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Critical Care <3 > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What is preload?

A

Volume of blood in ventricles at the end of diastole

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2
Q

What can increase preload?

A

hypervolemia
regurgitation of valves
Heart failure

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3
Q

What is Afterload?

A

resistance the left ventricle must overcome to circulate blood

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4
Q

What can increase afterload?

A

hypertension
vasoconstriction

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5
Q

An increased afterload can increase…?

A

cardiac workload

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6
Q

What are chemoreceptors?

A

receptors that are sensitive to changes in partial pressure

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7
Q

What are baroreceptors?

A

receptors that are sensitive to stretch and pressure

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8
Q

What 3 things affect stroke volume?

A

preload
afterload
contractility

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9
Q

What is cardiac output?

A

volume of blood ejected from the heart per minute

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10
Q

CO =

A

heart rate x Stroke volume

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11
Q

What is the range of Cardiac output?

A

4-8 L/min

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12
Q

What is ejection fraction?

A

fraction of blood ejected with each beat

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13
Q

What is the normal EF?

A

60-70%

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14
Q

What is cardiac index?

A

an assessment based on body size

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15
Q

Cardiac index parameters?

A

2.8-4.2 L/min

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16
Q

How is Cardiac index calculated?

A

Cardiac output / body surface area

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17
Q

What is contractility?

A

the force of ventricular contraction

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18
Q

What is systemic vascular resistance?

A

the resistance the blood flow has to overcome in the blood vessels
higher SVR = more constriction

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19
Q

How is arterial BP calculated?

A

Cardiac output x systemic vascular resistance

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20
Q

What are some cardiac considerations when it comes to older adults?

A

more sensitive to meds
monitor effectiveness
reinforce teaching
circulation decreases with aging
increase monitoring post procedures

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21
Q

Nursing assessment for patients with an A-line?

A

neuro vascular
assess q hour: pulse, pallor, cap refill, no bleeding or hematoma

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22
Q

What are some A-line complications?

A

thrombosis
embolism
hemorrhage
infection

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23
Q

What is Angina?

A

chest pain/ squeezing associated with myocardial ischemia
can be a precursor to a heart attack

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24
Q

What is stable angina? ECG presentation?

A

chronic and occurs with exertion
relieved by rest

May see T-wave inversion

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25
Q

What is unstable (crescendo) angina? ECG presentation?

A

more often and more severe
not easily relieved by rest

May see ST elevation

26
Q

Symptoms of angina

A

left pectoral, epigastric, or retrosternal pain
can radiate
pain associated with dyspnea, diaphoresis, or lightheadedness
lasts 1-5 minutes

27
Q

What is the dosage for sublingual nitroglycerin?

A

0.4 mg q 5 minutes for up to 3 doses

28
Q

What is acute coronary syndrome?

A

an imbalance between myocardial oxygen supply and demand
result of decreased coronary artery perfusion

29
Q

Atherosclerosis vs arteriosclerosis

A

Arteriosclerosis is a general term for thickening of blood vessels
atherosclerosis is a specific type of arteriosclerosis involves fatty deposits in the arteries, i.e. clogged arteries

30
Q

causes of ACS?

A

atherosclerosis
emboli
blunt trauma
spasm

31
Q

what are the atypical symptoms women have with ACS?

A

N&V
dyspnea
diaphoresis
syncope
fatigue
palpitations

32
Q

Assessment for someone with ACS?

A

crushing, tight, squeezing feeling
precordial, substernal or back
radiate to arms, neck, or jaw
clammy, cool, pale, diaphoretic
elevated Troponin

33
Q

What should you inspect for on the ECG for an AMI?

A

ST elevation
ST depression
new onset of left bundle branch block

34
Q

What are some labs to assess for AMI?

A

Troponin T and I
Myoglobin
CKMB
Serum lipids

35
Q

What are some complications of AMI?

A

cardiac dysrhythmias
HF
thromboembolism

36
Q

What is percutaneous transluminal coronary angioplasty?

A

procedure to compress plaque to increase blood flow to the myocardium

37
Q

What is the criteria for PTCA?

A

uncompromised collateral flow
noncalcified lesions
lesions not on bifurcations of vessels

38
Q

What is RAP/CVP? Normal value?

A

direct measurement of pressure in right atrium
2-6 mm Hg

39
Q

Assessment for a RAP/CVP?

A

Zero/balance
waveform analysis
PEEP
Positioning
monitor for complications

40
Q

Complications of a RAP/CVP

A

infection
pneumothorax/hemothorax
carotid puncture
heart perforation
dysrhythmias

41
Q

What is variant (Prinzmetal’s)? Treatment?

A

Vasospasms
MAY see ST elevation
Calcium channel blocker

42
Q

What are modifiable factors for CAD?

A

Smoking
obesity
cholesterol
diabetes
hypertension

43
Q

What is the number 1 intervention for a patient that comes in with chest pain?

A

12-lead EKG

44
Q

What medication must you have if you have a stent?

A

Anticoagulation therapy

45
Q

What is the post cath care?

A

bed rest
bed no higher than 30 degrees
monitor site
antiplatelet drugs after procedure

46
Q

What is the medical management for hyperlipidemia?

A

low cholesterol, low salt
stop smoking
exercise aerobic
weight loss
lipid-lowering agents
management HTN and diabetes

47
Q

What is a CABG?

A

Coronary artery bypass graft

ischemia areas of the myocardium are revascularized

48
Q

What are some complications of cardiac surgery?

A

low cardiac output
renal impairment
G.I. dysfunction
mediastinal bleeding
infection
hypovolemia
atrial dysrhythmias

49
Q

Complications of a CABG?

A

resp insufficiency
shock
death
AMI
emobli
stroke
pain

50
Q

What is Pericarditis?

A

inflammation of the pericardium
can be from an MI

51
Q

What is the assessment for pericarditis?

A

friction rub
pulses paradoxus
ST elevation
Precordial pain

52
Q

What is endocarditis?

A

inflammation of the endocardium
typically infective

53
Q

s/s of right sided heart failure

A

fatigue
ascites
N/V
JVD
edema
increased CVP

54
Q

s/s of left sided heart failure

A

paroxysmal nocturnal dyspnea
cough
crackles
wheezes
blood-tinged sputum
tachypnea
restlessness
exertional dyspnea
cyanosis

55
Q

What are some diagnostics used to diagnose HF?

A

Echo (for EF)
ABG’s
Serum electrolytes
BUN/creatinine
CBC
BNP
ECG

56
Q

Heart failure treatment/goals

A

improve pump action
reduce cardiac workload
optimize gas exchange

57
Q

What are some heart failure complications?

A

pulmonary edema
cardiogenic shock

58
Q

What is an aneurysm?

A

dilation or thinning of the wall

59
Q

Aortic dissection

A

tear of intimal layer of the vessel
sudden
sharp
shifting pain
life threatening

60
Q

what are some abnormal physical findings for endocarditis?

A

Janeway lesions
Osler nodes
Splinter hemorrhages
Roth spots

Critical Care <3 (16 decks)

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