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Fundamentals of Nursing > Cardiovascular/EKG > Flashcards

Cardiovascular/EKG Flashcards

1
Q

Stroke volume

A

Amount of blood ejected with each heartbeat

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2
Q

Cardiac output

A

Amount of blood pumped by ventricle in Liters per minute

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3
Q

Preload

A

Degree of stretch of cardiac muscle at the end of diastole

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4
Q

Afterload

A

Resistance to ejection of blood from ventricle

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5
Q

Ejection fraction

A

Percent of end diastolic volume ejected with each heartbeat

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6
Q

What medication should be given to increase contractility in patients with heart failure?

A

Digoxin

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7
Q

Peripheral vascular resistance gives

A

Afterload

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8
Q

To decrease afterload, what meds should be given?

A

Vasodialator
Nitroglycerin
Ca+ channel blockers
Beta blockers

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9
Q

To decrease prelaod, what medication should be given?

A

Diuretics (Lasix, hydrochlorathiazide, K+ sparring)

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10
Q

Contractility is increased by

A

Catecholamines

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11
Q

Lab tests for CVD

A 
CK, CK-MB
Myoglobin
Troponin T and I
Lipid profile 
BNP
C-reactive protein
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12
Q

What does the P wave represent

A

Atrial depolarization

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13
Q

What does the QRS represent

A

Ventricular depolarization

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14
Q

The T wave represents

A

Ventricular repolarization

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15
Q

P-R interval should be b/w how many seconds

A

0.12 and 0.20 seconds

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16
Q

QRS complex should be how many seconds

A

0.12 seconds or 3 small boxes

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17
Q

R-R wave or P-P wave is used to determine

A

Rate and regularity of cardiac rhythm

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18
Q

Lipid profile is used to evaluate

A

A persons risk for developing CAD, especially if there is a family hx of premature heart disease, or to dx a specific lipoprotein abnormality

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19
Q

HDL transports

A

Cholesterol out of the arteries

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20
Q

LDL deposits

A

Cholesterol in the artery

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21
Q

Cholesterol is required for

A

Hormone synthesis and cell membrane function

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22
Q

Normal level for cholesterol

A

200mg/dL

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23
Q

Normal value for triglycerids

A

less than 150mg/dL

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24
Q

Normal value for LDL

A

less than 100mg/dL

Less than 70 for very high risk patients

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25
Q

Normal value for HDL

A

Men: 35-70mg/dL
Women: 35-80mg/dL

In patients with CAD the goal is to increase it to more than 40mg/dL for males and 50 for women

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26
Q

A lipid profile tests

A

Cholesterol
Triglycerides
Lipoproteins (LDL and HDL)

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27
Q

Factors that lower HDL

A

Smoking
Diabetes
Obesity
Physical inactivity

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28
Q

QT interval should be between how many seconds

A

0.34 to 0.43 seconds

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29
Q

ST segment is depressed with

A

Ischemia

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30
Q

ST segment is elevated with

A

Cardiac injury

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31
Q

Atherosclerosis

A

Abnormal accumulation of lipid deposits and fibrous tissue within arterial walls and lumen

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32
Q

Manifestations of atherosclerosis

A 
Sx are due to myocardial ischemia
Angina pectoris
MI
Heart failure
Sudden cardiac death
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33
Q

Angina may be described as

A

Tightness
Choking
Heavy sensation

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34
Q

Other sx of angina include

A

Dyspnea/SOB
Dizziness
N/V

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35
Q

Unstable angina is characterized by

A

Increased frequency and severity and is not relieved by rest and NTG

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36
Q

Medications to treat angina

A 
NTG
Beta blockers
Ca+ channel blockers
ASA
Clopidogrel (Plavix)
Heparin 
Glycoprotein IIB/IIIa agents
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37
Q

An MI is caused by

A

reduced blood flow in a coronary artery due to rupture of an atherosclerotic plaque and subsequent occlusion of the artery by a thrombus

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38
Q

Contractility

A

The ability of cardiac muscle to develop force for a given muscle length

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39
Q

Heart failure can be caused by

A

CAD
HTN
Cardiiomylopathy
Atherosclerosis

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40
Q

Sx of left sided HF

A 
Crackles
Dyspnea
Dry cough
Low 02 sat
S3 or gallop
Pt may report orthopnea
Diminished CO
Oliguria
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41
Q

Sx of right sided HF

A 
JVD
Edema of lower extremities
Hepatomegaly
Ascites
Generalized weakness (reduced CO)
42
Q

In right sided HF, hepatomegaly may increase pressure on the diaphragm causing

A

Respiratory distress

43
Q

Meds used to treat HF

A 
Beta blockers
ACE inhibitors
Angiotensin Receptor blockers
Diuretics
Digitalis
44
Q

ACE inhibitors

Lisinopril, Enalapril

A

Promote vasodilation and diuresis, ultimately decreasing afterload and preload. Decrease the secretion of aldosterone, promote renal excretion

45
Q

Patients on ACE inhibitors are monitored for

A

Hyperkalemia
Hypotension
Alterations in renal function

46
Q

Angiotension receptor blockers

Diovan/Valsartan

A

Block the vasoconstricting effects of angiotensin II. Used as an alternative to ACE inhibitors

47
Q

Beta Blockers

-lol, cavedilol, metoprolol

A

Relax blood vessels, lower BP, decrease afterload and cardiac workload. Dose is titrated up

48
Q

Side effects of beta blockers

A 
Dizziness
Hypotension
Bradycardia
Fatigue
Depression
49
Q

Diuretics

A

Remove excess extracellular fluid by increasing urine output

50
Q

Example of Loop diuretic

A

Lasix (furosemide)

51
Q

Example of thiazide diuretic

A

Hydrochlorathiazide

52
Q

Spirinolactone (Aldactone)

A

K+ sparring diuretic that blocks the effects of aldosterone in the distal tubule and collecting duct

53
Q

Digitalis (Digoxin)

A

Increases the force of myocardial contraction and slows conduction thru the AV node. Improves contractility

54
Q

Cardiogenic shock occurs when

A

Decreased CO leads to inadequate tissue perfusion and initiation of the shock syndrome

55
Q

NY heat association classification of heart failure

Stage 1

A

No limitation of physical activity

Ordinary activity does not cause fatigue, palpitations, or SOB

56
Q

NY heat association classification of heart failure

Stage 2

A

Slight limitation of physical activity

Comfortable at rest, but ordinary physical activity causes fatigue, palpitations, or SOB

57
Q

NY heat association classification of heart failure

Stage 3

A

Marked limitation of physical activity

Comfortable at rest but less than ordinary activity causes fatigue, palpitations, or SOB

58
Q

NY heat association classification of heart failure

Stage 4

A

Unable to carry out any physical activity w/o discomfort

Sx of cardiac insufficiency at rest

59
Q

Classification of BP

Prehypertension

A

Systolic: 120-139
Diastolic: 80-89

60
Q

Classification of BP

Stage 1 hypertension

A

Systolic: 140-159
Diastolic: 90-99

61
Q

Classification of BP

Stage 2 hypertension

A

Systolic: 160<
Diastolic: 100<

62
Q

What is primary HTN?

A

High BP from an unidentified cause, most common

63
Q

What is secondary HTN?

A

High BP that is secondary to a condition

cause such as renal disease, narrowing of renal arteries, medications

64
Q

HTN can result from

A

Increases of CO, increases in peripheral resistance

65
Q

Sx of HTN

A

may be asymptomatic
CAD with angina
MI
Nocturia

66
Q

Meds for HTN

A 
Thiazide diuretics
ACE inhibitors
ARB's
Beta blockers
Ca+ channel blockers
Vasodialators
67
Q

What is DASH dieting?

A

A diet that is rich in fruits, vegtables, and low fat dairy products with a reduced content of saturated and total fat

68
Q

What is hypertensive emergency?

A

BP is extremely elevated and must be lowered immediately to prevent damage to target organs. Goal is to reduce pressure by 20-25% within the first hour

69
Q

What is hypertensive urgency?

A

BP is very elevated but there is no evidence of impending or progressive target organ damage.. Associated with severe headaches, nosebleeds, or anxiety. ACE inhibitors and beta blockers are used to treat.

70
Q

Myocardial cells that become necrotic from prolonged ischemia or trauma release

A

CK
CK-MB
Myoglobin
Troponin T and I

71
Q

BNP is a neurohormone that regulates

A

BP and Fluid volume

72
Q

What is secreted by the ventricles in response to increased preload

73
Q

Elevations of BNP can occur from

A

Pulmonary embolus
MI
ventricular hypertrophy

74
Q

Normal level of BNP

A

100pg/mL, greater than that is indicative of HF

75
Q

C-Reactive protein is produced by _____ in response to ______

A

The liver, inflammation

76
Q

What is metabolic syndrome?

A

A cluster of conditions that occur together, increasing your risk of heart disease, stroke and diabetes.

77
Q

What are the metabolic risk factors?

A 
Obesity
High cholesterol
High levels of C-reactive protein 
High blood pressure
High blood sugar
High fibrinogen levels
78
Q

Patho of atherosclerosis

A

Inflammation begins with injury, injury is initiated by smoking, HTN, or hyperlipidemia. The presence of inflammation attracts macrophages. Macrophages ingest lipids, becoming “foam cells” that transport lipid into the arterial wall. The macrophages release substances that contribute to oxidation of LDL which fuels the progression of the atherosclerotic process. Smooth muscle cells prliferate and form a fibrous cap over a core. This protrudes into the lumen of the vessels, narrowing it and obstructing blood flow.

79
Q

Risk factors for CAD

A 
Elevated LDL
Age, Gender
Smoking history
Level of cholesterol and HDL
Metabolic syndrome
80
Q

Nitrates (Nitroglycerin)

A

Standard treatment of angina pectoris. Potent vasodilator., improves blood flow, relieves pain, primarily dialates veins. Preload is reduced

81
Q

Stable angina

A

predictable and consistent pain that occurs on exertion and is relieved by rest and or NTG

82
Q

intractable or refractory angina

A

Severe incapacitating chest pain

83
Q

Silent ischemia

A

objective evidence of ischemia (ekg changes with stress test) but pt reports no pain

84
Q

Variant angina

A

pain at rest wit reversible ST segment elevation, thought to be caused by coronary artery vasospasm

85
Q

Patients taking beta blockers are cautioned not to stop taking them abruptly because

A

Angina may worsen and MI may develop

86
Q

Calcium channel blockers

Amlodipine/Norvasc

A

Slow heart rate and decrease the strength of myocardial contraction (Negative inotropic effect).

87
Q

Side effects of Ca+ channel blockers

A

Hypotension
AV block
Bradycardia
Constipation

88
Q

What is myoglobin

A

A heme protein that helps transport oxygen

89
Q

An EKG should be obtained within how many minutes from the time a patient reports pain or arrives in the ED

A

10 minutes

90
Q

EKG changes that occur with an MI

A

T wave inversion
ST elevation
Abnormal Q-wave

91
Q

STEMI

A

Patient has ekg with evidence of acute MI with characteristic changes in two contiguous leads on a 12 lead. In this type of MI, there is significant damage to the myocardium

92
Q

NSTEMI

A

The pt has elevated cardiac biomarkers but no definite EKG evidence of acute MI. In this type of MI there may be less damage to the myocardium.

93
Q

Side effects of ACE inhibitors

94
Q

Most common cause of abdominal aortic aneurysm

A

Atherosclerosis

95
Q

Patho and Sx of abdominal aneurysm

A

Damaged media layer of vessel caused by weakness, trauma, or disease. Risk factors include genetic predisposition, smoking, and HTN. Sx include patient reporting a feeling that their heart beating in their abdomen when lying down, feeling of abdominal mass.

96
Q

Raynauds Phenomenon

A

Form of arteriolar vasoconstriction that results in coldness, pain and pallor of the fingertips and toes. Most common in women between 16-40y/o

97
Q

Medical management of Raynauads

A

Avoiding the stimuli (cold, tobacco)
Ca+ channel blockers may be effective
Sympathectomy

98
Q

Arterial ulcer

A

Characterized by pain caused by activity and relieved after a few minutes of rest. Typically small, circular, deep ulcerations on the tips of toes or in the web spaces b/w of the toes. Often occur on the medial side of the hallux or 5th lateral toe

99
Q

Cause of arterial ulcer

A

Combination of ischemia and pressure

100
Q

Venous ulcers

A

Characterized by pain described as aching or heavy. The foot and ankle may be edematous. Typically large, superficial and highly exudative.

101
Q

Time for venous ulcer to heal

A

6-12 months completely

Fundamentals of Nursing (12 decks)

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