Cardiology and resuscitation Flashcards
When is nitroglycerin contraindicted and how many doses can a payient have?
Contradicted in patients with a systolic blood pressure below 100 mmHg, patients with head injury, patients who had taken erectile dysfunction medications and patients who taken the max dosage of 3
How should you treat a chest pain patient?
- Place in position of comfort (Fowler or Semi-fowler position)
- Administer oxygen to keep SpO2 at 95-99%
- High priority patients require immediate transport
How should CPR be conducted on a patient
- The heel of one hand placed on the lower half of the sternum, with the other hand placed on the top
- Chest compressions should be done in cycles of 30
- Compressions should be at a depth of 2 to 2.4 inches
- rate of 100 to 120 per min
If an AMI is left untreated, what timeframe do 90% of myocardial cells die
Within 4 to 6 hours
What is cardiogenic shock? Early signs? Signs and symptoms?
When heart lacks enough power to force the appropriate volume of blood throughout the body
Early signs: restlessness, anxiety, hypoperfusion
SIgns and symptoms: Dyspnea; cool,clammy skin; weak, thread pulse; tachycardia; rapid, shallow breathing; nausea/vomiting; hypertension
What is the cause of angina pectoris
Lack of adequate oxygenation to the heart
Compression to ventilation ratio for one person CPR on a pediatric patient
Compression to ventilation ratio for two-person CPR for infant patients
- 30:2
- 15:2
What is cardiac tamonade? Signs and symptoms?
The pericardium fills with blood and prevents ventricles from filling
Signs and symptoms: Beck’s Triad (JVD, narrow pulse pressures, muffled heart tones)
What are the components of Beck’s Triad and what condition does a person exhibit it?
JVD, narrow pulse pressures, muffled heart tones
Exhibited in cardiac tamponade
What is aspirin? What is it used for? What are the contraindications?
- Aspirin acts as an antipyretic (fever reducer), analgesic (pain reducer), anti-inflammatory agent (inflammation reducer), and platelet-aggregation inhibitor (prevents clots from forming or growing in size).
- Used after AMI to prevent future AMIs
- Contraindications to aspirin include allergy to aspirin (absolute), preexisting liver damage (absolute), bleeding disorders (relative), and asthma (relative).
What happens in left-sided heart failure? What are the signs and symptoms
Lungs become congested in fluid because the left side of the heart fails to pump blood effectively
Signs and symptoms: wet lung sounds, pink frothy sputum, and severe dyspnea
What happens in Right-sided heart failure? What are the signs and symptoms
Blood backs up in vena cava, resulting in pedal edema or JVD
What is a common chest pain description associated with AMI
Crushing, squeezing chest pain unrelieved by nitroglycerin
What is ventricular tachycardia? What are the signs and symptoms
A rapid heart arrhythmia in which the electrical impulse begins in the ventricle (instead of the atria). This may result in inadequate blood flow and eventually deteriorate into cardiac arrest.
Signs and symptoms: Lightheaded, chest pain, palpitations
What is supraventricular tachycardia
Heart dysrhythmia with rate above 150 bpm
What is an Aortic aneurysm? What are the hallmark indicator? How is it described?
A life-threatening condition that occurs when the layers of the aorta, the body’s main artery, separate
Includes very sudden chest pain
Most often described as stabbing, or tearing.
What is acute coronary syndrome and what are the conditions associated with it?
Term used to describe group of symptoms caused by myocardial ischemia (decrease in blood flow to the heart)
Conditions associated with it
- Stable angina
- Unstable angina
- AMI
What is pericardial effusion? What can it lead to?
Collection of fluid between pericardial sac and myocardium that can lead to cardiac tamponade
What is the process of impulses in the pacemakers of the heart that triggers the hearts contractions
- Normal impulses begin in sinus node in the uper part of right atrium
- The electrical impulses from the SA node travels to the AV node between atria and the ventricles
- From AV node the electrical impulse travels through both ventricles via Bundle of HI
- Then travels through right and left bundle branches and Purkinje fibers before causing the muscle cells of ventricles to contract
What is systemic circulation?
a pathway in the human body that carries oxygenated blood from the heart to the body’s tissues and organs, and then returns deoxygenated blood to the heart
What is considered the primary pacemaker of the heart?
SA node in the upper part of the right atrium
What is Atherosclerosis
Disorder in which calcium and a fatty material called cholesterol build up and form a plaque inside the walls of blood vessels, obstructing flow and interfering with their ability to dilate or contract.
What is Arteriosclerosis?
describes the hardening of the arteries and can reduce perfusion of the tissues.
What is a thromboembolism
is a blood clot that floats through blood vessels until it reaches an area too narrow for it to pass, causing it to stop and block the blood flow at that point.
What interventions should be considered for patients with ischemic-type chest discomfort?
- If oxygen saturation is below 90%, start oxygen at 4 L/min and titrate
- Give aspirin 162 to 325 mg
- Administer nitroglycerin
What are common erectile dysfunction medications?
Viagra/sildenafil
Cialis/tadalafil
Levitra/vardenafil
How long do you spend checking a patient’s pulse
10 seconds
What are the side effects of epinephrine from an autoinjector device
Epinephrine is a sympathomimetic hormone and activates the body the same as the fight and flight response
Its side effects are tachycardia, diaphoresis (sweating), palpitations
What is preload and afterload?
Preload is the pressure in the heart as it prepares to receive blood. As the preload increases the ventricles stretch and increase in size
Afterload is the resistance against which the heart pumps
Contractility
Strength of the heart to pump blood to the body
Cardiac output
The amount of blood pumped by the heart per minute
What is hypovolemic shock? Causes?
Type of shock in which the body loses fluid volume
Caused by losing 20% or more of its volume
Can be hemorrhagic or non-hemorrhagic
Hemorrhagic shock
Type of hypovolemic shock in which severe blood loss leads to inadequate oxygen delivery at the cellular level.
What is a Silent AMI? What occurs?
A type of AMI that women, elderly, and patients can diabeties have atypical symptoms when having it.
Signs and symptoms
No pain at all
Diaphoretic and pale
What is angina pectoris? Describe stable and unstable angina pectoris
Angina pectoris is caused by a brief moment of lack of oxygen to the heart’s tissues.
Stable angina pectoris is pain that occurs in response to exertion that increases cardiac oxygen demand and is relieved by rest or nitroglycerin.
Unstable angina is pain occurring with an absence of exertion that increases cardiac oxygen demand. It is also relieved with rest or nitroglycerin.
What is an acute myocardial infarction? What are common symptoms associated with an AMI
An AMI is a blockage in the heart’s coronary arteries
Chest pressure, nausea, dyspnea, diaphoresis, chest pain, radiation of pain, left arm pain, jaw pain
What is commotio cordis
Sudden cardiac arrest caused by blunt trauma in the chest?
Possible causing are getting hit with baseball bat, getting kicked or punched in the chest
Where are each of these valves located in the heart?
Tricuspid valve
Pulmonic valve
Mitral valve
Aortic valve
Tricuspid valve: Located in between right atrium and right ventricle
Pulmonic valve: Located between the right ventricle and pulmonary artery
Mitral valve: Located between the left atrium and the left ventricle
Aortic valve: Located between the left ventricle and aorta
What are the target SpO2 levels of ACS, a stroke and post-cardiac-arrest care
ACS: 90%
stroke: 95% to 98%
post–cardiac-arrest care: 92% to 98%
