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Cardiovascular Emergencies Flashcards

1
Q

What is congestive heart failure?

A

A condition where the heart is unable to pump sufficiently to maintain blood flow to meet the body’s needs.

Congestive heart failure can be caused by various illnesses over time.

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2
Q

What are some causes of congestive heart failure?

A
  • Hypertension
  • Arrhythmias
  • Diabetes
  • Coronary artery disease
  • Valvular stenosis
  • Cardiomyopathy
  • Emphysema
  • Obesity
  • Pulmonary embolism
  • Anemia
  • Thyroid disease

These conditions can lead to the deterioration of heart function over time.

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3
Q

What are the right-sided signs and symptoms of congestive heart failure?

A
  • Pitting pedal edema
  • Hepatojugular reflux
  • Liver enlargement
  • Nocturia
  • Jugular vein distention

These symptoms indicate fluid overload and right heart dysfunction.

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4
Q

What are the left-sided signs and symptoms of congestive heart failure?

A
  • Crackles
  • Shortness of breath
  • Pulmonary edema (rales)
  • Tachypnea
  • Left ventricular hypertrophy
  • Tachycardia
  • Ventricular gallop

Left-sided heart failure usually develops first and affects pulmonary circulation.

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5
Q

What are the interventions for congestive heart failure?

A
  • Administer oxygen
  • Establish intravenous (IV) access
  • Monitor cardiac performance
  • Administer medications as ordered (e.g., furosemide, morphine, nitroglycerin)
  • Monitor intake and output

Specific interventions help manage symptoms and improve patient outcomes.

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6
Q

What is the best patient position to hear S3 (ventricular gallop) and S4 (atrial gallop)?

A

Left lateral.

This position enhances the ability to auscultate heart sounds.

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7
Q

What is acute myocardial infarction?

A

A condition resulting from a clogged coronary artery supplying blood to the heart muscle.

This blockage leads to ischemia and potential damage to the heart tissue.

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8
Q

What patient history is often associated with acute myocardial infarction?

A
  • Hypertension
  • Coronary artery disease
  • High cholesterol
  • Smoking

These risk factors contribute to the development of coronary artery blockage.

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9
Q

What are the main causes of cardiovascular emergencies?

A

Blood clots, coronary arterial spasm from cocaine use, smoking, obesity, hyperlipidemia, and genetics.

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10
Q

What are the contributing factors to cardiovascular emergencies?

A

Hypertension, coronary artery disease.

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11
Q

List common signs and symptoms of cardiovascular emergencies.

A
  • Nausea and vomiting
  • Diaphoresis
  • Shortness of breath
  • Fatigue
  • Anxiety
  • Hypertension or hypotension
  • Chest pain (pressure, squeezing, tightness, or vague) that may radiate to the left shoulder or jaw.
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12
Q

How might females present in cardiovascular emergencies?

A

With vague weakness, fatigue, and dyspnea.

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13
Q

What does the acronym MOVE! stand for in cardiovascular emergencies?

A

Monitor, Oxygen, Venous access, and EKG within 10 minutes.

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14
Q

What does the acronym MONA represent in the context of cardiovascular emergencies?

A
  • Morphine
  • Oxygen
  • Nitroglycerin SL
  • Aspirin.
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15
Q

What tests should be performed prior to administering heparin or thrombolytics?

A

Stool hemoccult and coagulant studies.

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16
Q

What is the antidote for heparin?

A

Protamine sulfate.

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17
Q

A patient allergic to shellfish might also be allergic to which medication?

A

Protamine sulfate.

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18
Q

What does arterial occlusion mean?

A

A clogged artery.

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19
Q

List the causes of arterial occlusion.

A
  • Coronary artery disease
  • Atherosclerosis
  • Hypertension
  • Smoking
  • Hyperlipidemia.
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20
Q

What are the signs and symptoms of arterial occlusion?

A

Cool/pale affected extremity.

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21
Q

What interventions are recommended for arterial occlusion?

A

Maintain extremity pulses through Doppler ultrasound and prepare for surgery.

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22
Q

What is endocarditis?

A

An infection of heart valves.

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23
Q

What causes endocarditis?

A

Bacterial infection in the bloodstream that attaches to faulty heart valves.

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24
Q

List the signs and symptoms of endocarditis.

A
  • Cool extremities
  • Nail bed changes
  • Chest pain.
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25
What interventions are needed for endocarditis?
Anticipate cultures from multiple sites and a complete blood count.
26
What are aortic injuries?
Injuries to the aorta that may result in aneurysm.
27
What can happen if aortic injuries are not identified?
The patient can bleed to death.
28
What are the causes of aortic injuries?
* A history of trauma * Coronary artery disease. * Chest/abdominal pain.
29
What are the signs and symptoms of aortic injuries?
* Hypotension * Loss of pulses * Stronger pulse on one side that radiates to the back.
30
What is endocarditis?
An infection of the inner lining of the heart and/or the heart valves. ## Footnote Endocarditis occurs when a person with faulty heart valves contracts a common bacterial infection.
31
What are common causes of endocarditis?
Occurs when a person with faulty heart valves contracts a bacterial infection, e.g., from skin infections. ## Footnote Bacterial infections can travel through the blood and attach to faulty heart valves.
32
List the signs and symptoms of endocarditis.
* Chills * Fever * Splinter hemorrhaging of the nail beds * Chest pain * Systolic murmur
33
What interventions are anticipated for a patient with endocarditis?
* Obtain multiple blood cultures from multiple sites * Administer antibiotics intravenously * Perform a complete blood count
34
What are aortic injuries?
Injuries that may occur anywhere on the aorta, resulting in aneurysm, tear, or rupture. ## Footnote Without immediate surgery, the patient can bleed to death rapidly.
35
What are potential causes of aortic injuries?
* Hypertension * Coronary artery disease * Congestive heart failure * Recent chest/abdominal trauma
36
List the signs and symptoms of aortic injuries.
* Hypotension * Loss of consciousness * Hypertension in upper extremities * Stronger pulse in arms than in legs * Tearing chest pain radiating to the back * Tearing abdominal pain * Chest wall ecchymosis * Paraplegia
37
What is the critical importance of identifying an aortic injury early?
To prevent rapid bleeding to death. ## Footnote Immediate surgery is crucial for survival.
38
Fill in the blank: Endocarditis occurs when a person with _______ contracts a bacterial infection.
faulty heart valves
39
True or False: Aortic injuries can only occur in the ascending aorta.
False
40
Fill in the blank: Common signs of endocarditis include chills, fever, and _______.
splinter hemorrhaging of the nail beds
41
What is the first intervention for a patient in cardiovascular emergencies?
Get patient on a stretcher
42
What vital signs should be obtained in cardiovascular emergencies?
Blood pressure in all extremities
43
What should be notified to the provider in cardiovascular emergencies?
Patient signs and symptoms immediately
44
What preparations should be made for a patient in cardiovascular emergencies?
Prepare for immediate surgery
45
How many large-bore IV lines should be established?
Two large-bore IV lines
46
What should be monitored in cardiac performance?
Monitor cardiac performance
47
What should be provided to the patient in cardiovascular emergencies?
Oxygen
48
What diagnostic test should be performed in cardiovascular emergencies?
Electrocardiogram
49
What should be measured in addition to vital signs?
Pulse oximetry
50
Which type of trauma most commonly causes a descending thoracic aortic laceration?
Deceleration trauma that causes shearing
51
What characterizes symptomatic bradycardia?
Heart rate is less than 60 beats per minute
52
What is a potential consequence of symptomatic bradycardia?
Inadequate blood circulation
53
What are some underlying conditions that can contribute to bradycardia?
* Coronary artery disease * Heart disease * Second- or third-degree heart blocks * Hypertension * Thyroid disease * Lung disease
54
What are common signs and symptoms of symptomatic bradycardia?
* Heart rate lower than 60 beats per minute * Altered loss of consciousness * Chest pain * Diaphoretic * Pale
55
What does ABC stand for in the context of interventions for bradycardia?
Airway, Breathing, Circulation
56
What should be provided to the patient during bradycardia intervention?
Oxygen
57
What medication may be pushed intravenously during symptomatic bradycardia?
0.5 to 1.0 mg of atropine
58
At what intervals should atropine be administered?
3- to 5-minute intervals
59
What pacing methods should be established for bradycardia?
* Transcutaneous pacing * Internal pacer
60
What medications may be administered in addition to atropine for bradycardia?
* Dopamine * Epinephrine
61
What is supraventricular tachycardia?
A heart rate that is regular but exceeds 150 beats per minute
62
How can supraventricular tachycardia be classified?
Symptomatic/unstable or asymptomatic/stable
63
What are some common causes of supraventricular tachycardia?
* Stress * Caffeine * Smoking * Cocaine use * Alcohol use * Thyroid disease * Heart failure * Pulmonary embolism * Chronic obstructive pulmonary disease * Pneumonia * Medications (asthma, cold, digoxin)
64
What are the signs and symptoms of supraventricular tachycardia?
* Palpitations * Chest pain * Diaphoresis * Anxiety * Pulse rate greater than 150 beats per minute
65
What should be anticipated if a patient with supraventricular tachycardia is symptomatic and unstable?
Prepare for immediate synchronized cardioversion 50 to 100 J biphasic
66
What interventions should be anticipated for a stable, asymptomatic patient with supraventricular tachycardia?
* Attempt vasovagal maneuvers * Monitor cardiac performance * Open large-bore IV line * Provide oxygen * Check vital signs * Measure pulse oxygen * Perform electrocardiogram * Administer adenosine rapidly by IV push * Slow down AV conduction with beta-blockers, calcium channel blockers, digoxin, or amiodarone
67
Fill in the blank: If a patient is stable and asymptomatic, one intervention is to give the patient a _______.
coffee straw
68
True or False: Diaphoresis is a sign of supraventricular tachycardia.
True
69
What are the two irregular rapid rhythms in which there is no pulse?
Ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT) ## Footnote These conditions are critical and require immediate medical intervention.
70
What are the possible causes of Ventricular Fibrillation and Pulseless Ventricular Tachycardia?
* Poor cardiac perfusion due to coronary artery disease * Shock * Hypokalemia * Myocardial infarct * Electrocution ## Footnote These causes can lead to decreased blood flow and oxygen to the heart.
71
What are the signs and symptoms of Ventricular Fibrillation and Pulseless Ventricular Tachycardia?
* Decreased level of consciousness * No pulse * VF or VT on cardiac monitor ## Footnote These signs indicate a life-threatening situation requiring immediate action.
72
What is the first step in the intervention for Ventricular Fibrillation or Pulseless Ventricular Tachycardia?
Assess for a pulse within 10 seconds ## Footnote If no pulse is present, immediate action is required.
73
What should be done if there is no pulse present in a patient with VF or VT?
Call for help while initiating CPR starting with chest compressions ## Footnote Do not interrupt chest compressions while applying cardiac monitor/defibrillation pads.
74
What are the shockable rhythms in the context of cardiac emergencies?
Pulseless VT or VF ## Footnote These rhythms can be treated with defibrillation.
75
What does the acronym DEAL stand for in advanced cardiovascular life support?
Defibrillation, Epinephrine, and Amiodarone or Lidocaine ## Footnote These are key components in the management of pulseless VT and VF.
76
What is the initial shock energy recommended for biphasic defibrillation?
120-200 J biphasic ## Footnote This energy level is used for the first shock in cases of pulseless VT or VF.
77
What is the recommended dose of Epinephrine during CPR for pulseless VT or VF?
1 mg IV/IO every 3-5 min ## Footnote This is administered during CPR to enhance the chances of restoring a pulse.
78
How often should CPR be performed in cycles during the treatment of pulseless VT or VF?
CPR 30/2 for five cycles or 2 min ## Footnote This rhythm of CPR is critical for maintaining blood flow to vital organs.
79
What medication can be administered for pulseless VT or VF if the patient remains pulseless after 2 min of CPR?
Amiodarone 300 mg, 150 mg second dose or lidocaine ## Footnote These medications are used to manage the arrhythmia.
80
What additional treatment may be considered for torsades de pointes during CPR?
Magnesium 1-2 g IV/IO ## Footnote Torsades de pointes is a specific type of ventricular tachycardia that may require magnesium.
81
What does electrical activity in the heart not indicate?
It does not mean the heart is actually pumping.
82
What is the first step if no pulse is detected?
Perform CPR starting with chest compressions.
83
What interventions should be performed if no pulse is present?
* Check for a pulse * Perform CPR * Insert an IV line * Monitor oxygen * Administer epinephrine
84
What is the effect of nitroprusside (Nipride) administered intravenously?
It reduces afterload and increases cardiac output, decreasing myocardial oxygen demand without affecting the heart rate.
85
What type of electrocardiogram changes might you see in a patient with a potassium level of 7.8?
* Bradycardia * Peaked T waves * Widened QRS complex
86
What equation defines cardiac output?
Heart rate x stroke volume.
87
What are the manifestations of digoxin toxicity?
* Blurred vision * Halos * Arrhythmias
88
What is the treatment for digoxin toxicity?
* Glucagon * Phenytoin (Dilantin) * Digoxin immune fab (Digibind)
89
Name three vasopressors.
* Norepinephrine * Dopamine * Metaraminol
90
What is the antidote for warfarin (Coumadin)?
Vitamin K.
91
What does heparin affect?
Partial thromboplastin time.
92
What does warfarin (Coumadin) affect?
Prothrombin time.

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