Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Acute Care > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Basic Anatomy:

Mediastinum

A 
- the central compartment of the thoracic cavity
contains:
- heart & its vessels
- esophagus
- trachea
- phrenic n. & cardiac n.
- thoracic duct
- thymus
- lymph nodes of the central chest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Basic Anatomy - pericardium

A

the membrane that encloses the heart and protects it from infection and trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Basic Anatomy - epicardium

A

the outermost layer of the heart

also protects from infection and trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Basic Anatomy - myocardium

A

cardiac muscle tissue

provides the major pumping force of the ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Basic Anatomy - endocardium

A

lines the inner surface of the heart, valves, chordae tendinae, and papillary muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Basic Anatomy - tricuspid valve

A
  • R atrium/ventricle

- prevents backflow during ventricular systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Basic Anatomy - bicuspid/mitral valve

A
  • L atrium/ventricle

- prevents backflow during ventricular systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of pressure system is the R side of the heart?

A

low pressure system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What type of pressure system is the L side of the heart?

A

high pressure system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What occurs during atrial systole?

A

the period of atrial emptying

includes atrial kick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What occurs during atrial diastole?

A

filling of the atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What occurs during ventricular systole?

A

ventricular contraction

1st reading of BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What occurs during ventricular diastole?

A

filling of the ventricles

2nd reading of BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is ejection fraction?

A

the percentage of end diastolic volume ejected during systole
normal: 60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the components of the perfusion triangle?

A
  • heart (pump)
  • blood vessels (container)
  • blood (content)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What occurs when the perfusion triangle has a pump dysfunction?

A

CHF

cardiogenic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What occurs when the perfusion triangle has a container dysfunction?

A

septic shock

anaphylactic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What occurs when the perfusion triangle has a content dysfunction?

A

hypovolemic shock
bleeding
gastric bleeding
cerebral hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What factors may adversely affect cardiac output?

A

preload
Frank-Starling mechanism
afterload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How might preload adversely affect cardiac output?

A

it effects the amount of tension on ventricular walls before contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How might the Frank-Starling mechanism adversely affect cardiac output?

A

FSM is the length tension relationship that enables ventricular filling and contraction to create an adequate SV
more blood returns during diastole, increased volume –> increased pressure –> more blood ejected during systole
adversely affected by CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How might afterload adversely affect cardiac output?

A

it determines the force against which cardiac muscles must contract

Key factors:

  • vascular compliance
  • vascular resistance (BP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is responsible for cardiac conduction?

A

SA node
PNS
ANS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does the SA node do?

A

it is the pacemaker of the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the normal value for MAP?

A

at least 75% indicates adequate perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the normal value for EF?

A

60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What would an ST depression on an ECG indicate?

A

ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What would ST elevation on an ECG indicate?

A

MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What would an inverted T wave on an ECG indicate?

A

MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What would a prominent Q wave on an ECG indicate?

A

MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What would a wide QRS complex on an ECG indicate?

A

bundle branch block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is a Premature Ventricular Contraction (PVC)?

A

a rhythm disturbance associated with CVD, drugs, anxiety, exercise, etc…
- relatively normal for older adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is ventricular tachycardia?

A

HR >100bpm
usually a regular rhythm
most common after an acute MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is ventricular fibrillation?

A

A chaotic rate and rhythm which will lead to death if untreated
may need AED to shock the heart back into a regular rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is an AV block?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What causes an AV block?

A
  • age and heart disease
  • myocarditis
  • acute infection
  • MI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is an agonal rhythm?

A

an irregular HR <20bpm

typically near death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is valvular heart disease?

A

stenosis, regurgitation, or prolapse affecting one or more of the 4 valves in the heart

39
Q

What is myocardial heart disease?

A

aka: cardiomyopathy

a disease of the heart muscle tissue

40
Q

What is pericardial heart disease?

A

aka: pericarditis

affects the pericardium and includes cardiac tamponade

41
Q

What is cardiac tamponade?

A

a hemorrhage around the heart due to trauma

- causes fluid accumulation which compresses the heart and prevents the ventricles from completely refilling

42
Q

What is associated with cardiac tamponade?

A

JVD
muffled heart sounds
narrowing pulse pressure
- decreased SBP, increased DBP

43
Q

What is heart failure?

A

a pump dysfunction that reduces CO

44
Q

What is the most common cause of heart failure?

A

cardiomyopathy

45
Q

What are the different types of heart failure?

A 
Left
Right
High output
Low output
Systolic
Diastolic
46
Q

What is thrombolytic therapy?

A

an acute management strategy for patients experiencing MI
Includes:
- fibrin selective agents
- fibrin non-selective agents

47
Q

When is thrombolytic therapy indicated?

A

For:

  • chest pain suggesting MI
  • elevated ST segment
  • bundle branch block
48
Q

What is the timing for thrombolytic therapy?

A

Varied protocols

  • some within 3hrs of onset of chest pain
  • may be within 6-24hrs of onset of symptoms
49
Q

When is thrombolytic therapy contraindicated?

A

in patients at risk for excessive bleeding

50
Q

What are other considerations for thrombolytic therapy?

A

it is typically used in conjunction with other medications

51
Q

What is percutaneous revascularization?

A

a balloon tipped catheter is threaded into an occluded artery and then inflated to make the artery patent once again

52
Q

What are other considerations for percutaneous revascularization?

A
  • An endoluminal stent may be placed to maintain patency

- often an OP procedure

53
Q

What is a Coronary artery bypass graft?

A

A vascular graft used to revascularize the myocardium when a coronary artery is occluded

54
Q

What are the typical vasculature used for a coronary artery bypass graft?

A
  • saphenous vein
  • internal mammary artery
  • radial artery
55
Q

What are the different types of approach for a coronary artery bypass graft?

A

Standard Approach:
- median sternotomy: a transection from sternal notch to xiphoid process
Minimally Invasive Approach:
- no sternal precautions

56
Q

What are the post-op possibilities for coronary artery bypass graft?

A
  • mediastinal chest tube
  • external pacemaker
  • intravascular catheter
57
Q

What are cardiac ablation procedures?

A
  • removal or isolation of ectopic foci in order to reduce rhythm disturbances
  • also radiofrequency ablation
58
Q

How does radiofrequency ablation work?

A

uses alternating low and high power frequency to destroy cardiac tissue

59
Q

What is a maze procedure?

A

used to ablate atrial fibrillation

**the leg used for this procedure must remain straight and immobile for 3-4hrs

60
Q

What is cardioversion?

A

restores normal heart rhythm in tachycardia arrhythmic conditions
- includes electric shock and medications

61
Q

What should be monitored for cardioversion?

A
  • activity response with HR and BP

- if a device does rate modulation (and what its upper limit is)

62
Q

What does a cardiac pacemaker implantation do?

A

provides pacer function to ensure regular heart rhythm

63
Q

What does an automatic implantable cardiac defibrillator do?

A

Manages ventricular arrhythmia by defibrillating the myocardium as needed to restore normal rhythm

  • delivers a shock if abnormal rhythm is detected
  • battery powered device under the skin that monitors heart rate
64
Q

What should be considered for automatic implantable cardiac defibrillators?

A
  • not all devices provide rate modulation

- a patient’s HR may not change with activity during PT

65
Q

What is a life vest?

A

a personal external defibrillator worn by patients at high risk of sudden cardiac arrest
- includes garment and monitor

66
Q

What is a ventricular assist device (VAD)?

A

a device used to unload R or L ventricle and support pulmonary/systemic circulation which can be used as terminal treatment

67
Q

What are precautions for VAD?

A
  • know emergency procedures in case of battery failure
  • maintain patency of drive lines with external pump
  • monitor hemodynamics
68
Q

What are complications of VAD?

A
  • thrombus formation
  • CVA
  • hemorrhage
  • line infection
  • renal or hepatic insufficiency
69
Q

What are sternal precautions?

A
  • no UE pushing/pulling
  • no overhead reaching >90deg
  • no lifting objects > 10#
  • no resistive exercises of UE
  • driving is restricted
70
Q

What is the purpose of sternal precautions?

A

to reduce the risk for sternal dehiscence

71
Q

How long are sternal precautions?

A

usually 8 weeks but depends on surgeon

72
Q

What are the risk factors for sternal dehiscence?

A 
obesity
COPD
DM
Smoking
PVD
Repeat thoracotomy
Female
Pendulous breasts
73
Q

What is stable angina

A

usually predictable, episodic, triggered by physical and/or psychological stressors

  • occurs with constant frequency over time
  • not relieved by rest or nitroglycerin
74
Q

What is unstable angina

A

new onset, occuring at rest or minimal exertion
progressive in nature with increased frequency of episodes
refractory to previously effective medicine
more likely to lead to MI

75
Q

What do you do if a patient reports chest pain?

A
  • stop the activity
  • let the patient rest in a position of comfort
  • monitor vital signs (BP, HR, SaO2, RR, telemetry)
  • use Angina Rating Scale/Canadian Cardiovascular Society classification of angina
  • determine if pain is cardiogenic vs non-cardiogenic or stable vs unstable
  • have the patient take nitroglycerin if prescribed
  • educate patients on stable vs unstable chest pain
76
Q

What types of telemetry are used to monitor patient activity tolerance for cardiac conditions?

A 
BP
MAP
HR
RR
SaO2
77
Q

What is telemetry used for?

A

allows for continuous monitoring of HR and rhythm along with respiratory rate

78
Q

How does telemetry work?

A
  • 5 color coded leads placed on chest

- electrical signals are converted to radio waves and allow for central monitoring at a nurse’s station

79
Q

What should be considered for telemetry?

A
  • frequently can become “unstuck” with activity
  • PT activities may alter rate/rhythm (artifacts)
  • watch the monitor while patient is at rest prior to initiating any activity
  • may be able to put telemetry on hold or take portable box with pt
80
Q

What are the general guidelines for Rate of Percieved Exertion (RPE)?

A

intensity is
- 5 or less on a 10 point scale
OR
- 13 or less on a 6-20 point scale

81
Q

What are the MET values for various tasks?

A 
Sitting - 1.3
Standing - 1.8
Home activity (folding/putting away laundry) - 2.3
Home activity (moderate cleaning) - 3.5
Brisk walk - 4.3
Yard work - 5.0
Running - 23
82
Q

Describe the Cardiac PT Intervention Guidelines

A
  • Low level or high level
  • check with nurse before tx and report pt status after tx
  • tx tailored to what will get that pt out of bed and transitioned to a lower level of care
83
Q

Describe the phases of cardiac interventions

A
  • warm up
  • conditioning
  • cool down
  • education
84
Q

Describe the cardiac intervention warm-up phase

A

performed at lower level of activity than exercise program

85
Q

Describe the cardiac intervention conditioning phase

A

functional mobility training and aerobic based conditioning

86
Q

Describe the cardiac intervention cool down phase

A

may consist of stretching or deep breathing

87
Q

Describe the cardiac intervention patient education phase

A

promote self-monitoring and symptom recognition, establish safe and sustainable exercise program, lifestyle modifications, medication management

88
Q

Describe the goal of cardiac rehabilitation

A
  • Achieve optimal physical, psychosocial, and functional status within limits of heart disease
  • establish safe exercise and activity parameters
89
Q

Describe Phase I cardiac rehabilitation

A
  • started as soon as the patient is stable
  • begins in inpatient (acute care, TCU, subacute, SNF)
  • GOAL: to tolerate ADLs, walking, climbing stairs
  • education about risk factors and lifestyle modifications
90
Q

Describe Phase II cardiac rehabilitation

A
  • early OP rehab
  • usually about 2 weeks after cardiac event
  • continued patient education
  • progression of activities and exercise
91
Q

Describe Phase III cardiac rehabilitation

A
  • maintenance and prevention

- usually begins 2-3 months after cardiac event

92
Q

Describe cardiac patient d/c considerations

A
  • prognosis
  • PLOF
  • social situation
  • home set up
  • equipment
93
Q

What is an appropriate outcome measure for cardiovascular patients?

A

Marburg Heart Score

94
Q

What is the Marburg Heart Score?

A

an outcome measure that predicts the likelihood of diagnosis of CAD

  • includes:
    • age 55+ in men/ 65+ in women
    • known CAD or cardiovascular disease
    • pain not reproducible by palpation
    • pain worse with exercise
    • patient’s assumption that pain is cardiogenic in origin

Acute Care (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions