CEN Cardiovascular Flashcards by Linsay AugustinCRNA

Possible causes of Hypertensive emergency

Cocaine use 
amphetamine use
Eclampsia
PHEOCHROMCYTOMA
AORTIC DISSECTION
ALCOHOL WITHDRAWL

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Treatment of Hypertensive emergency includes _______

Vasoactive infusion with NITROPRUSSIDE

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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

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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

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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

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Compensatory stage of shock symptoms are

Tachycardia
Blood pressure changes
Tachypnea

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Irreversible (REFRACTORY) stage of shock symptoms are:

MODS and death.

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SUBJECTIVE clinical presentation of progressive stage of schok

Anorexia,
nausea
chest pain
dyspnea

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Uncompensated (PROGRESSIVE) stage of shock include

Hypotension
Hypothermia
Dysrhythmias
Tachypnea

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3 MOST COMMON Causes of obstructive shock

PE
Cardiac Tamponade
Tension Pneumothorax

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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

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The Trendelenburg position is NOT recommended for shock as it increases________

Intracranial pressure.

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Most common causes of Cardiopulmonary arrest

5 Hs and 5Ts

Hypovolemia
hypoxia
hydrogen ions
Hypo/hyperkalemia
Hypothermia

Toxins
Tension (pneumothorax)
Thrombosis
Tamponade

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patient taking anabolic steroids are at increased risk for

Heart attack, stroke
altered carb metabolism
IMMUNOSUPRESSION

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A packed of RBC can raise hemoglobin by ____ mg/dl

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Torsades de pointes is associated with which cardiac dysrhythmias which consists of _______Vtach

Polymorphic:; HYPOMAGNESEMIA

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In pregnant women, CO increases by ____ %, HR increased by ___ -___ bpm, and BP DECREASED __ -___mmghg

30; 15-20bpm; 15-20

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Gestational hypertension defined as SBP >______and diastolic > ____

140; 90

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A condition NOT ASSOCIATED with low voltage across the precordium ______; it is rated associated with poor

Left BBB; R-wave progression across the precordium

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Conditions associated with low voltage:

Pericardial effusion
Obesity
Amyloid heart disease
EMPHYSEMA

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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

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Patients with ARTERIAL peripheral vascular disease experience _________ while patients with VENOUS peripheral arterial vascular disease experience______ pain

CLAUDICATION

cramping.

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Arterial vascular experience

excruciating pain, DIMINISHED pulses, PALE color and COOL temperature

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Venous peripheral vascular experience

Cramping, NORMAL pulses, normal or RUDDY color and WARM temperature.

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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

2. 5-4 2. 2-2.5 2. 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

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.