Cardiology

Question 1

Cardiogenic Shock

Answer 1

Often caused by myocardial infarction, the problem is that the heart lacks enough power to force the proper volume of blood through the circulatory system. It can occur immediately or as late as 24 hours after onset of AMI

Question 2

What signs will present that will differentiate hypovolemic shock from cardiogenic shock?

Answer 2

It is a result of the malfunction of the body organs.

1. Chief Complaint - chest pain, dyspnea, tachycardia
2. Heart Rate - Bradycardia or excessive tachycardia
3. Signs & Symptoms of CHF
4. Arrhythmias

Question 3

List the Signs & Symptoms of Cardiogenic Shock

Answer 3

1. 1st sign is Air Hunger. The Brain is sensing that it is not getting enough air therefore anxiety and restlessness sets in
2. Cool, Pale and Clammy Skin will present. The body will begin shunting blood to the vital organs and the brain therefore cutting off blood to skin
3. Compensation will begin to set in and a increase in pulse rate will occur. It will usually be above 120 but not always
4. Rapid and Shallow breathing along with nausea, vomiting of drop in temperature.
5. Late sign will be malfunction of organs and the blood pressure will begin to drop.

Question 4

How do you treat pt. with cardiogenic shock?

Answer 4

1. Position head comfortably. Semi Fowler position however they may not tolerate and be more alert in supine position
2. Administer high flow oxygen
3. Assist Ventilations in necessary
4. Cover pt with blanket to preserve body heat.
5. Gain IV access and give a fluid bolus of 20 mL/Kg of isotonic crystalloid if the pt is hypotensive. Monitor breath sounds for edema
6. Transport

Question 5

Pericardium / Pericardial Sac

Answer 5

a thick fibrous membrane that surrounds the heart within the mediastinum and prevents over distention of the heart

Question 6

What enters the right atrium?

Answer 6

Blood enters the R. atrium via the superior and inferior vena cavae and the coronary sinus.

Question 7

What is the Coronary Sinus?

Answer 7

it is the end of the great cardiac vein and collects blood returning from the heart walls

Question 8

What enters the Left atrium?

Answer 8

Blood from four pulmonary veins enters the L. Atrium.

Question 9

What separates the atrias?

Answer 9

interatrial septum

Question 10

What separates the ventricles?

Answer 10

interventricular septum

Question 11

What are the 2 atrioventricular valves called?

Answer 11

Tricuspid Valve and Mitral Valve

Question 12

Tricuspid Valve

Answer 12

Separates the RIGHT atrium from the RIGHT Ventricle

Question 13

Mitral Valve / Bicuspid Valve

Answer 13

Separates the LEFT atrium from the LEFT Ventricle

Question 14

Pulmonic Valve

Answer 14

Regulates blood flow from the RIGHT ventricle to the pulmonary artery

Question 15

Aortic Valve

Answer 15

Regulates blood flow from the LEFT ventricle to the Aorta

Question 16

Which is the largest and strongest Ventricle and Why?

Answer 16

The LEFT Ventricle because it has the responsibility to of pumping blood through blood vessels of the entire body.

Question 17

Chronotropic State

Answer 17

Control of the rate contraction

Question 18

Dromotropic State

Answer 18

Control of electrical conduction

Question 19

Intropic State

Answer 19

Control of the strength of contraction

Question 20

Cardiac Output

Answer 20

The amount of blood pumped through the circulatory system in 1 minute.

Question 21

What rhythms do the AED Fix?

Answer 21

Ventricular Fibrillation and Ventricular Tachycardia

Question 22

Which pt. will benefit from the AED?

Answer 22

You should apply the AED only to unresponsive patients who are pulseless.

Question 23

What are the two types of AED and how do they shock?

Answer 23

Monophasic and Biphasic. Monophasic machine will shock from one positive point to a negative point. Biphasic will shock simultaneously in two directions.

Question 24

Angina Pectoris

Answer 24

When for a brief period, heart tissues are not getting enough oxygen (ishemia)

Question 25

What is the difference between a stable and unstable angina?

Answer 25

A stable angina is normally relieved after rest and/ or medication and has a relatively fixed frequency. A unstable angina with a unfixed frequency and may or may not be relieved with rest.

Question 26

What are the contraindications for giving a Pt. Nitroglycerin?

Answer 26

1. A BP under 100.
2. Use of erectile dysfunction within the last 24 hours
3. Maximum dose prescribed which is 3 dosages

Question 27

What is the MOST typical finding in right sided myocardial infarction? Why?

Answer 27

Look for the classic triad of distended neck veins, clear lungs, and hypotension—the signs of a right ventricular infarction.4 These signs emerge as the right heart loses its ability to handle systemic venous return. Right atrial pressure rises and jugular vein distention occurs without pulmonary congestion.

Question 28

What is the MOST typical finding in Left sided AMI and why?

Answer 28

Clinical signs of an infarction of the left ventricle may include tachycardia, hypertension, and dyspnea. Damage to the left ventricle compromises the heart’s ability to send oxygen-rich blood to the rest of the body. The drop in cardiac output stimulates sympathetic compensation, which results in tachycardia and increased blood pressure from circulating catecholamines.7

In patients with congestive failure, dyspnea results from pulmonary congestion, as the injured left ventricle is unable to eject its contents and as blood flowing in from the lungs has nowhere to go.