Complex Cardiovascular

Question 1

atherosclerosis

Answer 1

causes CAD, lipids accumulate in arteries, forming a plaque

Question 2

normal total cholesterol

Answer 2

140-199

Question 3

triglycerides

Answer 3

under 150

Question 4

HDL

Answer 4

over 45

Question 5

LDL

Answer 5

under 100

Question 6

ACS symptoms

Answer 6

nausea, diaphoresis, SOB, anxiety, heartburn, fatigue, palpitations, pallor, dysrhythmias

Question 7

what groups often have abnormal ACS symptoms

Answer 7

diabetics, elderly, females

Question 8

atypical ACS symptoms

Answer 8

GI upset, fatigue, gray/blue, neck/jaw/back pain, upset stomach

Question 9

stable angina

Answer 9

caused by buildup of plaque, chest pain lasting 5-10 minutes resolving in rest

Question 10

unstable angina

Answer 10

unpredictable chest pain, occurs when plaque is beginning to rupture, often leads to MI

Question 11

unstable angina symptoms

Answer 11

not relieved with rest, transient/no EKG changes, no biomarker elevation

Question 12

variant angina

Answer 12

chest pain occurring when vessel spasms, typically @ rest or while sleeping

Question 13

variant angina treatment

Answer 13

calcium channel blockers - verapamil, diltiazem, amlodipine

Question 14

s/s of NSTEMI

Answer 14

ST depression, T wave inversion, elevated biomarkers

Question 15

s/s of STEMI

Answer 15

ST elevation, T wave changes in 2 continuous leads

Question 16

3 immediate steps in suspected ACS

Answer 16

assess presentation, 12 lead, biomarkers

Question 17

troponin

Answer 17

released w cardiac necrosis

Question 18

troponin T

Answer 18

less than 0, sex variations, raises with renal failure

Question 19

troponin I

Answer 19

0-12; won’t raise with skeletal/renal damage

Question 20

what should you give immediately with ACS

Answer 20

aspirin, nitro, morphine

Question 21

other meds u may give with ACS

Answer 21

beta blockers, ACE inhibitor, high dose statin, heparin, Ca channel blocker

Question 22

reperfusion techniques

Answer 22

fibrinolytics, CABG, PCI

Question 23

ideal STEMI treatment

Answer 23

PCI

Question 24

what to monitor for post cath

Answer 24

back pain, decreased UO, chest pain

Question 25

post cath complications

Answer 25

myocardial ischemia/thrombosis, bleeding, hematoma formation

Question 26

CABG post op equipment

Answer 26

A line, CVP, PA cath, chest tubes, pacing wires, vent, NG to LIS

Question 27

CABG post op care

Answer 27

early ambulation, extubate within 3 hours, cough pillow, pain & glucose control, strict BP control, neuro checks

Question 28

normal chest tube findings post CABG

Answer 28

up to 150ml/hour of blood

Question 29

contraindications to fibrinolytic administration

Answer 29

pregnancy, home blood thinners, recent stroke/trauma, bleeding disorder

Question 30

indications of improvement after fibrinolytic administration

Answer 30

improved chest pain, no ST elevation

Question 31

indications of worsening after fibrinolytic administration

Answer 31

increased pain, dysrhythmias

Question 32

side effects of fibrinolytics

Answer 32

bleeding - high risk of hemorrhagic stroke

Question 33

s/s of pulmonary edema

Answer 33

increased O2 needs, cyanosis, anxiety, pink frothy sputum, cool clammy skin, accessory muscle use, suffocating

Question 34

oxygenation interventions for pulmonary edema

Answer 34

CPAP/BIPAP, intubation

Question 35

CPAP/BIPAP considerations

Answer 35

must be able to take mask off themselves - will aspirate if they throw up

Question 36

medications for pulmonary edema

Answer 36

vasodilators, nitroglycerin, morphine

Question 37

causes of endocarditis

Answer 37

pacemaker insertion, cardiac cath, prosthetic valve, dental work, IV drug use

Question 38

endocarditis treatment

Answer 38

abx

Question 39

myocarditis

Answer 39

usually from viral process & treated too late - manage CHF or dysrhythmias

Question 40

pericarditis symptoms

Answer 40

pain at clavicular area, neck, scapula, friction rub, poor CO

Question 41

pericarditis treatment

Answer 41

NSAIDs for pain, pericardiocentesis

Question 42

valve regurgitation

Answer 42

valves don't properly close, blood flows backward

Question 43

valve stenosis

Answer 43

valves do not fully open, leaflets become stiff, hypertrophy occurs

Question 44

possible cause of valve stenosis

Answer 44

endocarditis

Question 45

symptoms of valve disorders

Answer 45

fatigue, DOE, chest pain, heart failure

Question 46

medical management of valve disorders

Answer 46

oxygen, diuretics, manage dysrhythmias, abx

Question 47

cardiac tamponade patho

Answer 47

accumulation of fluid in pericardial sac - heart is compressed, ventricles can't fully fill

Question 48

Beck's triad

Answer 48

hypotension, JVD, muffled heart sounds

Question 49

symptoms of cardiac tamponade

Answer 49

beck's triad, tachycardia, elevated CVP, decreased UO, impending doom

Question 50

cardiac tamponade treatment

Answer 50

emergent return to surgery - pericardiocentesis

Question 51

dilated cardiomyopathy

Answer 51

enlarged LV, PVCs

Question 52

hypertrophic cardiomyopathy

Answer 52

thickened, stiff LV walls

Question 53

restrictive cardiomyopathy

Answer 53

LV contract & fills poorly

Question 54

takotsubo cardiomyopathy

Answer 54

broken heart syndrome, weakened LV with severe stress, resolves on its own or progresses into HF