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Module 7 > Care of The Cardiac Patient > Flashcards

Care of The Cardiac Patient Flashcards

1
Q

depolarizing=

A

contracting

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2
Q

repolarizing=

A

resting

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3
Q

pacemaker cells that helps the heart function on its own regardless of what the brain does

A

SA Node

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4
Q

when SA node fires then the HR is

A

60-100bpm

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5
Q

what node is next in line if the SA node stops working

A

AV node

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6
Q

when the AV node fires then the HR is

A

40-60 bpm

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7
Q

if something is wrong with the AV node what fires next

A

purkinje fibers

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8
Q

when the purkinje fibers fire then the HR is

A

20-40 bpm

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9
Q

what are the 2 parts of autonomic nervous system

A

sympathetic and parasympathetic

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10
Q

in sympathetic the heart is beating

A

fast

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11
Q

in parasympathetic the heart is beating

A

slow

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12
Q

which nerve responds in parasympathetic

A

vagus nerve located at the carotid (cranial nerve 10)

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13
Q

starling’s law of the heart

A

stroke volume is dependent on venous return

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14
Q

if venous return is _______ then stroke volume is _______ and cardiac output is ______

A

increased; increased; increased

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15
Q

what does the right coronary artery feed

A

the SA node, right atrium, AV node, and part of the posterior wall

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16
Q

if there is an inferior wall MI what could be blocked

A

right coronary artery

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17
Q

what does the left main coronary artery bifurcate into

A

left anterior descending branch and the left circumflex branch

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18
Q

if there is an occlusion at the top of the left main coronary artery what is it called

A

“widow maker”

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19
Q

what feeds the left atrium

A

left circumflex branch

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20
Q

what feeds the septum wall

A

left anterior descending branch

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21
Q

on an EKG how many “big squares” are 1 second

A

5

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22
Q

on an EKG how many seconds is 1 tiny square

A

0.04sec

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23
Q

what are the different hardwire monitoring of ECG/EKG

A

three lead system
five lead system
12 lead system

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24
Q

what are the different telemetry monitoring of ECG/EKG

A

three lead system

5 lead system

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25
Q

why should you change a 5 lead EKG daily AND date them

A

pt sweats and the gel is conductive gel, so when pt sweats it has salt in it so the EKG can be obscured

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26
Q

what is the placement for 5 lead EKG

A 
RA (white)
LA (black)
MCL (Brown)
RL (green)
LL (red)
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27
Q

for a 5 lead (limb lead) what is lead one

A

RA (-) to LA (+)

28
Q

for a 5 lead (limb lead) what is lead 2

A

RA (-) to LL (+)

29
Q

for a 5 lead (limb lead) what is lead 3

A

LA (-) to LL (+)

*Legs are ALWAYS positive and V1 (MC) is always negative, so aVr, aVl, and aVf are all +

30
Q

flat lines that tell us what is elevated and what is depressed

A

isoelectric lines

31
Q

for it to be sinus rhythm what needs to be present

A

p wave needs to be upright and accompany QRS

32
Q

P wave should be no longer than ____ boxes

A

3

33
Q

PR interval should be no longer than ___ boxes

A

5

*if longer this should tell you there is a block

34
Q

QRS interval should be _____ boxes because if wider there is a block

A

2.5

35
Q

QT interval should be __-__ large boxes

A

1-2

36
Q

atrial depolarization causes

A

P wave

37
Q

what are the 2 phases of the P wave

A

completes right side them moves over to left atrium

38
Q

ventricular depolarization causes

A

QRS wave

  • initial Q can be present or absent
  • a significant Q wave is when it is 1/3 the height of the R wave (major problem) myocardial damage
39
Q

ventricular repolarization causes

A

T wave

  • slower because we are heading into the resting phase
  • ALWAYS an R wave before the T wave
40
Q

sometimes you see this wave, sometimes you don’t. if you see them its usually associated with repolarization of purkinje fibers

A

U wave

  • if you see it ask if they are diabetic, cardiac hx, taking digoxin, hypokalemic, hypothermic
  • mostly seen in slower heart rates <65
41
Q

what is important about the pause occurring at the AV node (PR segment)

A

allows time for blood to empty from the atrium into the ventricle

42
Q

what is important about the ST segment

A

line is flat and after that it will show us if the T wave is inverted, depressed, or elevated

43
Q

T wave inversion=

A

ischemia

44
Q

ST depression=

A

injury

45
Q

ST elevation=

A

infarction

46
Q

ST segment below the isoelecto line

A

ST depression= injury
*if it looks like a label it is digitalis effect

give oxygen and ask about meds

47
Q

ST segment above the isoelectro line

A

ST elevation= infarction

  • tx is MONA
  • even if pt states they are not having chest pain you still get 12 lead EKG and call physician
48
Q

what is MONA

A

morphine, oxygen, nitroglycerine, aspirin,

then cardiac cath or surgery

49
Q

what should you do if the T wave is inverted

A

indicates ischemia so give oxygen and let physician know

50
Q

originates in the right or left VENTRICLE, does not follow normal conduction path, each ventricle fires separately, these are wide and bizarre shaped

A

premature ventricular contraction (PVC)

51
Q

every other beat is a PVC=

A

bigeminy

*give oxygen

52
Q

every third beat is a PVC=

A

trigeminy

53
Q

a pair of PVC, one is up one is down

A

multifocal couplet

54
Q

if pt is having multiple PVCs (>6/min) what should be given

A

lidocaine

55
Q

what van V tach turn into

A

ventricular fibrillation

56
Q

what is the purpose of a pacemaker

A

control heart rate when conduction is compromised

57
Q

paces either the atria or ventricle

A

single chamber

58
Q

paces both atrium and ventricle

A

dual chamber

59
Q

what is the 3 letter system for pacemaker

A

first letter= chamber is being paces
second letter= chamber is being sensed
third letter= response to heartbeat

60
Q

what is important to teach the pt who gets a pacemaker

A

do not raise affected extremity above shoulder, bend at the knee, or push up for 2 weeks (cause dislodged electrode)

61
Q

what interval will be wide if pt has a pacemaker

A

QRS

62
Q

pt has a pacemaker that shows a spike with no response is

A

failure to capture

63
Q

pt has a pacemaker what fires after pt’s own beat is

A

failure to sense

64
Q

failure to sense is the most ______ because if fires ______ the pt’s own ______ and if we have electrical impulse after pt own beat it might hit on the ___ wave and could cause an __ on __ phenomenon

A

concerning; after; beat; T; R on T

65
Q

what is an indication that pacer wire is dislodged or perforated the myocardium

A

hiccupping, rhythmic chest wall or diaphragmatic twitching

*must notify physician and monitor pt

66
Q

what are the 6 steps of rhythm strip analysis

A
  1. regularity of R wave
  2. calculate HR
  3. identify P wave (upright, present before QRS)
  4. measure PR interval
  5. measure QRS complex
  6. ST depression or elevation
  7. is there any other unusual occurrence

Module 7 (8 decks)

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