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acute care > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Perfusion triangle in a nutshell
heart blood and vessels

A

Heart - pump
Blood - contents
Vessels - containers
when one of these go out this results in hemodynamic instability

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2
Q

ways can cardiac output be adversely affected?

A

HR and SV increase or decrease

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3
Q

MAP - define

A

average arterial pressure throughout one cardiac cycle

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4
Q

Norms MAP and what decreased values indicate

A

Normal: 70 – 100 mmHg
Decreased: not enough blood flow to major organs → can lead to permanent damage

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5
Q

Ejection fraction define

A

percentage of blood pumped per ventricular contraction

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6
Q

Non stemi or Stemi which is more severe

A

stemi ( ST elevation) is more serious than nstemi ( ST depression)
indicates MI

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7
Q

Normal EF values and decrease in EF indicates

A

60 %
decreased = cardiomyopathy, weak heart muscles

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8
Q

ST elevation indicates

A

MI

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9
Q

ST depression of 1-2mm indicates

A

ischemia

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10
Q

know how to ID BP, MAP, HR, RR, SpO2

A

GREEN: HR
RED: BP
PURPLE: this is also BP (from a cuff) and shows last 5 readings
YELLOW: this measures pulmonary artery pressure (PAP) via a Swan Ganz catheter.
BLUE: oxygen saturation
WHITE: RR

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11
Q

What does this ECG show? can lead to?

A

AFIB
most common heart arrhythmia; can lead to syncope due to no atrial kick
Found with CHF, CAD, HTN, other cardiac conditions

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12
Q

What does this ECG show? can lead to?

A

V tach- Some blood filling in ventricles
most common after acute MI

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13
Q

What does this ECG show? can lead to?

A

V fib
chaotic rate and rhythm; will lead to death if untreated

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14
Q

What does this ECG show? can lead to?

A

Pt. reports skipped beat
If it continues = insufficient pumping of blood

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15
Q

Agonal Rhythm

A

irregular, < 20bpm, near death

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16
Q

AV Blocks

A

rhythm disturbance where electrical conduction from atria to ventricles is partially or completely blocked

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17
Q

Valvular heart disease

A

affects one or more of the 4 valves in the heart
stenosis - narrowing
regurgitation- backflow of blood
prolapse- valve not holding

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18
Q

Myocardial heart disease

A

affect heart muscle tissue, referred to as cardiomyopathy

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19
Q

Pericardial heart disease:

A

affects the pericardium, may be referred to as pericarditis

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20
Q

Cardiac tamponade

A

fluid in pericardium , ventricles cant expand, affects EF + SV

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21
Q

Thrombolytic Therapy indications and contraindications

A

chest pain suggesting MI, elevated ST segment, bundle branch block
NOT FOR pts who are risk for bleeding

22
Q

PTCA (percutaneous transluminal coronary angioplasty)
PT consideration

A

Pt. had reduced circulation – monitor vitals

23
Q

Coronary Artery Bypass Graft (CABG)

A

used post MI
Vascular graft is used to REVASCULARIZE myocardium when coronary artery is occluded
saphenous veins, internal mammary artery, or radial artery

24
Q

Sternal Precautions

A
  1. no UE pushing or pulling
  2. overheadreaching (>90 degrees)
  3. no lifting objects >10 lbs, 4. Driving is usually restricted as well.
25
Q

Automatic Implantable cardiac defibrillator
purpose and PT consideration

A

manages ventricular arrhythmia by defibrillating myocardium
** watch HR and BP

26
Q

AICD/ICD (Automatic implantable cardiac defibrillator)

A

Battery powered device under skin monitors heart rate
Delivers shock if abnormal rhythm detected
** pts heart rate may change with physical activity ( may not have rate modulation)

27
Q

External defibrilator - life vest

A

Worn by patients at high risk of sudden cardiac arrest

28
Q

VAD (Ventricular assist device)

A

used to support pulmonary /systemic circulation
can be for terminal treatment

29
Q

precautions VAD

A

emergency procedures in case of battery failure, maintain patency of drive lines with external pump,
MONITOR HEMODYNAMICS

30
Q

precautions VAD

A

emergency procedures in case of battery failure, maintain patency of drive lines with external pump, monitor hemodynamics

31
Q

precautions VAD

A

emergency procedures in case of battery failure, monitor hemodynamics

32
Q

stable vs. unstable angina

A

stable angina - predictable and triggered by exercise , relieved by rest or nitroglycerin
unstable angina - occurs at rest, more likely to lead to an MI

33
Q

Marburg Heart Score used for

A

Predicts likelihood of dx of CAD

34
Q

Heart rate activity level monitoring general recommendation?

A

average population: 20 to 30 beat increase

35
Q

HR activity level monitoring for pts on beta blockers?

A

do not exceed 20 beats above resting HR

36
Q

AICD HR activity level monitoring

A

target HR 20-30 beats below threshold rate on defibrillator

37
Q

Post heart transplant activity

A

HR not an accurate measure

38
Q

HHR (HR recovery) define

A

difference between peak HR with exercise minus HR at 60 seconds

39
Q

Normotensive systolic blood response

A

increase 5-12 mm Hg per increase in METs

40
Q

What are MET values

A

metabolic equivalents
how many calories you burn during physical activity

41
Q

abnormal response in BP

A

Systolic decrease of 10 mm Hg below resting
Systolic response of > 180 mm Hg
Diastolic response of > 110 mm Hg

42
Q

Know METs <4

A

sitting - 1.3
standing - 1.8
home activity ( folding laundry and putting it away) - 2.3
Home activity (moderate effort of cleaning): 3.5

43
Q

Know METs ≥4

A

walking: 4.3
yardwork : 5.0
running: 23.0

44
Q

RATE OF PERCEIVED EXERTION (RPE) modified borg scale

A

Borg RPE Scale (6-20)

45
Q

Onset of murmurs, S3 heart sounds, S4 heart sounds indicates

A

potential cardiac decline

46
Q

Presence or increase in bibasilar crackles

A

potentially indicates CHF

47
Q

cardiac rehabPhase I
what setting

A

Started as soon as patient is stable
Begins in inpatient setting (acute care, TCU, subacute, SNF)

48
Q

cardiac rehab Phase I goal

A

= tolerate ADLs,
= walking functional distances,
climbing stairs (1-4 METS) with appropriate VS
no cardiovascular symptoms
= Education about risk factors and lifestyle modifications ESSENTIAL

49
Q

cardiac rehab Phase II
what setting
what is continued and progressed

A

Early outpatient rehab
Usually starts about 2 weeks after cardiac event
Continues patient education
Progresses exercises and activities

50
Q

cardiac Phase III - setting and goal

A

Maintenance and prevention
Usually begins 2-3 months after cardiac event

51
Q

What is Auscultation

A

evaluate valve function, rate, and rhythm, valve compliance, and
ventricular compliance

52
Q

Pitting Edema scale know generally

A

1 to 4
mild to severe

acute care (13 decks)

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