Cardiology 2 Flashcards
how do you calculate cardiac output
CO=stroke volume X heart rate
symptoms of poor cardiac output
Decreased LOC
chest pain, weak peripheral pulses
SOB, crackles, rales
cool, clammy mottled extremities
decreased UOP
What is the frank starling law
the more blood on the right side of the….
causes of decreased cardiac output
bradycardia
arrhythmias
pulseless vtach
vfib
asystole
svt
hypotension
MI
cardiac disease muscle
Causes of increased CO
increased blood volume sometimes
tachycardia sometimes
medications
inotropes
what medication decrease heart rate
ace inhibitors
ARBS
nitrates
What are the types of coronary artery disease
acute stable angina
acute coronary syndrome (MI)
What is chronic stable angina
narrowing of coronary arteries and plaque build up
periods of ischemia causing chest pain
periods of decreased blood flow
treatment of chronic stable angina
Nitro
how do you give nitro
sublingualy
1 pill every 5 min for 3 doses
store in dark container
do not swallow
call Ems if not relieved after first pill
may experience headache
what does nitro do
venous arterial dilation>decreases afterload>increased cardiac output
how do patients decrease workload of the heart
rest
do not overeat
no caffeine
avoid temperature extremes
no smoking
promote weight loss
reduce stress
What is an mi
decreased blood flow to the heart leading to decreased oxygen causing ischemia and necrosis
act quickly to limit damage (heart muscle is dying)
MI assessment
chest pain
radiating to left arm or jaw between shoulder blade
epigastric discomfort
SOB
fatigue
vomiting
What is CPK-BMP
cardiac specific isoenxyme
increases wit damage to cardiac cells
what is troponin
cardiac biomarker
increases with MI
what is myoglobin
protein in muscle cells
increases with damage to any muscle
negative results can help rule out an MI but positive results are not specific
Treatment of MI
Cath lab within 90 minutes for PCI especially if a semi
oxygen
aspirin
nitro
morphine
education for MI
quit smoking
increase activity
heart healthy diet
avoid isometric exercises
walking is a good choice
What is included in a heart healthy diet
low salt
low fat
low cholesterol
What is heart failure
inability to pump enough blood to meet the body need for blood and oxygen
causes of heart failure
hypertension
cardiomyopathy
endocarditis
mi
what happens in left heart failure
blood cannot move forward so backs into lungs
assessment of left heart failure
pulmonary congestion
wet lung soiunds
dyspnea
cough
blood tinged sputum
s3 heart sound
orthopnea
What happens in right sided heart failure
blood is backing into body and not going out to lungs
assessment of right sided heart failure
jugular venous distention
dependent edema
hepatomegaly
splenomegaly
ascites
weight gain
fatigue
anorexia
cause of right hear failure
left sided heart failure
treatment of heart failure
decrease workload of heart
ace inhibitors
ARBS
digoxin
diuresis
Education for diuretics
take in the AM
monitor electrolyte levels
low sodium diet
elevate HOB
daily weight
report any increase of 2-3 pounds in one day
What is a hypertensive crisis
180/120
causes and risk factors of hypertension
family history
African american
increased age
obesity
HDL
CAD
stress
smoking
high salt intake
caffeine
Assessment of hypertension crisis
vision changes
headaches
dizziness
nosebleeds
SOB
angina
hypertension complications
stroke
mi
renal failure
heart failure
vision loss
What is shock
when vitals organs are not receiving adequate oxygenation causing organ damage
Types of shock
hypovolemic
cariogenic
distributive
What is hypovolemic shock
loss of blood flow
not enough blood entering heart
body vasoconstricts
Causes of hypovolemic shock
hemorrhage
traumatic injury
dehydration
burns
signs of hypovolemic shock, compensating
weak
pale
anxious
tachycardic
signs of failing hypotension
weak pulses
hypotension
decreased loc
pale
cool clammy
decreased uop
Treatment of hypovolemic shock
fix the cause
replace vomue
support perfusion-vasopressors
What Is cariogenic shock
heart can’t pump blood sufficiently
Causes of cariogenic shock
MI
cardiac tamponade-obstructive shock
pulmonary embolism
assessment of cardiogenic shock
decreased profusion
volume overload
signs of volume overload
jvd
crackles
sob
muffled heart sounds
s3 soudn
Treatment of cariogenic shock
treat the cause
improve contractility-dopamine, dobutamine
decrease afterload, diuretics, dobutamine
IABP
LVAD
transplant
treatment for cardiac tamponade
pericardiocentesis
What is distributive shock
something causes an immune or autonomic response
alters vascular tone
peripheral vasodilation
blood pressure cant provide blood to vital organs
Causes of distributive shock
anaphylactic
neurogenic- SCI
septic
