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Cardiovascular System > E x a m #1 > Flashcards

E x a m #1 Flashcards

1
Q

Hypertension diet

A
  • low sodium
  • low fat
  • low cholesterol
  • alcohol/smoking cessation
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2
Q

Types of angina

A

Stable: exercise/emotional stress. Relieved by rest/nitroglycerin
Unstable: “ , increases in occurrence, severity, overtime. Tight squeezing, heavy pressure, or constriction in chest. Pain can radiate to jaw, neck, or arm.

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3
Q

Nursing considerations for angio/cardiac catherization

A

Pre: assess allergies, mark pedal pulses. Consent form signed. Renal function. NPO 6-8 hours. pre - medications (Solu-medrol)
Intra: local anesthesia, awake and sedated. warm and flushed when dye is inserted.
Post: direct pressure on incision (groin), monitor for bleeding/hematomas, thrombosis. continuous cardiac monitoring. analgesics. monitor urine output and rate of hydration.

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4
Q

Vtach

A

Lower chambers of heart beat very quickly.
Chest discomfort, fainting, dizziness, SOB
TX: Antidysrhythmic drugs (lidocaine)

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5
Q

Vfib

A

Heart beats w/ rapid, erratic electrical impulses. Occurs due to untreated Vtach. Life threatening.
TX: defibrillation, CPR

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6
Q

Afib

A

Abnormal rhythm, rapid, & irregular
Fatigue, SOB, angina
TX: antidysrhythmic drugs, anticoagulants, cardioversion. WARFARIN, ASPIRINS, defib.

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7
Q

Aflutter

A

Atria beats too quickly
Mild dyspnea, palpitations, fatigue, hypotension
TX: Medications (anticoagulants)

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8
Q

PVC (premature ventricular contractions)

A

Extra, abnormal heartbeats that begin in one of the heart’s two lower chambers
Hypotension, hypoxia, weakness, SOB, fainting
TX: antiarrythmia meds (amiodarone), eliminate caffeine/stress if no heart disease

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9
Q

Asystole rhythm strips

A

Cardiac arrest rhythm w/ no electrical activity on the EKG monitor.
Angina before arrest.
Tx: CPR

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10
Q

Myocardial infarction causes

A
  • male
  • family history
  • increased age
  • obesity
  • smoking/alcohol/drug abuse
  • stress
  • HTN
  • high cholesterol
  • hyperlipidemia
  • coronary artery stenosis
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11
Q

S/S and reasons (for MI)

A
  • persistent, crushing, substernal chest pain (radiates to left arm, jaw, neck, shoulder)
  • diaphoresis
  • SOB
  • heartburn, N/V
  • dizziness
  • decreased LOC
  • pallor, cool, & clammy skin
  • anxiety
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12
Q

Cardiac enzymes - use

A

A specific marker in diagnosing a MI. Released into bloodstream when heart muscle suffers ischemia.

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13
Q

Cardiac kinase - importance

A

Enzyme specific to cells of brain (CK - BB), myocardium (CK - MB), & skeletal muscle (CK - MM)
Elevated = heart attack, damage, or condition that produce damage to skeletal muscles/brain

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14
Q

Correct use of defibrillator, pad placement

A

Yell “clear” before administering shock
Make sure Pt is dry
Place pad on right center of chest above nipple, other bad slightly under other nipple & left of rib cage.

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15
Q

S/S of Right - sided HF

A
  • fatigue
  • peripheral venous pressure
  • ascites
  • enlarged liver & spleen
  • distended jugular veins
  • weight gain
  • gi distress
  • dependent edema
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16
Q

S/S of Left - sided HF

A
  • dyspnea
  • fatigue
  • altered mental status
  • oligura
  • pulmonary congestion
  • tachycardia
  • elevated pulmonary capillary wedge pressure
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17
Q

How to monitor HF:

A

daily weights, I&O, lung sounds, ABG’S, electrolytes, SAO2, chest xray

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18
Q

P wave

A

contraction of atria, electrical pulse is generated

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19
Q

Q wave

A

first negative deflection and represents initial ventricular septal contraction
early ventricular depolarization

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20
Q

R wave

A

first positive deflection and may be small, large, or absent depending on the lead
early ventricular depolarization

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21
Q

S wave

A

negative deflection following the R wave and not present in all leads

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22
Q

T wave

A

repolarization of the ventricles

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23
Q

How to apply & perform on ECG

A

To record the electrical activity of the heart overtime
Application:
- position patient supine w/ chest exposed
- wash skin
- attach one electrode to each of the client’s extremities by applying electrodes to flat surfaces above the wrists and ankles and the other six electrodes to the chest, avoiding chest hair
PT education:
- get rest
- remain still and breathe normally

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24
Q

Cardiac tamponade - findings

A

fluid accumulation compresses the heart. widened mediastinum and cardiomegaly. low amplituded QRS complexes. elevated right atrial pressure, right ventricular diastolic pressure, CVP. pericardial effusion w/ signs of compression.
hypotension, jugular venous distention, muffled heart sounds, paradoxical pulse

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25
Risks for HTN
- African americans - obesity - stress - family history - alcohol/smoking - renal disease
26
Classifications for HTN - values **
Pre hypertension: S 120 - 139 D 80 - 89 | Stage 1: S 140 - 159 D
27
Classifications for HTN - values **
Pre hypertension: S 120 - 139 D 80 - 89 Stage 1: S 140 - 159 D 90 - 99 Stage 2: S equal or >160 D equal or >100
28
Low cholesterol diet
- fish - whole/multi grains - fruit & veggies - omega - 3 fatty acids - nuts restricted animal fats and saturated fats
29
Electrolyte imbalances that can affect cardiac status
Potassium 3.5 - 5.9 | Calcium 9 - 10.5
30
Risk factors for CAD (coronary artery disease)
- family history - age - sex - culture/ethnicity - smoking - HTN - hyperlipidemic - DM - obesity - oral contraceptives - psychosocial issues
31
Labs needed to be monitored for heparin/Coumadin - expectances and ranges
- aPPT: 30-45 - PT: 11-12.5 sec - INR: 0/7-1.8 - Platelet 150,000-400,00 - CBC
32
Labs needed to be monitored for heparin/Coumadin - expectances and ranges
- aPPT: 30-45 - PT: 11-12.5 sec - INR: 0/7-1.8 - Platelet 150,000-400,00 - CBC
33
Purpose of taking anticoagulants/blood thinners in different disorders
prevent further blood clots, inhibits vit k
34
Cardioversion
the delivery of a direct counter shock to the heart synchronized to the QRS complex. For clinical manisfestation of dysrhythmias Includes: atrial dysrhythmias, supraventricular tachycardia, v tach w/ pulse, a fib
35
S/S of hyper/hypokalemia
Normal range: 3.5-5.0 Hyperkalemia: muscle weakness, tingling, nausea, bradycardia Hypokalemia: muscle weakness, tremors, muscle cramps, constipation
36
Pacemaker - how to assess
battery operated device that electrically stimulates the heart when the SA node of the heart fails to maintain an acceptable rhythm Battery failure: syncope, dizziness, hypotension Call cardiologist prior to surgeries, remind clients to carry a copy of pacemaker settings and to wear a medic alert How it affects ECG: when it fires, a spike is seen on the ecg
37
Stress electrocardiogram
cardiac muscle is exercised by clients on treadmill, testing workload of the heart
38
Echocardiogram - pt education
non-invasive ultrasound test to diagnose valve disorders and cardiomyopathy. used to measure size and depth of heart, ejection fraction, cardiac output. lie on left side w/ HOB elevated.
39
Artherosclerosis
type of arteriosclerosis that involves the formation of plaque w/in the atrial wall and is the leading risk factor for cardioV disease *hardening & narrowing of the arteries -- silently/slowly blocks arteries, putting blood flow at risk Nonmodifier factors: family history, age, sex, culture, ethnicity Modifiable factors: smoking, hyperlipidemia, HTN, DM, obesity, sedentary, stress, oral contraceptives, psychosocial Diet: help obtain or maintain healthy levels of cholesterol and fatty molecules called lipids
40
A&P of heart. Location/names of arteries & veins throughout the body
located in the thoracic cavity in the mediastinal space. endocardium, myocardium, epicardium, pericardium. right atrium --> veins --> right ventricle --> pulmonary artery (deoxygenated blood) pulmonary veins (oxygenated blood) left atrium --> left ventricle --> aorta & out of body *watch video
41
Factors that affect BP
- family history - sodium intake - sedentary - obesity - hyperlipidemia - alcohol/smoking - stress - African american
42
Labs that indicate HTN & S/S
elevated BUN, creatinine elevated serum corticoids ecg, chest xray S/S: headaches, visual changes (dizziness, fainting), epistaxis (nose bleed), bruits, flushed face, nocturia, edema
43
Vessels & valves of the heart + auscultation
To auscultate: erb's point (3rd left left sternal border), pulmonic valve area (2nd left intercostal space, left sternal border), triscuspid valve area (4th ics, Lsb)
44
Coronary artery bypass graft (CABG) + nursing considerations
invasive surgical procedure, most common cardiac surgery. used to restore vascularization of the myocardium. most effective when client has sufficient ventricular function. 40-50% ejection fraction = success. NC: monitor vs, chest tubes, hemodynamic pressures, pain, fluids & electrolytes. informed consent. preoperative meds: anxiolytics (diazepam, lorazepam) Donor site: graft vein/artery is taken from a healthy blood vessel in body. graft is then surgically attached above and below obstructed/poorly functioning artery
45
Percutaneous transluminal coronary angioplasty
invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle extracardiac vein. post procedure NC: monitor vs 15 min x 4, 30 min x 2, 1 hr x 4. monitor groin site. check CMST. position: supine w/ leg straight. administer aspirin, heparin, lovenox
46
HDL & LDL
high density cholesterol "good" HDL >40 low density cholesterol "bad" LDL <100
47
Pulmonary edema
abnormal buildup of fluid in lungs = SOB | often caused by congestive HF.
48
Nitrates (nitroglycerin)
relaxes smooth muscle layer of blood vessels in stable angina. relaxes spasms of coronary arteries. S/S: headache, flushing, nausea/vomiting, hypotension NC: avoid alcohol, don't operate heavy machinery Dosage: q12h patch & sublingually
49
Diuretics use & action
block reabsorption of sodium and chloride and to prevent reabsorption of water
50
Loop d's - side effects
dehydration hyponatremia hypotension hypokalemia
51
K+ sparing d's - side effects
hyperkalemia | menstrual cycle irregularities, gynecomastia
52
Thiazides - medical interactions
NSAIDS | Bblockers
53
Beta blockers - side effects and pre assessments
``` bradycardia decreased cardiac output orthostatic hypotension bronchoconstriction assess HR, BP ```
54
Calcium channel blockers
Side effects: weight gain, edema in lower extremities, dizziness, appetite increase, constipation, tingling/numbness, gi discomfort Contra: systolic dysfunction. 2nd/3rd degree heart block. wolfe-parkinson white syndrome. CHF, CAD.
55
Importance of salt substitutes w/ ACE inhibitors
reduces effects, may cause retained potassium
56
Angiotensin II receptor blockers - adverse effects
``` dizziness headache n/v/d/ hyperkalemia hypotension muscle/bone pain rash ```
57
Anti - dysrhythmias purpose
treat dysrhythmias
58
Inotropics - effect of K+ w/ digoxin
digoxin competes w/ K+. toxicity. changes the force/speed of muscle contractions.
59
Anti-hyperlipidemics
Tx for high levels of fats
60
Statins
Major side effects: muscle pain, liver damage, DM, neuro (confusion, memory loss) Contra: pregnancy, breastfeeding, liver disease, elevated liver enzymes
61
Anti - anginals goal
relieve ischemia, reducing frequency & severity of angina attack, & preventing a heart attack
62
Furosemide (Lasix)
loop diuretic - edema due to HF, HTN. side effects: dehydration, hypocalcemia, hypochloremia, hypokalemia, hypomagnesemia, metabolic alkalosis contra: hepatic coma, anuria, liver disease NC: assess for skin rash, fluid & electro, change positions slowly, report muscle weak, cramps, nausea, tingling
63
Digoxin
inotropics, antiarrhythmics for HF, afib/flutter, paroxysmal atrial tachycardia Side effects: headache, weakness, blurred vision, yellow/green vision, ecg changes, electrolyte imbalances Contra: av block, constrictive pericarditis, uncontrolled ventricular arrhythmias NC: monitor ecg, monitor bp, apical pulse. take pulse and report. first sign of digoxin toxicity is change in HR in children
64
Aldactone (spironolactone)
potassium sparing diuretics for edema, HTN, hypokalemia Side effects: hyperkalemia Contra: anuria, acute renal insufficiency, hyperkalemia, Addison's disease. NC: assess for rash, check BP weekly.
65
Propanalol, atenolol
antiarrhythmic, antiHTN, beta adrenergic blocker manage HTN Side effects: anxiety, fatigue, fever, abd. pain, vomiting, muscle weakness NC: monitor BP & I&O daily. instruct pt to take @ same time everyday. report SOB.
66
Verapamil
antiHTN, antiarrhythmic, phenylalklylamine derivative to treat chronic angina Side effects: confusion, hypo/hypertension, tachycardia, edema, diarrhea NC: maintain ecg monitoring, assess for bradycardia & hypotension, encourage fiber increase
67
Lidocaine
antiarrhythmic, aminoacetamide to treat ventricular tachycardia or ventricular fibrillation Side effects: confusion, bradycardia, nausea, lethargy, paresthesia
68
Hydrochlorothiazide, chlorothiazide
AntiHTN, diuretic, benzothiadiazide to manage HTN Side effects: fever, headache, hypotension, abd. cramps, diarrhea, vertigo NC: monitor fluid I&O, daily weights, BP, BUN & creatinine. take drug in morning and early evening to avoid awakening to urinate late at night
69
Captopril, lisinopril
AntiHTN, ACE inhibitor to control HTN Side effects: fever, chest pain, orthostatic hypotension, angioedema, tachycardia NC: monitor BP, instruct pt to take drug 1hr before meals. avoid sunlight. change positions slowly to minimize orthostatic hypotension
70
Coumadin, Plavix, lovenox
Anticoagulant, platelet aggregation inhibitor to prevent/treat pulmonary embolism, venous thrombosis Side effects: weakness, abd. cramps, vomiting, loss of consciousness NC: monitor INR, avoid alcohol. take consistent amnts of vit K (dark leafy greens)
71
Nifedipine (Procardia)
antiHTN, antianginal, dihydropyridine derivative to manage angina Side effects: anxiety, chest pain, confusion, headache, muscle cramps, weakness NC: monitor I&O, daily weight. fluid retention may lead to heart failure, do not take drug w/in 1hr of high fat meal or w/ grapefruit
72
Vytorin (Simvastatin/ezetimibe)
antihyperlipidemic to treat hyperlipidemia Side effects: fatigue, abd. pain, headache, N/V NC: obtain liver function prior to therapy, urge pt to take drug in evening, follow low fat, cholesterol diet. avoid grapefruits.
73
Losartan
antiHTN, ARB to manage HTN Side effects: hypotension, diarrhea, vomiting, fatigue, headache NC: African descent w/ hypertension may not benefit from losartan to reduce stroke risk, monitor bp and renal function, avoid potassium containing salt. avoid exercising.
74
Eplerenone (Inspra)
AntiHTN, methyl ester to improve left ventricular systolic dysfunction and congestive HF after an acute MI Side effects: dizziness, fatige, abd. pain, diarrhea, elevated BUN + creatinine NC: monitor BP, monitor K+ every 2 weeks for the first month. do not use potassium-containing salt.

Cardiovascular System (2 decks)

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