CARDIOLOGY Flashcards
What are the heart auscultation points and where are they located?
What do murmurs in the heart usually sound like?
They are often described as musical, blowing, or swooshing sounds that occur between normal heart sounds.
What does a pericardial friction rub sound like?
High pitched, scratchy sound heard at the apex of the heart
Why does the patient have to lie flat for several hours following a coronary arteriogram?
Hemostasis has to be obtained in the artery that was cannulated for the procedure. Most commonly, this is the femoral artery. So compression is applied to the puncture site and the client may have to lie flat for several hours to ensure homeostasis.
Are sedating medications or general anesthesia used for a coronary angiography?
Sedating medications are used for a coronary angiography and most clients typically go home the same day unless other interventions have been performed.
How should the carotid arteries be palpated?
The carotid arteries should be palapted seperately to avoid vagal stimulation which causes dysrhythmias such as bradycardia or syncope. Other pulses can be assessed siimultaneously.
How should jugular vein distention be assessed?
jugular vein distention should be asssessed with the client sitting in a semi-fowler’s position (HOB at 35-45 degree angle)
What is the point of maximam impulse?
It is the location at which the cardiac impulse can best be palpated on the chest wall, this is usually at the fifth intercostal space at the midclavicular line.
Why is it important to assess PMI?
A displaced PMI (below the fifth ICS) may be an indication of an enlarged heart. (dilated cardiomyopathy)
What are classic signs of DVT?
unilateral leg edema, warmth, erythema, and fever. Swelling in just one leg is HIGHLY concerning
What is an aortic dissection?
tear in the inner lining of the aorta that allows blood to surge between the layers of the arterial wall. This causes perfusion to vital organs to become impaired, and this dissection can QUICKLY turn into life threatening cardiac tamponade or aortic rupture.
What are the MAIN characteristics of an aortic dissecttion?
Acute onset of excruciating, sharp, or ripping chest pain that radiates to the back.
What are priority treatments for aortic dissection?
Emergency surgical repair is the main treatment that is REQUIRED. Before that, the PRIORITY is decreasing the risk of aortic rupture by maintaining normal pressure in tha aorta. Administing IV beta blocker medication helps achieve this by lowering the HR and BP, which are usually elevated with an aortic dissection.
What are risk factors that may cause endocarditis in a patient?
prosthetic material in the body, history of endocarditis, or unrepaired cyanotic heart defect.
What are the proper steps for taking orthostatic BP?
- have the client lay down for atleast 5 minutes before starting the procedure Next
- measure BP and HR
- have the client stand
- repeat BP and HR measurements after standing at 1 and 3 minute intervals
What is the purpose of taking nitroprusside medication?
It is a highly potent vasodilator that is used in hypertensive emergencies and for situations in which BP control is of the utmost importance (aortic dissection). It causes a drastic drop in BP within 1 minute of administration, so the client’s BP should be monitored properly with this medication
What is a bruit?
A swishing or buzzing sound that indicates turbulent blood flow in the aneurysm
What is a normal BNP level and what do high levels indicate?
normal BNP should be <100. High BNP indicates that the client is exhibiting symptoms of acute HF.
What is cardiac tamponade?
pericardial effusion is a buildup of fluid in the pericardium. tamponade is a SERIOUS complciation of pericardial effusion, and it develops as the effusion increases in volume and results in compression of the heart.
What is the treatment for tamponade?
emergency pericardiocentesis (needle instered into the pericardial sac to remove fluid)
What key assessment should be made by the nurse for a patient who will soon undergo abdominal aneurysm repair?
Abdominal aneurysm surgery involves a large abdominal incision and requires cross clamping the aorta proimally and distally to the aneurysm. So the nurse should pay special attention to peripheral pulses and renal status. Decreased/absent puses post operatively can indicate embolization or graft occlusion.
What is the prioirty intervention after a pacemaker is placed in a patient?
Assessing the function of the pacemaker is the priority after placement so a cardiac monitor should be attache before making other assessments.
How should patients with symotatic bradycardia be treated?
with atropine
What is aortic stenosis?
narrowing of the aortic valve, which obstructs blood flow from the left ventricle to the aorta. As this progresses, the heart ejects a smaller fraction of blood volume from the left ventricle during systole. This decreased ejaction fraction results in a narrowed pulse pressure, weak pulse, and syncope.
What is a MIDCAB?
Minimally invasive direct coronary artery bypass grafting that dissect the internal mammary artery that is used as a bypass graft.
What are priority nursing interventions for a patient with an air embolism?
- position the client in left lateral trendelenburg position to promote venous air pooling in the heart apex rather than at the lung capillary beds
- apply an occlusive dressing at the insertion site to prevent entry to more air into the bloodstream
What is a pacemaker failure to capture?
pacemaker spikes that are not followed by QRS complexes. This indicates malfunction of the pacemaker
What is the priority treatment for pacemaker failure to capture?
the nurse’s priority is to use transcutaneous pacemaker pads to normalize the HR, BP, and adequately perfuse organs until the permanent pacemaker is replaced
What is V-fib characterized by?
V-fib is charcterized by irregular waves and varying shapes.
What is atrail fibrillation?
it is ECG where P waves are not visible but are replaced by fibraillatory waves.
What is an inferior vena cava filter?
It is a device that is inserted percutaneously and it traps blood clots from lower extremity vessels such as embolus from DVT and prevents them from migrating to the lungs and causing a PE. This is prescribed for those who have recurrent emboli
