CARDIOVASCULAR SYSTEM Flashcards

1
Q

-1st heart sound
-“lubb”
-systole

A

S1

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2
Q

-2ND HEART SOUND
-dubb
-t-wave

A

S2

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3
Q

ventricular repolarization (relax)

A

s2

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4
Q

closure of AV valve

A

“lubb” s1

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5
Q

closure of tricuspid/mitral valve

A

“systole” s1

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6
Q

closure of semilunar valve

A

dubb ; s2

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7
Q

closure of aortic/pulmonic

A

diastole; s2

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8
Q

-3rd heart sound
-murmur heard

A

S3

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9
Q

what causes s3 heart sound

A

ventricular gallop

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10
Q

normal occurence of s3:

A

-infants upto 6 mons
-pregnancy
-athletes

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11
Q

heart sound:
-Hypertension

A

s4

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12
Q

s4 is due to?

A

rapid filling of blood in ventricle

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13
Q

commonly assessed in elderly

A

s4

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14
Q

what causes s4?

A

atrial gallop

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15
Q

medication that delays impulses from SA to AV nodes

A

calcium channel blockers (dipine)

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16
Q

medication that decreases ventricular contractions; promote healing

A

beta-blockers

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17
Q

Nursing alert for CCB & BB

A

check HR & RR

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18
Q

SIDE EFFECTS OF CALCIUM CHANNEL & BETA BLOCKERS

A

-bradycardia
-hypotension
-vasodilation
-impotence

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19
Q

CONTRAINDICATIONS while taking Beta-blockers & calcium channel blocker

A

-asthma/bronchitis
-heart block: lowers ventricular contraction
-CHF: decrease cardiac output
-DM: increase viscosity + beta-blockers= thrombus (clot) formation

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20
Q

5 waves of ECG

A

P-WAVE
PR- INTERVAL
QRS-COMPLEX
ST- SEGMENT
T-WAVE
QT SEGMENT

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21
Q

atrial depolarization : ecg

A

p-wave

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22
Q

ecg:
-travel of impulse from SA to AV node
-drop of blood from atrium to ventricle

A

PR interval

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23
Q

ecg:
-s1 lubb
-ventricular depolarization

A

QRS complex

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24
Q

ecg:
-point of ventricular contraction just before relaxation

A

ST segment

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25
Q

ecg:
-s2 dubb
-ventricular repolarization

A

t-wave

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26
Q

whole phase of ventricular contraction to relaxation

A

QT segment

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27
Q

decrease myocardial oxygenation

A

CAD (Coronary artery disease)
ACS (acute corony syndrome)

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28
Q

AKA heart attack
-myocardial tissue necrosisdue to ischemia (low oxygen)

A

MI (myocardial infarction)

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29
Q

type of MI:
Both right & left coronary artery are obstructed

A

TRANSMURAL

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30
Q

type of MI:
1 coronary artery is only obstructed

A

SUBENDOCARDIAL

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31
Q

MI/ISCHEMIA
Short pathophysio

A

OCCLUSION
—->
Myocardial ischemia/ insufficiency
—->
Chest pain

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32
Q

occlusion in MI/ Ischemia

A

-Thrombus
-Atherosclerosis
-Arterioscelorosis

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33
Q

plaque formation

A

atherosclerosis

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34
Q

hardened plaques

A

arteriosclerosis

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35
Q

Universal sign of chest pain:

A

Levine’s sign

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36
Q

Characteristic of Chest pain:

A

Chest tightness

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37
Q

-Permanent/total blockage
-long in duration (>10 mins)
-cant be relieved by rest

A

MI

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38
Q

DOC for Angina pectoris

A

Nitroglycerin

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39
Q

Complication of MI

A

Ventricular arrhythmia/ Dysrrythmia
-Most life threatening
-Unstable: 1st 6-8 hours
-Safest: after 24 hours

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40
Q

DOC: MI

A

Morphine Sulfate

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41
Q

CARDIOGENIC SHOCK

A

DECREASE/LOW:
-Ventricular contraction
-HR
-cardiac output
-BP (shock)

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42
Q

Ventricular arrhythmia; SAFEST TIME

A

After 24 hours

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43
Q

Ventricular arrhythmia: unstable

A

1st 6-8 hours

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44
Q

Type of angina that is unpredictable and occurs at rest

A

unstable/atypical angina

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45
Q

Type of angina that is predictable and occurs on activity

A

stable/ typical angina

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46
Q

Type of angina that is due to vasospasm or exposure to cold

A

prinzmetal/ variant angina

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47
Q

DOC: Cardiogenic shock

A

ADRENALINE : E-N-D
-sympathetic
-Norepinephrine
-Epinephrine
-Dopamine

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48
Q

Left sided
s3 murmur
fluid shift to the lungs

A

CHF

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49
Q

Complications of MI

A

-Ventricular arrhythmia/ dysrhythmias
-Cardiogenic shock
-CHF

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50
Q

No. 1 cause of death in MI

A

PVC
(Premature ventricular contraction)

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51
Q

Characteristics of PVC:

A

-No P-waves
-Bizzare QRS
-Widening of QRS

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52
Q

DOC: PVC

A

lidocaine (xylocaine)
SE: lowers HR

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53
Q

SE of Lidocaine

A

lowers HR

54
Q

DOC: PVC w/ bradycardia

A

Atropine Sulfate

55
Q

Diagnostic test for MI

A

-Tropinin I
-CPK-MB
-SGOT (AST)
-LDL
-ECG

56
Q

troponin r/t heart

A

troponin I

57
Q

troponin not r/t heart

A

troponin T

58
Q

Most sensitive: Troponin

A

onset; 1-3 hours & remains elevated to 1 week

59
Q

Most specific: Troponin

A

only becomes positive to necrosis

60
Q

Onset & Peak of CPK-MB

A

onset: 4-6 hours
peak: 3-4 days

61
Q

cpk- ____ for brain

A

cpk-BB

62
Q

cpk-___ heart

A

cpk-mb

63
Q

these enzymes is significant to indicate/diagnose tissue damage

A

CPK-MB
CPK-BB

64
Q

AST

A

SGOT (HEART) Omega 3= Sweet heart

65
Q

ALT

A

SGPT (LIVER) hePa = Liver

66
Q

bad cholesterol (due to HPN)
-lead to atheroscelosis

A

LDL

67
Q

Most commonly used to dx MI

A

ECG

68
Q

ECG Zones of MI

A

3 I’s
-Ischemia: low oxygen (Inverted T-wave)
-Injury: damage (ST elevation)
-infarction: occlusion (Pathologic q-wave)

69
Q

low oxygen (Inverted T-wave)

A

ischemia

70
Q

damage (ST elevation)

A

cardiac injury

71
Q

occlusion (Pathologic q-wave)

A

infarction

72
Q

MANAGEMENT FOR ANGINA OR CHEST PAIN

A

R-O-N-P-A-T-H
-rest (sit): lowers 02 demand, lower 02 consumption
-oxygen administration: saturate ischemic myocardium
-nitroglycerine: parasympathetic stimulation
-morPhine sulfate: anticipate MI; Vasodilator
-aspirin
-thrombolytic
-heparin
***aspirin,thrombolyitc,heparin = bleeding precautions

73
Q

how to administer nitroglycerin

A

3 tabs @ 5 minutes interval

74
Q

SE of nitroglycerin

A

hypotension

75
Q

Nursing responsibility when administering NITROGLYCERIN

A

check BP before administering
Hold if SBP= <100 mmhg

76
Q

Most common complain upon 1st take of nitroglycerin

A

Headache
-NORMAL SIDE EFFECT
Burning/tingling sensation under tongue upon 1st take
-NORMAL SIDE EFFECT

77
Q

Route of Nitroglycerin

A

Sublingual

78
Q

where to store nitroglycerin

A

dark & airtight container
-photosensitive

79
Q

nitroglycerin can be stored up to

A

6 months

80
Q

Health educate: When to take nitroglycerin

A

Taken before strenous activity

81
Q

plan of care for MI

A

M-O-N-A-YAN
-Morphine sulfate
-Narcotic analgesic
-CNS depressant
-Decrease O2 demand; low o2
consump.
-O2 administration
-Nitroglycerin
-Aspirin (Antiplatelet)

82
Q

Antidote for morphine sulfate

A

Naloxone (Narcan)

83
Q

If the cause of MI is due to thrombus (clot)

A

M-O-N-A-T
THROMBOLYTICS
-dissolves thrombus
Effective within: 24 hours
Most effective: within 2-3 hours

84
Q

If the cause of MI is due to HPN

A

M-O-N-A-B
BETA-BLOCKERS (Metropolol)

85
Q

PTT is for

A

Partial Thromboplastin Time: HEPARIN

86
Q

PT is for

A

Protamine Time: WARFARIN

87
Q

Uses dye (contrast) where thin catheter is inserted to locate occlusion (blockage)

A

CARDIAC CATHERIZATION

88
Q

Site for Cardiac catherization

A

Brachial or Femoral

89
Q

Complications of cardiac Catheterization on site

A

-Bleeding
-hematoma
-vasospasm
-edema/swelling

90
Q

Uses balloon to inflate & deflate
-to relieve blockage or occlusion

A

PTCA (Percutaneous transluminal coronary angioplasty)

91
Q

Complication of PTCA:

A

Vasospasm
Thrombus

92
Q

DOC: Vasospam

A

vasodilator

93
Q

DOC: thrombus

A

anticoagulant

94
Q

by-pass- or diversion of blood flow to maintain circulation
-indicated for 2 or more occlusion

A

CABG (coronary artery bypass grafting)/ heart by pass
-Attached to heart-lung machine during surgery
-unconscious
-endotracheal tube
-Problem: communication
Nrsg intervention: Pen & paper

95
Q

S3 Murmur

A

CHF

96
Q

Types of CHF

A

Left sided CHF
Right sided CHF
Mixed combined L&R

97
Q

Cause of Right sided CHF

A

-Tricuspid stenosis
-pulmonic stenosis
-ventricular hypertrophy (r)
-COPD

98
Q

Causes of Left sided CHF

A

-Mitral stenosis
-MI
-aortic stenosis
-Rheumatic heart disease: cause by GHABS

99
Q

RIGHT SIDED CHF
S/SX

A

SYSTEMIC MANIFESTATION:
SEEN BY NAKED EYES
-jugular vein distention
-edema
-ascites
-hepatomegaly
-jaundice
-oliguria
-weight gain

100
Q

LEFT SIDED CHF
S/SX

A

BREATHING MANIFESTATION:
-dyspnea
-orthopnea
-rales or crackles
-pulmonary edema
DECREASE CARDIAC OUTPUT:
-dizziness
-fainting
-syncope
-restlessness (1st sign of hypoxia)
-muscle weakness
-fatigue
-apathy

101
Q

PLAN OF CARE FOR CHF
GOAL:

A

Decrease workload;
-low O2 consumption
-bedrest
-diazepam (valium): sedative & muscle relaxant
L-CHF: o2 admin
R-CHF: restrict fluid & administer diuretics

102
Q

DOC to increase cardiac output

A

DIGOXIN (LANOXIN)
S/SX that is expected/document: POLYURIA
S/sx that is reportable: OLIGURIA (toxicity)

103
Q

Position of choice for LEFT CHF

A

Sitting; upright; high-fowlers (dyspnea)

104
Q

Position of choice for RIGHT CHF

A

Low fowlers (30 degrees); to measure JVD

105
Q

(+) R- CHF

A

JVD is measured more than 4cm = positive Right sided CHF

106
Q

how to determine if diuretic is effective?

A

(-) lung clear sound upon auscultation
(-) crackles

107
Q

Nursing responsibility when giving digoxin?

A

Check: HR & Apical Pulse
Hold: <60 bpm

108
Q

S/SX of digitalis toxicity

A

BANDAV
-bradycardia
-anorexia
-nausea
-abdominal cramping
-visual disturbances (GREEN/YELLOW; HALO VISION)

109
Q

Antidote: Digitalis toxicity

A

DIGIBAND; IMMUNO FAB

110
Q

What heart sound is commonly assesed in elderly?

A

S4

111
Q

is the only VS tha increases (due to stiffening of blood vessels) with aging and the rest decreases.

A

BP

112
Q

heeart chamber that is the most damaged in pt with MI.

A

left Ventricle

113
Q

Common cause of non-compliance of beta-blockers among male pt.

A

IMPOTENCE

114
Q

Why there is no atrial repolarization?

A

The resting phase of atrium was overpowered by the contractions of ventricles.

115
Q

common cause of MI is

A

THROMBUS/ CORONARY ARTERY THROMBOSIS

116
Q

To relieve chest pain; “To saturate the ischemic myocardium.”

A

O2 Admin. (6-8 LPM)

117
Q

Universal sign of MI

A

LEVINE’S SIGN ;Chest hand clutching

118
Q

Intermittent Claudation; Decrease Leg muscular O2.

A

Buerger’s Disease

119
Q

-the nurse is caring for the pt wth MI, which of the ff cardiac enzyme is least specific?
A.Troponin B. cpk-mb C. SGPOT
D.Cpk-bb

A

c

120
Q

Reportable PVC

A

6-8 pvc/minute or Trigeminal PVC

121
Q

EPINEPHRINE AND LIDOCAINE EFFECT:

A

Epinephrine is vasoconstriction; thus delays/prolonged the effect of anesthesia

122
Q

1st drug of choice for PVC

A

Lidocaine
(However, Atropine sulfate is used for bradypneic pt)

123
Q

Priority, best, initial should prepare, 1st

A

Morphine Sulfate

124
Q

chest pain

A

o2

125
Q

-Mr. C is rush to the Hospital with Diagnosis of MI while transporting in ambulance, the pt complains of chestpain. Which of the ff drug will the nurse administer first?
A. Morphine B.aspirin C. Oxygen D.Nitroglycerine

A

aspirin (bc it is readily accessible)

126
Q

when to bring patient with MI to hospital if taking nictroglycerin

A

AFTER 2ND DOSE.

127
Q

INR (Imterntional Normalize Ratio)- Most specific for coumadin
-PT= 10-12 Secs
-PTT= 30-45 Secs
-INR= 1-2 secs

A

la lang

128
Q

Sex is resumed in MI

A

6 weeks post MI (1 1/2 month) and able to climb atleast 2 flights of stairs without SOB; Should be done before meal.

129
Q

When to resume ADL after cardiac catheterization?

A

:WHEN VS IS ALREADY STABLE.

130
Q

Due to alcohol TYPE OF CIRRHOSIS

A

Leannec’s/Portal Cirhossis

131
Q

Due to Right sided heart failure

A

CARDIAC CIRRHOSIS

132
Q
A