complains of abdominal discomfort,
nausea, dizziness, fatigue. She has taken 2 nitroglycerin’s with no relief. You should
MI
A 78 year old diabetic PT with a syncopal episode now complains of anxiety, shortness of breath and back pain. You suspect?
ACUTE CORONARY SYNDROME
a 92 year old male complains of headache, difficulty breathing, slurred speech and loss of grip in his left hand. what should you suspect?
Stroke
A buildup of calcium and cholesterol form plaque inside a blood vessel. Which
would most likely be the cause?
ACUTE CORONARY SYNDROME
a diaphoretic 65 year old male is experiencing a sudden onset of left jaw pain. vitals: BP 118/80, P 70, R 18. what should you suspect?
- acute coronary syndrome
A patient collapsed, revived w/ 1 AED shock. Now he is moaning, breathing on his
own. You should:
Turn to side & monitor airway
A patient complains of chest pain radiating to both shoulders after dinner. He’s pale diaphoretic and slightly short of breath. Vitals are BP 150/90 P 120 R 20. You suspect
MYOCARDIAL INFARCTION
A patient has been in cardiac arrest for 7 minutes after being struck by lightning
- Start chest compressions
A patient presents with a sudden onset of tearing chest pain, absent radial pulse on
the right arm, and a history of high blood
AORTIC DISSECTION
A sudden severe increase of blood pressure is called
Hypertensive crisis
After an AED has analyzed a patient, the machine states “shock advised.” The most
likely cause is:
Ventricular tachycardia
After blood has been oxygenated, it returns to the heart by entering the
LEFT ATRIUM
An 80 year old male presents with shortness of breath, fatigue, peripheral edema,
and jugular vein distention. Breath sounds reveal crackles and rhonchi.
The most likely CHF
An 84 year old male has a history of “Heart Problems”. Chief Complaint is chest
pain that started 30 mins ago at rest. BP 110/70 P 92 R 20 SPo2 95%. You should
Assist patient with prescribed Nitro
an AED delivers a “no shock indicated” message for a patient with no palpable carotid pulse. what should you suspect?
pulseless electrical activity
An asthmatic 50 year old female is sitting at her desk. She’s anxious and
complaining of tightness in her chest. You should?
Assist her with her prescribed inhaler
An oriented 78 year old female with pale, moist skin is complaining of indigestion.
Vital signs are BP 180/90, P 116, and irregular, R 24, and regular. What should you
MYOCARDIAL INFARCTION
an unresponsive 72 year old female is pale with peripheral cyanosis. she has a pulse of 20 beats per minute, what should you do?
Transport
angina pectoris=
chest pain that is caused by a temporary blockage of blood; short lived
Aspirin is administered to patients with chest pain because it?
DECREASES ABILITY TO FORM PLATELETS
At what rate should single rescuer CPR be performed for a 17 year old female?
120 per minute
atherosclerosis=
disorder in which there is an accumulation of fat and cholesterol in the arteries > creates plaque
blood flow as it travels through the heart?
inferior and superior vena cava > right atrium > tricuspid valve > right ventricle > pulmonary valve > pulmonary artery > LUNGS > pulmonary veins > left atrium > mitral valve > left ventricle > aorta
bradycardia=
heart rate less than 60 beats/min
cardiac arrest=
no pulse when the heart fails to generate effective and detectable blood flow
how is the pain from an MI different from the pain of an angina?
the pain of angina typically comes from exertion and will go away once the activity is stopped or with nitroglycerin. The pain from an MI can last several hours with no relief from nitroglycerin
hypertensive emergency=
caused by excessive high bp and can lead to stroke or aneurysm
If the heart lacks enough power to pump proper volume of blood through the
circulatory system, this is referred to?
CARDIOGENIC SHOCK
ischemia=
=lack of oxygen that deprives tissues of necessary nutrients resulting from partial or complete blockage of blood flow; potentially reversible because permanent injury has not yet occurred
myocardial infarction
death of heart muscle following obstruction of blood flow to it
myocardium=
heart muscle
The following patients are refusing your care. Which is at the highest risk of a negative outcome?
75 year old male taking Coumadin who fell on the street
The systolic blood pressure measures pressure during which of the following?
Ventricular contraction
The vessels that supply the myocardium are called the
Coronary arteries
What action does aspirin have on the body that makes it beneficial for patients have an acute myocardial infarction?
PREVENTING PLATELETS FROM CLOTTING
What are considered central pulses?
Carotid and femoral
what are major controllable factors for MI?
smoking, high BP, elevated cholesterol level, elevated glucose level (diabetes), lack of exercise, obesity
What are signs of CHF?
swollen ankles, high bp (hypertension), rapid heart rate (hypertension), crackles, shortness of breath, jugular vein distention, previous heart attack
what are the coronary arteries?
blood vessels that carry blood and nutrients to the heart muscle
What are the lower chambers of the heart?
left and right ventricles
what artery supplies the heart muscle with blood?
coronary
What chamber of the heart pumps blood into the aorta?
left ventricle
what chamber of the heart receives blood from the venae cavae?
right atrium
what element of blood is affected by sickle cell anemia?
Erythrocytes
What is cardiogenic shock?
a state in which not enough oxygen is delivered to the tissues of the body, caused by low output of blood from the heart. It can be a severe complication of a large acute myocardial infarction
What is CHF?
a disorder in which the heart loses part of its ability to effectively pump blood, usually as a result of damage to the heart muscle and usually resulting in a backup of fluid into the lungs
what is hypoperfusion?
inadequacy of cellular gas exchange
What is the cause of heart failure?
Inadequate ejection of blood from ventricles
What is the chamber of the heart that pumps blood into the lungs?
right ventricle
What is the heart divided down the middle by?
the septum
what is the name of the chambers of the heart that contract simultaneously to pump blood out of the heart?
Ventricles
What is the primary action of Nitro?
Dilate Coronary Arteries
What is the term for a pulse rate above 100?
Tachycardia
what is the term for adequate circulation of blood through the body’s tissue?
Perfusion
What is the upper chamber of the heart?
left and right atrium
What pressure is created when the heart contracts and forces blood into the arteries?
Systolic
what respiratory condition can be directly caused by congestive heart failure
pulmonary edema
what us acute coronary syndrome?
a group of systems caused by myocardial ischemia; includes angina and MI
when assessing an extremely hypothermic patient, what should you do?
expect the pulse check will take more time than normal
When do coronary arteries fill with blood?
DIASTOLE
Where do the left and right atrium receive blood from?
the right atrium receives blood from the vena cava and delivers it to the RIGHT ventricle-the left atrium: receives blood from the pulmonary veins and delivers it to the LEFT ventricle
Where does the aorta receive blood from and where does it deliver it to?
the aorta is the main artery of the left side of the heart that receives blood from the left ventricle and delivers it to all the other arteries that carry blood to the tissues of the body
Where does the heart receive its nutrition from blood passing through?
coronary artery
Where does the left atrium receive blood from and where does it deliver it to?
the left atrium receives blood from the pulmonary veins and delivers it to the left ventricle
Where does the left ventricle receive blood from and where does it deliver it to?
the left ventricle receives blood from the left atrium and delivers it to the aorta
Where does the right atrium receive blood from and where does it deliver it to?
? the right atrium receives blood from the vena cava and delivers it to the right ventricle
Where does the right ventricle receive blood from and where does it deliver it to?
the right ventricle receives blood from the atrium and pumps it into the pulmonary artery
where is the aortic valve?
between the left ventricle and the aorta - keeps blood from flowing back into the left ventricle and delivers it to the other arteries
Which artery is located in the neck?
Carotid
Which chamber of the heart is the most muscular?
left ventricle
Which of the following is a sign/symptom of cardiogenic shock?
Progressive hypotension
which of the following signs is most indicative of hypo perfusion?
altered mental status
which of the following would suggest a syncopal episode?
brief period of unconsciousness
Which patient is most likely to benefit from an AED?
54 y/o choking PT unresponsive no carotid pulse
Which valve controls blood flow between the left atrium and the left ventricle?
Mitral valve is also known as bicuspid valve between the left atrium and left ventricle
Which vessels regulate regional blood flow to the capillary beds?
Arterioles
Within two minutes of assisting your patient with his third nitroglycerin tablet, he complains of dizziness and becomes sweaty. Radial pulses are present, rapid, and weak. You should suspect that the:
NITROGLYCERIN CAUSES VASODILATION AND DECREASED PERFUSION
You are in an airport and see an adult collapse. As you get an AED from the wall, a
bystander starts CPR. If indicated, you should deliver the first shock:
As soon as possible on arrival at the patient’s side
You have just defibrillated a patient who now has a pulse and effective respirations, what position do you place them in?
RECOVERY
You observed an older male, slumped to the floor. He is pulseless. What should you
do?
Start chest compressions
