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NCM 118: Life Threatening Conditions > DIAGNOSTIC TEST THERAPEUTICS SURGICAL, MEDICAL & NURSING MANAGEMENT > Flashcards

DIAGNOSTIC TEST THERAPEUTICS SURGICAL, MEDICAL & NURSING MANAGEMENT Flashcards

1
Q

Highly sensitive
Early detection of MI within 2 hours
It assessed reperfusion
Most useful in ruling MI
DISADVANTAGE- rapid return to normal

A

MYOGLOBIN

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2
Q

(CK MM)-raises fast (2 hours) after MI; peaks at 6-8 hrs. returns to normal in 20- 36 hours.

A

MYOGLOBIN

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3
Q

Elevates 4-6hrs from the onset of infarction; peaks 24-36 hrs. returns to normal 4-7 days.

A

CK-MB (Creatinine Kinase Myoglobin)

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4
Q

normally undetectable or very low in the blood.
Chest pain and increased CK levels plus elevated CK-MB indicate that it is likely that a person has recently had a

A

heart attack.

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5
Q

Powerful tool for risk stratification ( remember the

A

KILLIP’s

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6
Q

Greater specificity and sensitivity to CK-MB
It detects confirm MI up to 2 weeks
Helpful to determine therapy

A

TROPONIN

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7
Q

(nanograms) male
normal myoglobin

A

10-95 ng

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8
Q

( nanograms) female

A

10-65 ng

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9
Q

Most specific lab test to confirm MyocardiaI
Infarction. And is elevated after the 1st 6 hours of attack

A

Troponin

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10
Q

0.1 ng/ml (onset: 4-6 hrs, peak: 12-24 hrs,
persist for: 4-7 days)

A

Troponin I

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11
Q

Troponin T

A

0.2 ng/ml (onset: 3-4 hrs, peak: 10-24
hrs, return to normal: 10-14 days)

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12
Q

To determine if the etiology of MI is due to

A

increased
cholesterol (Dyslipidemia).

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13
Q

They are the most common type of fat .
● They come from foods, especially butter, oils, and
other fats

A

Serum Triglycerides: 140-200 mg/dl

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14
Q

suggests tissue
oxygenation.
- Elevated WBC may indicate infectious heart
disease and MI.

A

Complete Blood Count

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15
Q
  • It is
    elevated in infectious heart disorder or MI.
  • Normal range: Males: 15-20 mm/hr
  • Females: 20-30 mm/hr
A

Erythrocyte Sedimentation Rate (ESR)

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16
Q

Elevated level
indicates tissue necrosis. Also known as (SGOT

A

Aspartate Aminotransferase (AST)-

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17
Q

Serum Glutamic Oxaloacetic Transaminase
- Normal Range:

A

7-40 mu/ml
- A high level of SGOT released into the
blood may be a sign of liver or heart damage

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18
Q

valuable in diagnostic of silent MI because it is
elevated for a long period of time.

A

Hydroxybuterate Dehydroxynase (HBD)

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19
Q

Indicator of renal
function
-

A

Blood Urea Nitrogen (BUN)

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20
Q
  • It measures time
    required for clotting to occur.
A

Prothrombin Time (PT, Pro Time)- I

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21
Q

Used to evaluate
effectiveness of COUMADIN

A

Prothrombin Time (PT, Pro Time)- I

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22
Q
  • Best screening
    test for disorders of coagulation.
A

Partial Thromboplastin Time (PTT)

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23
Q

Used to determine
the effectiveness of HEPARIN. Normal Range: 60-70
secs.

A

Partial Thromboplastin Time (PTT)

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24
Q

SERUM ELECTROLYTES

A

Sodium- 135-145 mmol/ L
- Potassium - 3.5- 5.0 mmol/L
- Calcium- 8.5- 10.5 mg/dl
- Magnesium - 1.3- 2.1 mg/dl

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25
Q

Hemodynamic Monitoring- S

A

Swan Ganz Catheter

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26
Q

Exercise Test

A

Treadmill Stress test
- Dobutamine/Adenosine
● Stress Test
- Myocardial Perfusion
● Scan Holter Monitor

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27
Q

Echocardiography identifies thickened ventricular walls, septal
thickening, and chamber dilation or restriction.

A

2D ECHO

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28
Q

KINDS OF 2D-ECHO

A

TRANSTHORACIC ECHOCARDIOGRAM

TRANSESOPHAGEAL ECHOCARDIOGRAM

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29
Q

two- dimensional 2-D Echo
- capable of displaying a cross-sectional
“slice” of the beating heart, including the
chambers, valves and the major blood
vessels that exit from the left and right
ventricle

A

TRANSTHORACIC ECHOCARDIOGRAM

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30
Q

If it’s difficult to get a clear picture of your heart with a
standard echocardiogram, your doctor may
recommend a transesophageal echocardiogram.
- Also known as TEE

A

TRANSESOPHAGEAL ECHOCARDIOGRAM

31
Q

The catheter is introduced through large veins- internal jugular
or subclavian and femoral veins

A

HEMODYNAMIC MONITORING
- Swan-Ganz Catheterization

32
Q

It is used to diagnosed heart failure or sepsis
● Monitor Therapy
● To evaluate the effectiveness of a certain drug

A

Swan-Ganz Catheterization

33
Q

POSt OP CARE

for Swan-Ganz Catheterization

A

Apply pressure to the incision site for about thirty
minutes manually or with a mechanical compression
device
● Take your patients vital signs every 15 minutes for two
hours after the procedure, th

34
Q

Evaluate or confirm the presence of heart disease
(such as coronary artery disease, heart valve disease,
or disease of the aorta)
● Evaluate heart muscle function

A

SWAN GANZ CATHETERIZATION

35
Q

is a special X-ray test.
● A procedure to find out if the coronary arteries are
blocked or narrowed, location and extent of
injury/damage diagnosed

A

A coronary angiogram i

36
Q

is essential if the patient needs
treatment such as
- Angioplasty or stent
- Coronary artery bypass surgery (CABG)
- Medical therapy

A

An angiogram

37
Q

Determine the amount of stress that the heart can
manage.
● Diagnose Coronary Artery Disease and heart related
cause of syndrome

A

EXERCISE STRESS TEST

38
Q

TREADMILL TEST
Nursing Considerations

A

Inform the patient to have an adequate rest at night.
● Avoid stimulants such as tea, coffee or chocolate on
the day of the test.

39
Q

An Adenosine Stress Test uses the drug ______________ to stress
the heart

A

Adenosine

40
Q

NURSING RESPONSIBILITY

DOBUTAMINE/ADENOSINE STRESS TEST

A

NO caffeine for 24 hours prior to the test, this includes
coffee, tea, and caffeinated pop
● Medications containing Theophylline, Aminophylline,
Viagra

41
Q

An imaging drug Thallium is injected thru IV
● Accurately visualize the motion of the heart walls
when the heart is stressed while patient is in bed

A

DOBUTAMINE/ADENOSINE STRESS TEST

42
Q

A battery-operated portable device that measures
and records heart’s activity (ECG) continuously for 24
to 48 hours or longer depending on the type of
monitoring used.

A

HOLTER MONITOR

43
Q

NURSING RESPONSIBILITY
● Once the Holter Monitor is attached

A

nurses must
document in the Patient’s Progress Notes the time of
attachment, and the prescribed time to be left ON.

44
Q

The first goal for healthcare professionals in
management of acute myocardial infarction (MI) is to

A

diagnose the condition in a very rapid manner.

45
Q

Act by augmenting perfusion at the border of the
ischemic zone.
- Generalized vasodilation
- Reducing myocardial O2 demand

A

Nitrates

46
Q

THERAPEUTIC: MEDICATION

Nitrates

A

Only a maximum of 3 doses at 5 min. interval.
● Offer sips of water before giving it sublingually.

47
Q

does have antipyretic, antiplatelet and
analgesic actions, but the primary reason aspirin is
administered to the client experiencing an MI is its
antithrombotic action.

A

ASPIRIN - antiplatelet therapy

48
Q

Thrombolytic Therapy that reduces the
risk of blood clot

A

HEPARIN -

49
Q

Nx Cons for Coumadin

A

Assess for bleeding
- Keep Vitamin K available.
- Monitor for Prothrombin Time

50
Q
  • is a class of medications that are particularly
    used to manage cardiac arrhythmias, and to protect the heart
    from a second heart attack after a first heart attack
A

Beta Blockers

51
Q

have the greatest benefit in patients
with ventricular dysfunction

A

ACE inhibitors

52
Q

To prevent straining during defecation

A

Laxative

53
Q

The occurrence of constipation relates to the

A

position
and range of myocardial infarction

54
Q

Long-term bed rest weakens

A

gastrointestinal
peristalsis

55
Q

are a class of drugs often prescribed by doctors to help
lower cholesterol levels in the blood. By lowering the levels,
they help prevent heart attacks and stroke

A

Statins

56
Q

What are statin side effects?

A

Myalgia and muscle pain
● Liver damage
● Increased blood sugar or type 2 diabetes

57
Q

is considered the drug of choice for the treatment
of malignant ventricular arrhythmias

A

Lidocaine

58
Q

Malignant ventricular arrhythmias are of 3 forms:

A
  1. out-of hospital ventricular fibrillation (VF),
  2. recurrent sustained ventricular tachycardia and
  3. torsades de pointes
59
Q

PTCA

A

Percutaneous Transluminal Coronary
Angioplasty

60
Q

CABG

A

Coronary Artery Graft Bypass Surgery

61
Q

Treatment of choice
● Performed to OPEN BLOCKED coronary arteries
caused by Coronary Artery Disease

A

PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

62
Q

It restores ARTERIAL BLOOD FLOW TO THE
HEART without OPEN-HEART surgery

A

PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

63
Q

is a
procedure to place a stent in an artery of the heart
that has plaque buildup.

A

Coronary intravascular stent placement

64
Q

mixture of fat and cholesterol.

A

Plaque

65
Q

Post management; stent replacement

A

Patients will take more than one antiplatelet drug such
as Aspirin, Clopidogrel, Ticlopine, Warfarin.
● Aspirin is used indefinitely and the other drugs are for
4 to 6 weeks

66
Q

Angioplasty fails
● Severe narrowing of 1 or more coronary artery
Commonly used: Saphenous vein and internal mammary
artery.

A

EMERGENT / URGENT CORONARY ARTERY GRAFT
BYPASS SURGERY (CABG)

67
Q

is the longest vein in
the body, begins on the medial side of the foot.

A

e great saphenous vein used for CABG

68
Q

a surgeon will make an incision down the center of
the sternum (breastbone), to get direct access to the
heart.

A

Traditional Coronary Artery BypassGraft (CABG) Surgery

69
Q

Connection to the heart-lung bypass machine
- The heart is stopped and the surgeon then performs
the bypass procedure

A

Coronary Artery Bypass Graft

70
Q

Minimally invasive bypass surgery can be performed
through a small thoracotomy (chest wall) incision for
patients that require a LIMA (left internal mammary)
graft

A

Minimally Invasive Coronary Artery Bypass (MIDCAB)
Surgery

71
Q

Who are good candidates for this procedure? CABG

A

if the blockages are present only on the vessels on
the left side of the heart, then most likely the patient is
a candidate.

72
Q

An electronic device that delivers direct stimulation to the heart
causing electrical depolarization and cardiac contractions.

A

CARDIAC PACEMAKER

73
Q

A process in which a person restored to health and maintains
optimal physiologic, psychosocial and recreational functions

A

CARDIAC REHABILITATION

74
Q
A

NCM 118: Life Threatening Conditions (12 decks)

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