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Critical Care FP-C 2.0 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

First thing the heart perfuses?

A

Itself via coronary arteries

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2
Q

Preload

A

Amount of blood returning to the heart

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3
Q

After load

A

Resistance against which the left ventricle has to pump against to get blood out of the heart

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4
Q

Leads affected by LCx/diagnonal LAD

A

Lateral leads
1-avL-V5-V6

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5
Q

Leads affected by LCx and/or RCA

A

Inferior leads
2-3-AVF

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6
Q

Leads affected by LAD

A

V1-V2-V3-V4

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7
Q

Starlings Law

A

Increased preload causes more myocardial stretch

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8
Q

X-ray finding with heart failure

A

Kerley B-lines

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9
Q

Treatment for Wolff-Parkinson’s-white

A

Procainamide

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10
Q

Dissection Findings

A

Tearing or ripping pain
Often tachy and hypertensive

X-ray findings:
Widened mediastinum

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11
Q

Dissection treatment

A

Anti pulse therapy is priority
-HR goal: 60-70 bpm
SBP goal: <120 mmHg
Aggressive analgesia

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12
Q
A

Overdampening

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13
Q
A

Underdampening

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14
Q

Normal RA CVP

A

2-6 mmHg

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15
Q

Normal RV pressures

A

Systolic: 15-25 mmHg
Diastolic: 0-5mmHg

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16
Q

Normal PA pressures

A

Systolic: 15-25
Diastolic: 8-15

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17
Q

Mixed Venous oxyhemoglobin saturation (SvO2)

A

Normal: 65-70%
Measures oxygen content of blood returning to right side of heart

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18
Q

Increased SvO2

A

Increased O2 delivery, decreased demand
(Right shift)

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19
Q

Decreased SvO2

A

Elevated O2 consumption/demand

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20
Q

Cardiac Index

A

2.5-5 L/min/m2
Reflects cardiac function in relation to the patients size

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21
Q

Systemic Vascular Resistance

A

800-1200 dyne

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22
Q

High SVR

A

Vasoconstriction

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23
Q

Low SVR

A

Vasodilation

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24
Q

Counterpulsation (IABP)

A

Ballon inflates in diastole: perfuses coronary arteries
Ballon deflates during systole: reduces afterload

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25
Q

IABP triggers

A

EKG
Arterial Waveform (pressure)

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26
Q

Normal IABP timing/waveform

A
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27
Q

Early inflation

A
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28
Q

Early/Late deflation

A
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29
Q

ECMO

A

Extra-corporeal membrane oxygenation
-pulls blood out and into ECMO machine
-Can be used up to 30 days

30
Q

Venous-Arterial ECMO (V-A)

A

Provides hemodynamic support
Provides flow
Offloads work of the heart

31
Q

Venous-Venous ECMO (V-V)

A

Indication: Refractory respiratory failure
Does not support hemodynamic flow

32
Q

Transducer

A

Phlebostatic axis: 4th ICS anterior mid-axillary line
Zero when transitioning between monitors and with significant altitude change

33
Q

Overdamping

A

Will yield low systolic BP
May be due to clot, air bubbles or kinks in line

34
Q

Underdampening

A

Overestimation of systolic BP
Underestimation of diastolic BP
Due to catheter whip, low pressure on fluid bag, tachydysrhythmias

35
Q

RA Waveforms

A

Measures central venous pressure (CVP)
Normal CVP: 2-6mmHg

36
Q

Drugs for AAA

A

Nipride and beta-blockers

37
Q

BNP

A

Brain natriuretic peptide

Heart failure marker
Below 100 = normal
Above 500-700= heart failure

38
Q

Normal blood volume

A

70 mL/kg adult
80 mL/kg Peds

39
Q

Normal ped SBP

A

SBP: 90 + (2x age)
DBP: 2/3 the SBP

Drops after 25% blood loss

40
Q

When to assess CVP/PA pressure?

A

When mechanically ventilated assess pressures at the end of exhalation

41
Q

Cardiogenic shock

A

CVP: high
CO: low
CI: low
PAS/PAD: High
SVR: High
Heart rate initially fast, then slows down

42
Q

CHF considerations

A

Preload: many are hypovolemic. Careful with diuretics and medications that can decrease preload

Lab test: BNP > 500

Medications; Natracor (neseritide) = synthetic version of BNP

43
Q

Treat HTN when BP?

A

Over 220 systolic
MAP over 130

44
Q

PAWP/PCWP

A

Looks at the left side of the heart, if high can indicate pulmonary congestion, CHF, and cardiogenic shock

45
Q

Neurogenic shock

A

CVP: down
CO: down
CI: down
PCWP: down
SVR: down (distributive shock)

46
Q

Arterial line sites

A

Radial, femoral

-maintain pressure bag at 300 mmHg

47
Q

Most common reperfusion

A

AIVR

48
Q

Most common hypothermia dysrhythmia

A

VF, Osborn wave

49
Q

MAP formula

A

2 x diastolic + systolic/3

50
Q

IABP signs/symptoms of balloon leak

A

Blood specs in tubing, alarm

51
Q

IABP clot prevention

A

Cycle manually every 30 minutes

52
Q

IABP increases CO by

A

10-20%

53
Q

IABP balloon rupture

A

Rusty flakes in line or turn machine off

54
Q

IABP migration/dislodged

A

Assess left radial and urine output

55
Q

Lethal IABP timing cycles

A

Late deflation and early inflation

56
Q

Phlebostatic axis

A

Where pressure measurements are made with invasive line

Fourth intercostal space, level of atria

57
Q

Hypertension

A

Mild: 140-159/90-99
Moderate: 160-179/100-109
Severe: over 180/110

58
Q

Volume for RBC administration

A

RBC: 10 mL/kg

59
Q

Volume for WBC

A

20mL/kg

60
Q

“PA Catheter”
Named?
Proximal port for?
S/S of bad placement?
Procedure for bad placement?
Measures?
Which port used?
Pressure bag set to?

A

Swan-Ganz
CVP, medications
VT, Ventricular ectopy
Float forward to PA or pull back to RA
Right heart directly, left heart indirectly
Distal port
300 mmHg

61
Q

Normal cardiac index

A

2.5 - 4.3

62
Q

Thrombolytics must be administered within

A

3 hours of onset of chest pain

63
Q

Hypovolemic shock

A

CVP: down
CO: down
CI: down
PAWP: down
SVR: high
Heart rate: fast

64
Q

Tetralogy of Fallot (TOF)

A

PROV
P-pulmonary stenosis
R-right ventricular hypertrophy
O-Overriding aorta
V- ventricular septal defect

65
Q

Atrial waveforms

A

“Filling pressures”

Right atrial pressure (CVP)
Left atrial pressure (PAWP/PCWP)

66
Q

RVMI

A

SVR: High
C.I.: Low
CVP: High
PAWP: Low

67
Q

Cardiogenic shock

A

SVR: High
C.I. : Low
CVP: High
PAWP: High

68
Q

Hypovolemic

A

SVR: High
CI: Low
CVP: Low
PAWP: Low

69
Q

Anaphylactic

A

SVR: Low
CI: Low
CVP: Low

70
Q

Neurogenic

A

SVR: Low
CI: Low

71
Q

Septic

A

SVR: Low
CI: High

72
Q

RICH ANSwer

A

RVMI
CARDIOGENIC
HYPOVOLEMIC
ANAPHYLACTIC
NEUROGENIC
SEPTIC

Critical Care FP-C 2.0 (15 decks)

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