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Critical Care > Cardiovascular Disorders > Flashcards

Cardiovascular Disorders Flashcards

1
Q

What are the 3 main risk factors for CAD?

A

Hyperlipidemia, hypertension, and smoking

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2
Q

What are the 3 characteristics of unstable angina?

A
  1. new onset with usual activity
  2. abrupt increase in severity of stable angina
  3. angina at rest, hard to control w/ drugs developing 1 month post-MI
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3
Q

How high above the isometric baseline must a ST elevation be to be considered a STEMI?

A

Greater than 1mm

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4
Q

A total occlusion is most likely to result in what type of infarction?

A

Transmural; all 3 layers of heart are affected

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5
Q

What is the biggest concern with a right coronary artery block?

A

Heart block d/t SA and AV node being supplied by this artery in MOST hearts

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6
Q

A block in the left anterior descending artery might affect what part of an ECG?

A

The QRS complex d/t bundle branches being supplied by this artery

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7
Q

A patient will go into emergency surgery if they have a blockage in which coronary artery?

A

Left main

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8
Q

How long after the onset of a MI is troponin I & T present? How long does it remain elevated?

A

3 hrs; 1-2 weeks

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9
Q

How long after the onset of a MI is CK-MB present? How long does it remain elevated?

A

4-8hrs; peaks within 15-24 hrs

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10
Q

True or false; after 4-6 weeks, necrotic tissue will be functional

A

False; it will heal into scar tissue which will maintain structural integrity, but will not be functional

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11
Q

What are the two zones that surround the zone of infarction?

A

Injury and ischemia

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12
Q

Ideally, the time from when a MI patient enters the ER and gets to the cath lab should be what?

A

Less than 90 minutes

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13
Q

What are the 4 objectives of MI treatment

A

Reduce preload, after load, contractility, and heart rate

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14
Q

Integrilin, Reopro, and Aggrastat belong to what class of drugs?

A

Glycoprotein IIb/IIIa Inhibitors (anti-thrombolytics)

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15
Q

True or false; GP IIb/IIIa inhibitors are not to be given to STEMI patients

A

True; they are only for NSTEMI or unstable angina b/c the platelets have not already aggregated in these conditions

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16
Q

What type of patients are ADP receptor inhibitor drugs for?

A

Patients who have had mechanical devices inserted, like a stent

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17
Q

How long must a patient be on ADPs if they have a drug-eluding stent?

A

At least one year

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18
Q

What drug antagonizes the effects of heparin ?

A

Protamine sulfate

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19
Q

What are the four criteria that must be met to be eligible for fibrinolytic therapy?

A

<12 from onset of chest pain
chest pain unresponsive to SL nitroglycerin
ST segment elevation on 12 lead EKG
no conditions that predispose to hemorrhage

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20
Q

What is the difference between clot plasminogen-specific agents and non-clot specific agents?

A

Clot plasminogen-specific agents target ALL CLOTS; non-clot specific agents target plasminogen in clots AND circulating blood (not widely used b/c of this)

21
Q

What are the 3 clot-specific agent?

A

alteplase (t-PA)
reteplase (r-PA)
tenecteplase (TNKase)

22
Q

True or false; ventricular dysrhythmias are a sign that reperfusion has not occurred

A

False; this is expected d/t sudden washing out of anaerobic materials, but it does require immediate defibrillation

23
Q

If you must place an IV on a fibrinolytic therapy patient, where should you place it?

A

Into a COMPRESSIBLE blood vessels (no arterial punctures!)

24
Q

True or false; nurses should be very cautious about using automatic BP cuffs on fibrinolytic therapy patients

A

True; sudden pressure could cause hematoma

25
Q

Why might a physician inject dye into the aortic valve during a coronary angiography?

A

To collect info about the left ventricle

26
Q

A patient who had a PCI is experiencing back pain, but his insertion site looks okay. What should the nurse suspect?

A

retroperitoneal bleeding

27
Q

Which of the following would the nurse not do for a patient who had a PCI; keep the HOB at 30 degrees, give plenty of fluids, keep atropine at the bedside

A

HOB 30 degrees- HOB should be flat

28
Q

What is the number one complication of AMI?

A

ventricular dysrhythmias- can occur immediately after reperfusion

29
Q

What will most likely be the treatment for an individual with a left main coronary artery occlusion?

A

CABG

30
Q

BNP is well correlated with what hemodynamic measurement?

A

LVEDP (preload)

31
Q

How does BNP affect preload?

A

Attempts to reduce it by inhibiting renin and aldosterone secretion, inhibiting sodium retention, and increases GFR

32
Q

Which drug mimics the actions of BNP?

A

nesiritide (NATRECOR)

33
Q

What two things should be limited in the diet of HF patient?

A

Sodium and fluids

34
Q

What would a physician test to differentiate between heart failure and pulmonary disease in a patient with acute dyspnea?

A

BNP

35
Q

What are the two main risk factors for AAA?

A

smoking and uncontrolled HTN

36
Q

Generally, when is surgery recommended for AAA?

A

When it is greater than 5cm in size, becomes symptomatic, or the person is hemodynamically unstable

37
Q

Which type of aortic dissection requires emergency surgery?

A

Proximal/ascending- pt can abruptly die from cardiac tamponade

38
Q

Which type of aortic dissection is associated with pain between the shoulder blades, in the chest and arms?

A

Proximal/ascending

39
Q

Which type of aortic dissection is associated with pain in the abdomen and lower back?

A

Distal/descending

40
Q

True or false; aortic dissection may lead to unequal pulses

A

True

41
Q

Why would a beta and alpha blocker such as Labetalol be given for aortic dissection?

A

To reduce the force of blood ejected from the left ventricle on the aorta; reduce contractility

42
Q

What drug is given post-operatively for a aortic dissection repair?

A

IV nitroprusside; titrated to decrease afterload/systolic pressure below 120

43
Q

True or false; aortic dissection often is mistaken for a MI

A

True; must do CT, TEE, or MRI to diagnose aortic dissection

44
Q

What are the 3 main risk factors for PAD?

A

smoker, diabetes, old

45
Q

The 5 Ps: pulselessness, paraesthesia, pallor, pain, and paralysis are symptoms of what?

A

PAD

46
Q

How does claudication progress as PAD worsens?

A

Starts out w/ pain in legs or buttocks during activity but is relieved at rest; eventually gets worse to the point where pain is experienced at rest, which is a sign of an anoxic limb (emergency!)

47
Q

What is a normal ABI?

A

0.9-1.0

48
Q

The nurse will want to ask the patient to hold their breath and use the bell of their stethoscope when…

A

They are listening over the carotid artery for a bruit

Critical Care (3 decks)

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