Chapter 6 Flashcards
1
Q
What do we measure on an EKG?
A
P wave
QRS complex
ST segment
T wave
2
Q
What does the PR interval tell us?
A
atrial depolarizations
3
Q
What is the time that the PR interval should be?
A
0.2 seconds
4
Q
what is the QRS segment
A
ventricular depolarization
5
Q
what is the QT segment?
A
ventricular repolarization
6
Q
preload
A
volume in ventricles prior to contraction
7
Q
stroke volume
A
volume of blood pumped out of the ventricles
8
Q
cardiac output
A
volume of blood pumped by each ventricle in one minute
9
Q
what is the equation for cardiac output
A
CO = SV x HR
10
Q
ejection fraction
A
% of blood pumped from the heart with each contraction
11
Q
describe the relationship between heart rate and cardiac output
A
HR increases
less filling time
Decreased cardiac output
12
Q
PNS does what
A
decreases HR
vagus nerve
13
Q
SNS does what
A
increases HR
norepinephrine
decrease CO
14
Q
why might someone have edema?
A
hypertension
heart failure
severe protein deficiency
renal failure
15
Q
What makes pulmonary arteries different from other arteries?
A
they are the only arteries that carry blood to the heart
16
Q
Blood pressure is influenced by what
A
- Cardiac output
- Compliance (ability of any compartment to expand to accommodate increased content)
- blood volume (hypovolemia/ hypervolemia)
17
Q
When should you NOT administer cardiac meds
A
BP lower than 100
HR higher than 100
18
Q
What factors are involved in the homeostatic regulation of the CV system?
A
Neural (ANS)
Endocrine (epinephrine, norepinephrine, ADH)
RAAS (renin angiotensin aldosterone system)
19
Q
Kidney functions
A
filtration, reabsorption, secretion, regulate BP, produce RBC, eliminate drugs and hormones
20
Q
What causes vasoconstricion (hormone)
A
seratonin
21
Q
fibrinolysis
A
degradation of a clot
22
Q
What are plasma anticoagulants
A
oppose coagulation
thrombus (clot)
23
Q
WBC count range
A
4,000 to 10,000
24
Q
platelet count range
A
150,000 to 400,000
25
hyperlipidemia takes what into account?
total cholesterol
triglycerides
LDL
HDL
26
normal ranges for cholesterol triglyceries, LDL and HDL
```
Cholesterol = less than 200
triglycerides = less than 150
LDL = less than 100
HDL = greater than 50
```
27
What is a big side fx to hypertension meds that impacts compliance?
ED / incompotence
| fatigue because BP is lower than what it usually is
28
embolus
a traveling thrombus
29
describe the damage that thrombi and emboli can do
they are caused by vessel damage
DVT
impede blood flow to tissues
platelets get stuck on fatty streaks of plague and this eventually forms a thrombus
30
Atherosclerosis
damage to vessel wall from irritation causing scar tissue
| -- lipids become attached to the lining of the arterial wall -- causing narrow arteries
31
Coronary artery disease
plague buildup in coronary arteries block blood flow delivering to cardiac muscle
32
MI
lack of blood flow to the cardiac muscle resulting in death of tissue
33
Cerebrovascular accident
interruption in cerebral arteries to the brrain
34
Cerebrovascular accident: TIA
transient ischemic attack
- for a period of time, an area of the brain has no CO2
- all symtoms resolve in 24 hours
- indicates that a worse embolic event is going to happen
35
Cerebrovascular accident: CVA
i think this is a stroke
36
Hemorrhagic vs embolic stroke
Ischemic strokes are caused by atherosclerosis or a blood clot that blocks the flow of blood to the brain
Hemorrhagic strokes are caused by a blood vessel that ruptures and bleeds into the brain.
37
Arrhythmia
deviation from the normal pattern of impulse conduction and contraction
38
Describe what is happening what there is a heart block
there is a delay in conduction, or disassociation in conduction between the atrium and the ventricle
39
Atrial fibrillation
atrium are not contracting; they are quivering --> blood is not ejected out of the properly; sit in atrium and clots; some people have symptoms; treat with meds that slow the HR to restore to normal sinus rhythm
40
ventricular tachycardia
sometimes w pulse and sometimes without a pulse (unstable); associated with people who are in CHF or recent MI; treat with meds that slow heart rate
41
What is the normal PR interval value? what does it indicate if it is normal that that value?
PR interval normal is less than 0.2 seconds
| --> if it is greater than this, its heart block
42
heart failure
heart is not pumping enough to meet the bodies needs
43
right sided heart failure
unable to pump to the lungs to pick up o2
44
left sided heart failure
unable to pump o2 to rest of body
45
What are things to check during the nursing process before administering cardiac medications?
Assessment (BP, HR, electrolytes, kidney function, coagulation)
implementation (is the med. appropriate at this time?)
Evaluation (produce desired response?)
46
extrinsic vs intrinsic pathway
The quick response; begins when damage occurs to the surrounding tissues; events of this pathway are completed in a matter of seconds.
intrinsic --> longer and more complex. In this case, the factors involved are intrinsic to (present within) the bloodstream. The pathway can be prompted by damage to the tissues or resulting from internal factors such as arterial disease. The events in the intrinsic pathway are completed in a few minutes.
47
What do the intrinsic and extrinsic pathways lead to?
common pathway -- where fibrin is produced to seal off the vessel. Once Factor X has been activated by either the intrinsic or extrinsic pathway, Factor II, the inactive enzyme prothrombin, is converted into the active enzyme thrombin. Then thrombin converts Factor I, the soluble fibrinogen, into the insoluble fibrin protein strands. Factor XIII then stabilizes the fibrin clot.
48
What are types of BP medications?
Diuretics
ACE inhibitors
Calcium channel blockers
Angiotensin II receptor blocker
49
what do ACE inhibitors do?
Block conversation of angiotensin I to angiotensin II
50
ACE inhibitor drugs all end in what?
-PRIL
51
ACE inhibitors: who is contrindicated?
pregnancy and impaired renal functions
52
ACE inhibitor side effects
cough
angioedema
pancytopenia
hyperkalemia
53
Angiotensin II Receptor Blockers do what?
block the release of aldosterone by binding with the angiotensin II receptors
54
Angiotensin Receptor Blockers (ARB) medications all end in what
-SARTAIN
55
Angiotensin Receptor Blockers (ARB): who is contraindicated?
pregnancy and renal dysfuntions
56
Angiotensin Receptor Blockers (ARB) side effects
cough and pancytopenia (but much less than ACE inhibitors)
57
What is an examples of a Calcium Channel Blocker?
diltiazem
| PINES (?)
58
what do calcium channel blockers do?
relax and dilate arteries and slow cardiac impulse
| - can be used for arrythmias
59
calcium channal blocker: administratoin considerations
no grapefriut
| immunosupression (sore throat is common)
60
what are examples of vasodilators
hydralazine and nitroprusside
61
when are vasodilators used?
hypertension emergencies
62
how do vasodilators work
cause vascular smooth muscle contraction
63
what is a byproduct of nitroprusside
cyanide
64
how might nitroprusside cause hypothyroidism?
blocks idodine uptake and cause hypothyroidism
65
what is an example of a nitrate
nitroglycerine
66
what is something to know about nitrates
do not combine with other nitrates
67
how should you take nitrates
sitting or lying down
68
why should you keep your bottle of nitroglycerine out of sunlight?
the sun can break down the compounds
69
what diuretic is first line of defsense for hypertesnion?
Thiazide - produced little increase in urine volume
70
what is something to keep in mind about Thiazide?
sulfa allergy
71
compare Ka sparing / wasting diurertics
Ka sparing - causes hyperkalemia
| Ka wasting - causes hypokalemia
72
what do diuretics affect
sodium and blood volume
73
what are anti-hypotensive angents?
Vasopressors
- dopamine
- dobutamine
- ephedrine
- epinepherine
- norepinephrine
74
What type of meds are used for heart failure?
cardiac glycosides
75
what is an example of a cardiac gylcoside
digoxin
76
what does digoxin do
increase cardiac contractilibity, slow HR
- therapeutic level and antidote
- Ka
77
what are 2 examples of anti arrhythmic meds
lidocaine
| amiodarone
78
What do you want to do before giving anti arrhythmic meds
check heart rate
| - do give to someone who is bradycardic (HR<60)
79
what are examples of anticoagulants
Heparin
Warfarin
Enoxaparin
80
What do anticoagulants do
prevent new clots
81
what do you want to check before giving anticoagulants
labs
82
what do anticoagulants increase the risk of?
bleeding
83
What are 2 examples of antiplatelet drugs, and what is a major side effect
aspirin
Clopidogrel
bleeding
84
What are 3 exmaples of thrombolytics
urokinase
streptokinase
tPA
85
What do thrombolytics do and what is a major side effect?
bust up clot
| bleeding
86
what are examples of antihyperlipidemic meds
statins
87
what are side effects of antihyperlipidemic meds
```
hepatotoxic
Rhabdo (muscle pain)
niacin flushing (take aspirin)
```
88
cholestyramine is what and causes what
antihyperlipidemic med and causes constipation
