CEN Cardiovascular Flashcards
Possible causes of Hypertensive emergency
Cocaine use amphetamine use Eclampsia PHEOCHROMCYTOMA AORTIC DISSECTION ALCOHOL WITHDRAWL
Treatment of Hypertensive emergency includes _______
Vasoactive infusion with NITROPRUSSIDE
When the patient has lost 35 % of his blood volume it is classified as _________and HR is _____
When the patient lost less than 15 %-30% it is ______and HR is ________or less
When the patient lost loss more than 40% of blood volume and is HR Is ____ or less
When a patient has lost less than 15 % of blood volume it is classified as __________ and HR is less than _____
Class III Hemorrhagic shock (30-40%; 125
Class II hemorrhagic shock; more than 100
Class IV hemorrhagic shock; less than 140
Class I hemorrhagic shock ; less than 100
Colloids should be used when ______ ______ is increased. For example , it should not be used in ______, _____ or ____During the first ___ to __ hours
capillary permeability
sepsis, anaphylaxis burns
24- 48 hours
What is the LEAST FAVORABLE site for IV during CPR and why?
Subclavian site
because CPR has to stop and it increased the chance for pneumothorax
Compensatory stage of shock symptoms are
Tachycardia
Blood pressure changes
Tachypnea
Irreversible (REFRACTORY) stage of shock symptoms are:
MODS and death.
SUBJECTIVE clinical presentation of progressive stage of schok
Anorexia,
nausea
chest pain
dyspnea
Uncompensated (PROGRESSIVE) stage of shock include
Hypotension
Hypothermia
Dysrhythmias
Tachypnea
3 MOST COMMON Causes of obstructive shock
PE
Cardiac Tamponade
Tension Pneumothorax
Which of the following positions may be helpful for the patient in shock? because it promotes _______ ______ to the ____side of the heart and therefore increases _______
Supine with legs elevated. Venous return; right; Cardiac output
The Trendelenburg position is NOT recommended for shock as it increases________
Intracranial pressure.
Most common causes of Cardiopulmonary arrest
5 Hs and 5Ts
Hypovolemia hypoxia hydrogen ions Hypo/hyperkalemia Hypothermia
Toxins
Tension (pneumothorax)
Thrombosis
Tamponade
patient taking anabolic steroids are at increased risk for
Heart attack, stroke
altered carb metabolism
IMMUNOSUPRESSION
A packed of RBC can raise hemoglobin by ____ mg/dl
1
Torsades de pointes is associated with which cardiac dysrhythmias which consists of _______Vtach
Polymorphic:; HYPOMAGNESEMIA
In pregnant women, CO increases by ____ %, HR increased by ___ -___ bpm, and BP DECREASED __ -___mmghg
30; 15-20bpm; 15-20
Gestational hypertension defined as SBP >______and diastolic > ____
140; 90
A condition NOT ASSOCIATED with low voltage across the precordium ______; it is rated associated with poor
Left BBB; R-wave progression across the precordium
Conditions associated with low voltage:
Pericardial effusion
Obesity
Amyloid heart disease
EMPHYSEMA
BEAU CHOPS mnemonic for pregnant woman in cardiopulmonary arrest stands for
Bleeding Embolism Anesthetic complications Uterine atony Cardiac disease Hypertension Others (Hs and Ts) Placental abruption or previa Sepsis
Patients with ARTERIAL peripheral vascular disease experience _________ while patients with VENOUS peripheral arterial vascular disease experience______ pain
CLAUDICATION
cramping.
Arterial vascular experience
excruciating pain, DIMINISHED pulses, PALE color and COOL temperature
Venous peripheral vascular experience
Cramping, NORMAL pulses, normal or RUDDY color and WARM temperature.
In a patient with a hemothorax, the nurse should prepare for emergent surgery if the initial drainage is more than
1500ml
For hemothorax, there may be
blunting of the costophrenic angle.
Nitroglycerin decreases _______ and it is a potent
_______
preload
vasodilator
If the transducer of hemodynamic monitoring system is low, the reading will be ______; the transducer need to be _____ and balanced to ____ before use and the patient should be in a ___ position
Too high ; leveled; zero. supine
The transducer should be zeroed at and placed _______ level with the _____ atriaum
horizontally; right.
Causes of pericarditis include
TB
MI
AORTIC DISSECTION
In a trauma patient without a gag reflex, you will need to use a ____________ airway adjunct in order to hold the tongue away from the patient’s ________
OROPHARYNGEAL
Hypopharynx
When a basal skull fracture is NOT SUSPECTED, to hold the tongue away from the patient a __________airway adjunct can be used
NASOPHARYNGEAL
Symptoms of right sided HF (NAJP)
peripheral edema JVD ASCITES NAUSEA S3
Symptoms of Left side HF (SPECD)
SOB
dyspnea
crackles
Pulmonary edema
Extensive ANTERIOR infarct include location
Left MAIN or LAD artery
LATERAL infarct is the (LATCIRC)
circumflex artery
Inferior infarct :
RCA
Ventricular repolarization is the
T wave
Atrial depolarization is the
P wave
Depolarization of the right and left ventricles
QRS complex
Ventricular depolarization
R wave
A patient with a complete Heart block with an intact sinus would most likely use an _______ ______ ______- pacer
Atrial triggered ventricular
Patient who have a complete heart block with a slow idioventricular rhythm
Fixed-rate ventricular pacer
For patient with sick sinus syndrome, sinus brady, sinus arrest or complete HB
Demand ventricular pacer is used.
Patients with a consistently slow sinus rate with an intact AV nodal conductions
Fixed rate atrial pacer
Best describes the function of a transducer
Converts a mechanical signal into an electrical signal.
What increases the magnitude of an electrical signal and filters out the electrical interference?
Amplitude.
the four pulmonary veins supply the _____atrium
LEFT
The inflow tracts of the RIGHT ATRIUM include
Thebesian veins
Superior and inferior vena cava
Coronary sinus
Ectopy has _____beats and ______does not
Fusion ; aberrancy does not.
Which hemodynamic parameter pressures is measured by mean, systolic, and diastolic________and it measure pressure of the
PA pressure ; Pulmonary artery
Conditions with elevated PAP
Pulmonary HTN
COPD
PE
LV failure
If a patient is receiving sympathomimetic agents, the diastolic pressure is expected to be _____ while the pulse pressure _______
higher; narrowed
If a patient is receiving vasodilators, diastolic pressure is expected to be _____while the pulse pressure is ________
Lower; widened
_________heavy pigment that occurs during shock when muscle tissue has been destroyed or
Myoglobinuria ; Rhabdomyolosis
When the patient has penetrating blunt trauma above the nipple line, his ______ ___ must be immobilized with the assessment of his airway
Cervical spine
________Infection of the mucous membrane caused by bacteria ________ _______
Diphteria; corynebacterium diphteriae
Example of parasitic infection is_______
Toxoplasmosis
Example of HELMINTHIC infection
Trichinosis
Age related cardiovascular changes include
Decreased blood vessel compliance
decreased INOTROPIC response to stimulation
Decreased Chronotropic response to stimulation
Decreased baroreceptor sensitivity
Which shock is characterized by decreased circulating volume
Hypovolemic
Conditions with HIGH URINE OSMOLALITY
Dehydration HF Renal stenosis glycosuria HYPERNATREMIA
Conditions with lower urine osmolality
DI
acute renal insufficiency
EXCESS WATER INTAKE
GLOMERULONEPHRITIS>
Define urine osmolality? Is it more accurate than specific gravity
measure the number of dissolved particles per unit of water in urine. Yes.
The SEMILUNAR VALVES are ______ and they caused the _____heart sound (S2)
AORTIC
PULMONIC
The ATRIOVENTRICULAR VALVES are ____ and ______and they caused the ___ heart sound (S1)
Tricuspid and mitral
Nitroprusside has a ____onset and should be titrated _____
rapid; slowly
Parameters consistent with adequate fluid resuscitation are
CVP 8-12 MAP > 60-70 SBP >90 UO> 30 Normal lactate SVO2 65-75
Normal hematocrit is women Normal hematocrit men Normal hemoglobin women Normal hemoglobin men Normal WBC
37-47% 42-52 12-16 14-18 5800-10800
Lithium may cause______other drugs also included TCA, phenytoin,
Dysrhythmias oh
Doxorubicin may cause
Cardiomyopathy
Phenothiazine can cause _______ in patients with cardiovascular disease
Hypotension
Patients with pneumothorax experiences pain on the _____ side and that radiates to the _____ or _____
affected; shoulders; neck
Patients with Dissecting aortic aneurysm chest pain is located in anterior chest,, radiates to
shoulder, back , abdomen
During compensated shock, the ___________ hormone encourages the _______cortex to release ______ and ________
Adrenocorticosteroid; adrenal ; glucocorticosteroid and aldosterone.
During the compensated shock, the antidiuretic hormone causes _____ and ______ of water at the ______
retention; vasoconstriction; renal tubules.
During the compensated shock, aldosterone encourages the reabsorption of water and sodium at the
Renal tubule.
Which layer of the cardiac wall keeps the heart in a stationary position
PERICARDIUM
A little as ____ to ____ ml of blood in the pericardia sac can have a detrimental effect on cardiac output
100-150
May improve pulmonary congestion by forcing alveolar fluid back into the pulmonary capillaries
BIPAP
Type of angina characterized by coronary artery spasms________occurs usually between _____ and ______
Prinzmetal’s angina
midnight and early morning
Associated with critical proximal stenosis
Wellens syndrome
normal cardiac index is _______
Subclinical hypoperfusion CI
Clinical hypoperfusion CI
- 5-4
- 2-2.5
- 0-2.2
Pt presented to ED stated that ICD fired 3 time, initial intervention include
Tap a magnet over the ICD to prevent firing and monitor
the pads should be place ____cm to reduce chance of damaging the device.
Most coronary veins empty in the
Coronary sinus
the coronary sinus empties into the
right atrium
Main cardiac channel empties in the
pretracheal node
The pretracheal node empties in the
right lymphatic duct
Formula to calculate QT interval________
QT / Square root of R-R interval
Pacemaker may fail to fire if there is
loose connections
lead fractures
sensing malfunction
If a patient has wandering atrial pacemaker, HR would be less than _______
100 bpm
3 conditions caused by hyperventilation
Respiratory alkalosis
cerebral vasoconstriction
cerebral ischemia
Does not cause cardiac disturbance
HypoNATREMIA
In the management of shock, contains both alpha and beta adrenergic activity
EPINEPHRINE
Heart sound also known as atrial gallop and TENESSE
S4
The ET tube can be used for drug administration as a last resort
2-2.5mg in 10cc of NS
The most common cause of Myocardial rupture is
High speed motor vehicle collision
MARFAN SYNDROME is characterized by which of the following cardiovascular conditions?
Acute aortic dissection.
Artery layers include inner layer ______ . muscle layer _____ and connective tissue layer ______
intima
media
adventitia
A patient who suffers from sinus tachycardia caused by anxiety should be treated with
ANXIOLYTICS
In shock , which of the following is MORE important to monitor than intracranial pressure (ICP)
Cerebral Perfusion pressure.
pulse alternans is _______ and it is seen in ______failure
pulse waves with every other beat weaker than the preceding one; LV
What is the pediatric patient first response to shock?
Tachycardia
What is late sign of shock in pediatric patients ?
Hypotension
Primary blast injuries examples
Pneumothorax
Tympanic membrane rupture
Cerebral air embolism
Which substances may produce potentially hazardous bodily fluids after a patient comes in contact with them?
Organophosphates (fertilizers)
What is High altitude illness/ acute mountain syndrome ?
Rapid ascent of an unacclimatized person to 8000 feet or higher from altitudes below 5000 feet. Results of hypoxia or insufficient oxygen due to decreased partial pressure oxygen at altitude, there is less oxygen available to the tissue due to incomplete hemoglobin loading.
