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Perfusion Exam > Class 2 > Flashcards

Class 2 Flashcards

1
Q

CAD definition

A

atherosclerosis along inner arterial walls of coronary arteries leading to decreased myocardial blood flow

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2
Q

main symptom of CAD

A

angina

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3
Q

what can occur as a result of CAD

A

MI

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4
Q

term for intermittent cramping

A

cautication

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5
Q

angina that occurs with activity or increased emotions

A

stable

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6
Q

this type of angina is predictable and consistent

A

stable

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7
Q

tx of stable angina

A

nitroglycerin

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8
Q

angina that may occur at rest that is sudden and severe

A

unstable

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9
Q

this type of angina increases in frequency, duration, and intensity

A

unstable

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10
Q

nitroglycerin does not help this type of angina

A

unstable

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11
Q

this type of angina is considered an emergency

A

intractable/refractory

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12
Q

this type of angina is thought to be related to coronary artery spasm

A

variant/prinzmetal

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13
Q

meds that reduce coronary artery spasms that may cause variant angina

A

CA channel blockers

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14
Q

anterior wall MI: left or right sided

A

left

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15
Q

inferior wall MI: left or right sided

A

right

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16
Q

STEMI

A

ST segment elevation MI

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17
Q

non-STEMI

A

ST segment depression, T wave inversion MI

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18
Q

class of med given for STEMI

A

fibrinolytic

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19
Q

class of med given for non-STEMI

A

anti-platelet

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20
Q

what area of the heart does an anterior wall MI effect

A

left ventricle

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21
Q

possible consequences of anterior wall MI

A

high risk for cardiogenic shock and pulmonary edema

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22
Q

immediate tx for chest pain

A

Morphine
Oxygen
Nitroglycerin
Aspirin

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23
Q

a discrepency in this wave indicates an MI at one time in a person’s life

A

Q wave

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24
Q

issue with statin drugs

A

can damage striated muscles leading to rhabdomyolysis

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25
Q

examples of cardiac enzymes

A

total creatine kinase
isoenzyme CK-MB
troponin T or 1

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26
Q

when is the CK elevated

A

when there is tissue damage

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27
Q

rhabdomyolysis caused by statin drugs can lead to what being elevated

A

CK-MM (specific to skeletal muscles)

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28
Q

what percent of CK is CK-MB

A

0-5%

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29
Q

if CK-MB is elevated it is indicative of what

A

damage to myocardium

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30
Q

which cardiac enzyme is unique to the myocardium

A

troponin

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31
Q

which cardiac enzyme stays elevated the longest

A

troponin

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32
Q

what is done if a patient has chest pain but a normal EKG and normal cardiac enzymes

A

further dx testing

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33
Q

what is done if a patient has chest pain and has an abnormal EKG and cardiac enzymes

A

medications: ACE, antiplatelet, anticoag, beta, CA channel blockers, nitrates
revascularization: fibrinolytic, thrombolytic, coronary artery bypass

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34
Q

purpose of a stress test

A

determines amt of exercise induced ischemia

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35
Q

what meds may be used in a pharm stress test

A

adenosine

dobutamine

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36
Q

procedure in which contrast is injected to assess perfusion in the coronary arteries and a catheter is inserted through vessels into the heart

A

cardiac cath

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37
Q

it is important to monitor for this following a cardiac cath

A

contrast induced nephrotoxicity

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38
Q

what 2 meds can protect the kidneys in relation to a cardiac cath

A

mucomyst (prevent contrast induced renal dysfxn)

metformin (do not give 24 hrs before and 48 hrs after to protect kidneys)

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39
Q

these 3 things may be used to achieve hemostasis at the insertion site of a cardiac cath

A

sandbag, angioseal, femostop

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40
Q

which hemostasis device is a mechanical inflation device developed by a nurse

A

femostop

41
Q

EKG changes indicative of ischemia

A

ST segment elevation/depression

T wave inversion

42
Q

ACE inhibitors and angiotensin II receptor blockers aim to prevent what

A

vasoconstriction and sodium reabsorption

43
Q

examples of ACE inhibitors

A

catopril
enalapril
lisinopril

44
Q

examples of angiotensin II receptor blockers

A

losartan

valsartan

45
Q

ACE inhibitors are commonly used to treat what

A

HF
MI
HTN

46
Q

why can tachycardia result due to taking ACE inhibitors

A

BP is low so perfusion must be maintained

47
Q

respiratory SE of ACE/angiotensin

A

dry cough

angioedema

48
Q

important labs to monitor when pts taking ACE/angiotensin

A

BUN and creatinine
potassium (hyper)
sodium (hypo)
WBC

49
Q

why is it important to prevent hyponatremia in pts taking ACE/angiotensin

A

the tx is with 150-200 ml/hr of IVF and if the pt has HF, they may not be able to tolerate lots of fluid

50
Q

oral antiplatelet agents

A

aspirin

plavix

51
Q

IV antiplatelet agents

A

aggrastat

intergrilin

52
Q

SE of oral antiplatelet agents

A

increased risk for bleeding
GI distress
TTP

53
Q

T or F: pts taking IV antiplatelet agents should be on bedrest

A

TRUE, the medication can cause bleeding to occur very quickly and the risk for injury should be reduced

54
Q

anticoagulants

A

heparin

lovenox

55
Q

normal and therapeutic level for aPTT

A

normal: 20-35 seconds
therapeutic: 40-70 seconds

56
Q

aPTT is related to what drug

A

heparin

57
Q

heparin induced thrombocytopenia

A

decrease in platelets by 25% or more OR a platelet count below 100,000

58
Q

what can occur due to HIT

A

bruising
destruction of platelets
clotting

59
Q

reversal agent for HIT

A

protamine sulfate

60
Q

those with allergies to what cannot take protamine sulfate

A

fish: salmon in particular

61
Q

which class of meds decrease platelet aggregation

A

antiplatelet agents

62
Q

which class of meds prevent prothrmbin—>thrombin and fibrinogin—>fibrin

A

anticoagulants

63
Q

which claass of med decreases myocardial o2 demand by decreasing the force of contractions, improve filling time by decreasing AV conduction and decreases afterload by vasodilating peripheral vessels

A

beta blockers

64
Q

beta blockers

A 
metoprolol
atenolol
propranolol
nadolol
labetalol
65
Q

what are beta blockers commonly used to treat

A

HTN
anxiety
HF
migraines

66
Q

be careful when giving pts with these issues beta blockers

A

COPD
asthma
constricts bronchioles

67
Q

assess for these 3 things when giving beta blockers and ca channel blockers

A

bradycardia
hypotension
orthostatic changes

68
Q

which class of med decreased myocardial o2 demand by decreasing contractility and AV conduction and by vasodilating peripheral vessels leading to decreased afterload and increase the myocardial o2 supply by vasodilating coronary arteries/prevent and treat CA vasospasm

A

calcium channel blockers

69
Q

calcium channel blockers

A

diltiazem
verapamil
amlodipine
nifedipine

70
Q

these 2 classes of meds can be given for SVT, a-fib, and a-flutter

A

beta blockers and ca channel blockers

71
Q

which class of med decreases myocardial o2 demand by vasodilating peripheral vessels leading to a decreased afterload and increase myocardial o2 supply by vasodilating CA

A

nitrates

72
Q

nitrates

A

nitrogylcerin, any med beginning with “nitro”

73
Q

what should you assess for when pt is taking nitrates

A

hypotension

HA

74
Q

EKG change that is indicative of blood clot

A

elevated ST segment

75
Q

which class of med activates the fibrinolytic system to generate plasmin and breakdown fibrin clots

A

fibrinolytics (thrombolytics)

76
Q

fibrinolytics

A

streptokinase
anisolated plasminogen-streptokinase activator complex (APSAC)
TNKase

77
Q

important to monitor for what when taking fibrinolytics

A

allergic rxn

78
Q

T or F: there is an increased risk of bleeding when taking fibrinolytics

A

TRUE

79
Q

how to tell if pt taking fibrinolytics has evidence of reperfusion

A

monitor EKG

80
Q

EKG change associated with LBBB

A

notched QRS complex

81
Q

what can indicated dissection of AAA

A

difference in the L and R arm BPs

82
Q

procedure done to open narrowed CA

A

percutaneous transluminal coronary angioplasty (PTCA)

83
Q

how many mins do you have to administer fibrinolytic following heart issue

A

30 mins

84
Q

how many mins do you have to get the balloon inflated in PTCA following heart issue

A

90 mins

85
Q

drug eluding stents

A

stent inserted into CA that releases a clot preventing drug over time

86
Q

surgical placement of artery or vein near blocked CA

A

coronary artery bypass graft (CABG)

87
Q

what is used to paralyze the heart during CABG

A

potassium

88
Q

complication related to induced hypothermia during CABG/cardiopulmonary bypass

A

blood becomes thickened

89
Q

complication related to hemodilution during CABG/cardiopulmonary bypass

A

can cause 3rd spacing and edema

90
Q

cardiopulmonary bypass

A

provides o2 and circulation for systemic perfusion during open heart surgery

91
Q

tx of low CO secondary to blood loss/vasodilation following CABG/cardiopulmonary bypass

A

IVF

colloids (RBC, volume expanders)

92
Q

tx of low CO secondary to poor ventricular fxn following CABG/cardiopulmonary bypass

A

diuretics

positive inotropes

93
Q

tx of low CO secondary to bradycardia following CABG/cardiopulmonary bypass

A

cardiac pacing (epicardial)

94
Q

what is used to treat HTN following CABG/cardiopulmonary bypass

A

IV nitroglycerin

95
Q

what is used to treat pericardial effusion following CABG/cardiopulmonary bypass

A

emergency sternotomy to release fluid around heart

96
Q

device that inflates during diastole and perfuses coronary arteries and decreases afterload

A

intra-aortic balloon pump (IABP)

97
Q

when may a ventricular assistive device be used

A

following open heart surgery

in endstage HF

98
Q

device that removes blood from the L vent and takes it to the aorta when the L vent is weak and not pumping well

A

ventricular assistive device (VAD)

99
Q

meds given for pulmonary edema

A

diuretic

morphine

Perfusion Exam (3 decks)

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