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NCLEX Prep > Cardiovascular System > Flashcards

Cardiovascular System Flashcards

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1
Q

normal PR interval

A

.10-.20

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2
Q

normal QRS complex

A

.05-.12

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3
Q

saw tooth waves are characteristic of…

A

atrial flutter

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4
Q

causes of atrial flutter

A

heart disease
MI
CHF
pericarditis

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5
Q

tx for atrial flutter

A

If hemodynamically stable → vigilant observation
If hemodynamically unstable → digitalis, beta blockers
Lastly - cardioversion

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6
Q

causes of atrial fibrillation

A

heart disease
pulmonary disease
stress
alcohol
caffeine

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7
Q

tx for a fib

A

If a common rhythm disturbance in a hemodynamically stable patient → might be no treatment
Digitalis, CCBs, BBs
Cardioversion if unstable
Sync cardioversion shocks on R wave

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8
Q

how to tx v tach

A

Patient is awake and alert with adequate vital signs → amiodarone
-150 mg IV bolus over 10 minutes
-Might add BB to prevent from coming back

If patient has inadequate vital signs and is not awake → treat with defib/cardioversion

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9
Q

what is v fib referred to as?

A

sudden cardiac death

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10
Q

tx for v fib

A

Defibrillate
CPR
Defibrillate
CPR, epinephrine 3-5 mins
Defibrillate
Continue with CPR, ACLS protocol
Second drug of choice = amiodarone high dose (300 mg IV)

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11
Q

do you have a pulse with v fib

A

rhythm does not generate a pulse

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12
Q

which receptors are in the heart

A

beta 1

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13
Q

when heart rate goes up, what is it called

A

chornotropy

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14
Q

when contractility increases, what is it called

A

inotrophy

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15
Q

what is CO

A

amount of blood heart pumps per minute
SV x HR

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16
Q

normal CO

A

4-8 l / minute

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17
Q

normal CVP

A

2-8 mmhg

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18
Q

MOA of ace inhibitors

A

blocks conversion of angiotensin to angiotensin II
results in decreased renin levels –> decreased aldosterone
results in vasodilation

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19
Q

3 nursing considerations for ACE inhibitors

A

can cause dry cough - need to manage so it doesn’t lead to angioedema
monitor BP
contraindicated during pregnancy

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20
Q

which drugs are the sartans?

A

ARBs

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21
Q

nursing considerations for CCBs

A

avoid grapefruit
monitor for orthostatic hypotension
gingival hyperplasia

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22
Q

what kind of drug is amlodipine

A

CCB (selective)

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23
Q

do patients on CCBs need to stop taking calcium supplements

A

no

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24
Q

what are 2 examples of arterial vasodilator

A

hydralazine
minoxidil

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25
Q

when is hydralazine used

A

hypertensive crisis

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26
Q

what are 2 venous dilators

A

nitroglycerine
isosorbide dinitrate

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27
Q

3 nursing considerations for beta blockers

A

do not discontinue abruptly
can mask signs of hypoglycemia
caution with asthma and COPD - can cause bronchospasm

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28
Q

what kind of med is amiodarone

A

k+ channel blocker

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29
Q

MOA of amiodarone

A

stops K+ from leaving cells and prolongs resting period

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30
Q

which clients should not receive atropine

A

clients with glaucoma because it’ll cause blurred vision (it is an anticholinergic)

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31
Q

when should adenosine be used

A

SVT

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32
Q

how should adenosine be administred

A

rapid push

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33
Q

what does digoxin do

A

increased contractility (+ inotrope)
decrease HR (- chronotrope)

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34
Q

what are therapeutic lab levels for digoxin

A

.5-2ng/ml

35
Q

early signs of digoxin toxicity

A

n/v
anorexia
vision changes

36
Q

late signs/symptoms of digoxin

A

bradycardia –> arrythmias

37
Q

which electrolyte abnormalities increases digoxin toxicity

A

hypokalemia
hypomagnesemia
hypercalcemia

38
Q

what does licorice extract act like

A

aldosterone –> Na/H2O retention, and K+ loss

39
Q

when should you hold digoxin

A

HR < 60

40
Q

what is the antidote for digoxin

A

digoxin immune fab

41
Q

do you have a pedal pulse in peripheral vascular disease

A

YES because when you palpate pulses you are feeling for pulsation through an artery

42
Q

what is peripheral vascular disease

A

inadequate venous return over a long period

43
Q

s/s of peripheral vascular disease

A

brown discoloration
uneven wound edges around ankle
swelling

44
Q

tx for peripheral vascular disease

A

elevate legs
focus on proper wound care

45
Q

superior vena cava syndrome: what is the patho

A

blood can’t drain from upper body d/t tumor or solid body putting pressure on SVC

46
Q

s/s of superior vena cava syndrome

A

headache
blurry vision
glossitis
distension of veins above chest
upper extremity edema
dyspnea
facial plethora

47
Q

what is facial plethora

A

facial swelling and puffiness
redness
symptom of SVC

48
Q

what are 4 causes of aneurysms

A

atherosclerosis
HTN
smoking
family history

49
Q

what is an aneurysm?

A

local dialation of a vessel wall
most common = aorta

50
Q

s/s of abdominal aortic aneurysm

A

abdominal/back pain
gnawing/sharp pain

51
Q

s/s of thoracic aortic aneurysm

A

SOB
hoarseness/struggling to swallow
upper back pain

52
Q

which patients are at risk for embolism

A

pregnancy d/t hypercoagulable state
a fib
long bone fracture (fat embolism)

53
Q

s/s of fat embolism

A

hypoxia
dyspnea
tachypnea
confusion
altered LOC
petechial rash

54
Q

what is peripheral arterial disease

A

atherosclerosis of arteries that perfuse limbs

55
Q

4 signs of PAD

A

pallor
pulselessness
hairlessness
intermittent claudication
poor/absent pedal pulses
eschar in wounds

56
Q

what is intermittent claudication

A

pain that occurs in legs when walking
pain that gets better with rest

57
Q

tx for PAD

A

dangle legs
antiplatelet therapy

58
Q

tx for PVD

A

elevate legs
proper wound care

59
Q

instructions for nitroglycerine

A

do not swallow
sublingual
administered 1 pill q5 mins for 3 doses
expect a headache!
keep in a dark bottle in dry, cool place

60
Q

is a myocardial infarction reversible or irreversible damage

A

irreversible

61
Q

what does ST elevation inidcate

A

injury
QRS does not come back to baseline
inverted T wave

62
Q

what would show ischemia on a EKG

A

ST depression and/or T wave inversion

63
Q

what is door to balloon time? (PCI)

A

90 minutes

64
Q

3 causes of pericarditis

A

infection
tumor
drugs

65
Q

4 findings for pericarditis

A

sharp chest pain
tachypnea
fever & chills
weakness

66
Q

tx for pericarditis

A

NSAIDs

67
Q

2 findings for pericardial effusion

A

chest pain
muffled heart sounds d/t fluid

68
Q

tx or pericardial effusion

A

pericardiocentesis to remove fluid

69
Q

cardiac tamponande s/s

A

chest pain
SOB
decreased CO
muffled heart sounds
JVD
narrowed pulse pressure (<40)

70
Q

what is endocarditis

A

infection and inflammation of the endocardium

71
Q

what is the number 1 cause of HF

A

HTN

72
Q

LHF symtpoms (FORCED)

A

fatigue
orthopnea
rales/restlessness
cyanosis/confusion
extreme weakness
dyspnea

73
Q

8 signs of RHF

A

JVD
dependent edema
hepatomegaly
splenomegaly
ascites
weight gain
fatigue
anorexia

74
Q

how do you decrease workload of the heart

A

ACEs to decrease afterload
ARBs to decrease afterload
diuretics
digoxin to increase contractility

75
Q

what does hyperkalemia look like on an EKG

A

wide flat P
prolonged PR
widened QRS
depressed ST
tall peaked T waves

76
Q

if you see prominent u-waves on an EKG, what electrolyte imbalance exists

A

hypokalemia

77
Q

what electrolyte disturbance can cause long QT

A

hypo calcemia –> can lead to v tach

78
Q

hypomagnesemia EKG

A

prolonged PR
long QT
can go into torsades!

79
Q

hypermagnesemia EKG

A

wide flat P wave
tall T wave (not peaked)

80
Q

what receptors does norepi work on

A

alpha 1
causes peripheral vasoconstriction

81
Q

when is dopamine used

A

low doses used in kidney failure to increase renal blood flow

low doses increases contractility

high doses cause vasoconstriction

82
Q

when is milrinone used

A

cardiogenic shock
decreased CO
congenital/aquired heart defects

83
Q

what kind of drug is milrinone

A

phosphodiesterase inhibitor
phosphodiesterase breaks down cAMP
allows heart o contract more

84
Q

s/s of cardiac tamponade

A

tachycardia
tachypnea
pericardial rub
JVD
hypotension
narrowed pulse pressure

NCLEX Prep (20 decks)

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