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IM 7 Test 1 > Care of the Cardiac Patient > Flashcards

Care of the Cardiac Patient Flashcards

1
Q

problems to right side of the heart lead to X2

A

generalized edema

decreased perfusion to the body

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2
Q

problems to left side of heart leads to

A

pulmonary congestion

decreased CO

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3
Q

preload

A

volume in ventricles at the end of diastole

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4
Q

afterload

A

resistance left ventricle must overcome to circulate blood

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5
Q

antidote to heparin

A

protamine sulfate

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6
Q

coumadin antidote

A

vitamin K

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7
Q

Acute Coronary Syndrome

A

condition characterized by decreased or blocked blood flow in the heart

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8
Q

3 categories of ACS

A

unstable angine
NSTEMI
STEMI

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9
Q

unstable angina

A

chest pain that will go away with treatment and does not cause necrosis

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10
Q

NSTEMI

A

causes necrosis

lab value changes

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11
Q

STEMI

A

causes necrosis

lab value changes

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12
Q

is NSTEMI or STEMI worse

A

STEMI

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13
Q

main objective with ACS

A

decrease O2 demand and increase O2 supply

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14
Q

first intervention with any cardiac problem

A

Apply Non-rebreather no matter what

decrease physical activity (wheelchair)

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15
Q

Ca Channel blockers in cardiac

A

reduces conduction and decreases HR

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16
Q

betablockers in cardiac

A

affect epi and adrenaline and decreases HR and contractility

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17
Q

Nitrates in cardaic

A

leaves less blood in ventricles and sends more out to the body

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18
Q

opioids in cardiac

A

causes coronary artery dilation to decrease workload

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19
Q

opioid of choice in cardiac patients

A

morphine

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20
Q

what is an MI

A

death or necrosis of myocardial cells caused by blockage

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21
Q

STEMI

A

100% blocked - emergent

cath lab immediately

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22
Q

what happens if STEMI is not promptly treated

A

total necrosis in 4-6 hours

generalized edema

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23
Q

akinesis

A

no pumping

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24
Q

NSTEMI

A

partial occlusion/narrowing

still need cath but have more time for imaging

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25
Q

when does hypoxia begin after O2 deprivation

A

10 seconds

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26
Q

goal for STEMI treatment time

A

cath lab within 90 minutes

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27
Q

Typical S/S of MI

A

CHEST PAIN/DISCOMFORT

Hyperglycemia

diaphoresis

tachycardia/pnea

S3/S4 heart sounds

Peripheral Vasoconstriction

SOB

AMS

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28
Q

how are MI Dx X6

A

elevated cardiac enzymes

elevated CK and CKMB levels

EKG

Stress test

ECHO

Angiogram

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29
Q

what shows early signs of ischemia

A

EKG

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30
Q

what shows late signs of ischemia

A

cardiac enzymes

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31
Q

how long does it take troponin to increase

A

5-7 hours

32
Q

how soon does troponin return to baseline

A

10-14 days

33
Q

baseline CK level

A

30-170

34
Q

when does CK return to normal

A

24-36 hours following injury

35
Q

why are there false positives for CK

A

non-specific - working out could falsely elevate it

36
Q

when does CK begin to elevate

A

6 hours after injury - peaks at 18 hours

37
Q

what does CK MB show

A

myocardial injury - not necessarily MI

38
Q

when does CKMB elevate

A

within 2 hours - peaks at 3-15 hours

39
Q

baseline CKMB

A

<90

40
Q

when does CKMB return to normal

A

12-24 hours post-injury

41
Q

Chest pain interventions X5

A 
O2
BR
Nitro X3
Labs
Morphine
42
Q

when should you hold nitro X2

A

if systolic <90 and if taken viagra that dayq

43
Q

mediations for MI X5

A 
nitrates
beta blockers
antiplatelet
anticoagulants
thrombolytic therapy
44
Q

clopidogrel class

A

antiplatelet agent

45
Q

HIT

A

body forms antibodies against heparin

46
Q

when does HIT usually occur

A

5-10 days into treatment or <24 hours

47
Q

when should you suspect HIT

A

Plt <150K or drop of 50% from baseline + heparin drip

48
Q

normal Plt value

A

150-300K

49
Q

PCI

A

percutaneous coronary intervention

50
Q

what is a PCI

A

catheter is inserted into femoral artery and into heart, clot is sucked out and artery is opened up

51
Q

allergy CI with PCI

A

shellfish

52
Q

post-op risk with PCI

A

bleeding

53
Q

how long are you on bedrest after PCI

A

24 horus

54
Q

what happens if PCI fails

A

CABG

55
Q

cardiogenic shock

A

inadequate tissue perfusion d/t cardiac dysfunction

56
Q

cardiogenic shock tx

A

give them something to make heart pump

57
Q

what tx should be avoided in cardiogenic shock

A

fluid infusion - avoid as much as possible

58
Q

cardiogenic shock classic s/s X2

A

increased HR and decreased BP

59
Q

amiodarone class

A

antidysrhythmics

60
Q

how to treat hypotension in cardiogenic shock

A

norepi and dopamine

avoid beta blockers

61
Q

how to treat fluid overload in cardiogenic shock

A

diuretics

vasodilators

62
Q

new medications following MI X4

A

aspirin
nitro
clopidogrel
Lipitor

63
Q

how long are you on bedrest post CABG

A

6 hours

64
Q

what will you always have after a CABG

A

chest type

65
Q

max chest tube drainage/hr

A

100 mL/hr

66
Q

what happens if chest tube disconnects from setup

A

put one inch of tube in sterile water until new setup

67
Q

aneurysm

A

artery wall weakens causing it to widen abnormally or balloon out

68
Q

nonruptured AAA s/s X3

A

abdominal, back or flank pain

pulsating abdomen

pain or discoloratoin in feet

69
Q

rupture AAA s/s X3

A

severe, untreatable pain

hypotension

pulsatile abdominal mass

70
Q

what happens if an AAA is ruptured

A

straight to OR

71
Q

2 surgeries for AAA

A

open repair

endovascular aneurysm repair (EVAR)

72
Q

what happens in an EVAR

A

diseased part of aorta is replaced

73
Q

AAA interventions

A

2 large bore IV’s

peripheral pulses

No X-RAY - only CT/contrast or MRI

74
Q

biggest risk for AAA

A

hemorrhage and death

75
Q

cardiac tamponade

A

pericardial effusion extends the sac beyond its limits

76
Q

beck’s triad

A

hypotension

JVD

muffled heart sounds

77
Q

cardiac tamponade tx

A

pericardiocentesis

IM 7 Test 1 (5 decks)

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