dysrhythmias

Question 1

Mean Arterial Pressure

Answer 1

tells average pressure in artery

need be higher than 60

Question 2

P wave

Answer 2

located in atrium

imp but will not die

Question 3

QRS

Answer 3

located in ventricle

will die if inadequate

Question 4

Cardiac Output (CO)

Answer 4

amt blood pumped from LV/min

= HR x SV

Question 5

increase HR

Answer 5

= decrease SV –> decreased CO
heart beating too fast, ventricle doesn’t fill enough (low stroke volume), not enough blood in ventricle leads to low cardiac output

Question 6

preload

Answer 6

dependent on amt blood going to heart

kidney failure and not excreting –> fluid overload –> large volume

Question 7

afterload

Answer 7

difficult pump blood out heart

BP 200/100

Question 8

contractility

Answer 8

force/effectiveness of each pump

force cardiac contraction independent of preload

Question 9

BP

Answer 9

= CO x peripheral vascular resistance

Question 10

cardiovascular system manifestations

Answer 10

pain
discomfort
cough
SOA
dyspnea
DOE
orthopnea
PND - when lay down, fluid shift from legs to heart
edema
fatigue
weakness
palpitations
dizziness
syncope
leg/calf pain

Question 11

med hx of pt w/ cardiovascular problems

Answer 11

angina, MI, meds, allergies, DM

Question 12

best indicator of fluid balance is weight

Answer 12

2.2 lb = 1 kg = 1 L fluid
takes 10-15 lbs before see edema
imp do daily wt on cardiac pts

Question 13

labs - cardiac markers

Answer 13

troponin T and I
creatine kinase - MB specific to heart muscles
myoglobin - see heart damage sooner but gone w/in 7 hrs

Question 14

labs - electrolytes affecting heart

Answer 14

Ca, Mg, K
lead to fatal dysrhythmia
can lead to death

Question 15

labs - BNP

Answer 15

stretching of ventricles causes BNP released

Question 16

labs - total cholesterol

Question 17

labs - triglyceride

Question 18

labs - LDL

Question 19

Labs - HDL

Answer 19

> 40

Question 20

labs - anticoags

Answer 20

PT/INR, PTT

Question 21

labs - ABG

Answer 21

if heart not pumping, fluid going to lungs

Question 22

labs - D-Dimer

Answer 22

tell if have clots

good lab use if having stroke

Question 23

diagnostic tests

Answer 23

EKG
ECHO - look at structure of heart
TEE
holter monitor - look at every min of day
stress test - how much can tolerate stress on heart
angiography - look see how blocked vessels are

Question 24

heart conduction - SA node

Answer 24

pacemaker of ehart

P wave

Question 25

heart conduction - AV node

Answer 25

PR segment

Question 26

heart conduction - Bundle of His

Answer 26

right and left bundle branch system

Question 27

P wave

Answer 27

1 P per QRS complex multiple indicates a-fib different origination if P waves look diff

Question 28

QRS

Answer 28

ventricular depolarization | tall and narrow b/c pump fast and hard

Question 29

J point

Answer 29

end of QRS segment

Question 30

ST segment

Answer 30

elevation - actively having MI | depression - K, Ca, Mg too high

Question 31

T wave

Answer 31

repolarization | tombstone T wave = active heart attack

Question 32

Normal Sinus Rhythm

Answer 32

``` Rate - 60-100/min Rhythm - normal P wave - present, consistent PR - 0.12-0.2 QRS duration - 0.04=0.1 second and constant ```

Question 33

sinus tachy

Answer 33

Rate - >100/min Rhythm - regular P wave - present, consistent PR -

Question 34

sinus brady

Answer 34

Rate -

Question 35

atrial dysrhythmias

Answer 35

``` Rate - Rhythm - P wave - PR - QRS - ```

Question 36

Supraventricular Tachy

Answer 36

``` Rate - Rhythm - P wave - PR - QRS - ```

Question 37

A-fib

Answer 37

``` Rate - Rhythm - irregular P wave - PR - n/a QRS - ```

Question 38

ventricular dysrhythmia

Answer 38

``` rate - rhythm - P wave - PR - QRS - ```

Question 39

ventricular fibrillation

Answer 39

nothing to count

Question 40

cardiac interventions - meds

Answer 40

``` beta blocker ca channel blocker ACE inhibitors diuretics antidysrhythmics antilipids inotropes - dobutamine, dopamine, Epi, digoxin ```

Question 41

cardiac intervention - MONA

Answer 41

morphine oxygen nitro ASA

Question 42

cardiac intervention - surgical tx

Answer 42

CABG surgical valve repair heart transplant cardiac cath

Question 43

cardiac intervention - devices

Answer 43

pacemaker | icd

Question 44

cardioversion - conscious

Answer 44

synchronized shock w/ QRS | requires to have rhythm

Question 45

defibrillation - unconscious

Answer 45

emergency | pt in v-fib/v-tach

Question 46

management of cardiac arrest

Answer 46

perform CPR first | defibrillate b/c no rhythm

Question 47

pacemaker

Answer 47

controls heart rate instead of SA node

Question 48

icd

Answer 48

shocks heart back into rhythm when heart forgets to

Question 49

HTN

Answer 49

60+ - `150/90

Question 50

causes of essential HTN

Answer 50

obesity smoking stress fam hx

Question 51

cause of secondary HTN

Answer 51

renal disease primary aldosteronism cushing's syndrome meds

Question 52

malignant HTN

Answer 52

BP 200/150 | need rapid intervention

Question 53

malignant HTN manifestations

Answer 53

HA blurred vision dyspnea

Question 54

malignant HTN - lifestyle modifications

Answer 54

``` sodium restriction wt reduction reduce etoh intake exercise decrease stress smoking cessation ```

Question 55

malignant HTN - med care

Answer 55

``` diuretics ca channel blockers ACE inhibitor ARBs aldosterone receptor antagonist beta-adrenergic blockers renin inhibitors ```

Question 56

malignant HTN - nursing care -

Answer 56

``` daily wt I&O urine output response of B/P electrolytes take pulses ischemic episodes (TIA) complications w/ 4 C's - CAD, CRF, CHF, CVA ```