CEN cardiology cont

Question 1

S/S of cardiac tamponade 9 things

Answer 1

1. becks triad
2. kussmauls sings
3. pulsus paradoxus
4. small EKC amplitude
5. electrical alterans
6. tachycardia
7. anxiousness
8. risk of PEA
9. restlessness

Question 2

becks triad is

Answer 2

JVD, hypotension, muffled heart sounds

Question 3

Kussmaul Sign is

Answer 3

increased JVD on inspiration

Question 4

Pulsus paradozus is

Answer 4

decrease in BP upon inspiration

Question 5

electrical alternans is

Answer 5

alternating amplitude of QRS complex

Question 6

TX of pericardial tamponade is 3 things

Answer 6

1. needle pericardiocentesis (subxiphoid)

2. thoracotomy for

Question 6

TX of pericardial tamponade is 3 things

Answer 6

1. needle pericardiocentesis (subxiphoid)
2. thoracotomy for pericardial window
3. support BP with pressors

Question 7

peripheral artery disease 5 S/S

Answer 7

shiny skin, hair loss, constant excruciating burning pain, cold extremity, decreased pulses or pulseless

Question 8

DX of PAD

Answer 8

Ankle bracial index (ABI) 0.9-1.3

Question 9

TX for PAD 2 things

Answer 9

Do not elevate the limb

prepare for embolectomy for critical limb ischemia

Question 10

PVD is caused by

Answer 10

damage to venous valces

Question 11

S/S of PVD is 4 things

Answer 11

leg pain, delayed wound healing, cellulitis, and ulcers

Question 12

DVT is

Answer 12

a clot in a peripheral vein in the pelvis, thigh, or lower leg d/t sluggish blood flow

Question 13

Risk factors for DVT is

Answer 13

Virchows Triad (venous stasis, vein damage, hypercoagulability

Question 14

three TX for DVT are

Answer 14

elevate extremity, compression, and anticoagulants

Question 15

Raynauds disease is

Answer 15

episodic intense vasospasm of the digits, nose or ears in response to stress or cold.

Question 16

blunt cardia injury is usually to the

Answer 16

right side of the heart (d/t positioning)

Question 17

5 S/S of blunt cardiac injury

Answer 17

chest pain unrelieved by ntg
dysrhythmias (ST and PVCs mostly)
ST elevation
Hypotension
cardiac failure

Question 18

DX of blunt cardiac injury is

Answer 18

ECG monitoring and echocardiogram

Question 19

TX for blunt cardiac injury (three things)

Answer 19

1. oxygen
2. admission cardiac monitoring
3. possible pressors

Question 20

cardiogenic shock is

Answer 20

inadequate tissue perfusion d/t pump failure (usually anterior wall MI)

Question 21

7n S/S of cardiogenic shock

Answer 21

tachypnea, crackles, pulmonary edema, S3 sound, Kerly B lines on CXR, cool clammy skin, hypotension

Question 22

5 TX for cardiogenic shock

Answer 22

Oxygenation
decrease preload with NTG and diuretics
decrease afterload with NTG or nipride
increase contractility with dobutamine/iabp
treat dysrhthmias

Question 23

VAD 6 things to know

Answer 23

audible hum with barley palpable pulses
MAP 60-90
doppler over radial or brachial artery
Contact VAD coordinator
Difibrillate with AP pads
CPR may damage device

Question 24

Obstructive shock is caused by these 5 things

Answer 24

percardial tamponade, tension pneumo, massive PE, supine vena cava syndrome in advanced pregnancy, abdominal compartment syndrome

Question 25

TX for obstructive shock

Answer 25

fix the underlying problem

Question 26

mass transfusion protocol ratios

Answer 26

1 plasma: 1 platelets: 1 pRBCs

Question 27

hypocalcemia is

Answer 27

common after MTP

Question 28

Dilution with NS in hypovolemic shock can cause this triad

Answer 28

hypothermia, acidosis, and coagulopathy

Question 29

administer blood products based on

Answer 29

TEG lab values

Question 30

in blunt abdominal trauma and pelvic fx use

Answer 30

permissive hypotension (don't pop the clot)

Question 31

Shock is

Answer 31

inadequate tissue perfusion

Question 32

Degree of shock is dependent on three things

Answer 32

cardiac output, hemoglobin, and oxygen saturation of hemoglobin

Question 33

Shock is not defined by

Answer 33

hypotension

Question 34

three things to monitor with shock are

Answer 34

serum lactate, pH, and base deficit

Question 35

hypovolemic shock (tank) is

Answer 35

loss of circulating volume, fill the pump, plug the leaks

Question 36

obstructive shock is

Answer 36

obstructed blood flow, relieve the obstruction

Question 37

Cardiogenic shock is (pump)

Answer 37

the pump is pooped, increase contractility