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ECG/Dysrhythmias Flashcards

1
Q

Left main

A

Left main (widow maker, CABG, cannot do angiography)

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2
Q

Left anterior descending artery

A

feeds anterior wall

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3
Q

Circumflex artery

A

lateral left wall of the heart

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4
Q

Right coronary artery

A

feeds inferior wall of the heart

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5
Q

posterior descending artery

A

posterior wall of the heart

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6
Q

cholesterol

A

less than 200

increases risk for CAD

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7
Q

LDL

A

Less than 160
main method of transport of cholesterol and triglycerides into the cell
Harmful effects in the deposition into cell walls

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8
Q

HDL

A

Transport cholesterol away from the tissues and cells of the artery wall to the liver for excretion
inverse relationship of elevated HDLs and CAD

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9
Q

BNP and what is it used for

A

Neurohormone that helps reduce BP and fluid volume
Secreted in the ventricles in response to increased preload and afterload in elevated ventricular pressure
BNP increases as the ventricular walls expand from increased pressure so it is helpful to monitor heart failure
obtained quickly used effectively in the ER
Can also indicate a PE, MI, Ventricular Hypertrophy
higher than 100= likely heart failure

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10
Q

C reactive protien and hemocystine

A

Produced in the liver in response to systemic inflammation
inflammation has a role in the development of artherosclerosis
predicts CVD risk
people with high hs-crp levels (3 or higher) are at an increased risk for CVD
Amino acid linked to the development of arteriosclerosis because it damages endothelial lining and promotes thrombus formation
An elevated blood level of hs is thought to increase r/f CAD, CVA, PVD, but not an independent predictor of CAD

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11
Q

Coagulation studies

A

injury to the vessel wall initiates the formation of thrombus
coagulation cascade is activated
complex factor interactions among phospholipid , calcium, clotting factors that convert prothrombin to thrombin
coagulation studies are routinely preformed before invasive procedures such as cardiac cath, electrophysiology, cardiac catheterization

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12
Q

nursing interventions after cardiac catheterization

A

fast 8-12 hrs before procedure
can not drive home
IV meds given but will be on hard table for 1-2 hrs
explain about palpitations
cough and deep breathing
Valvsa manuvar
observe site for bleeding and hematoma
check dorsal pedis and posterior tibalis q15 minutes 1hr, 30min 1 hr, q4 till discharge
assess bp, HR evaluate temp, color, capillary refill of effected extremity
dysrythmia after wards
bed rest 2-6 hours

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13
Q

CVP and what is it used for ?

A 
central venous pressure 
pressure measured in the right atrium or vena cava 
equal at the end of diastole 
normal in 2 to 6 mmHg 
main reason for monitoring= hypovolemia
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14
Q

normal CVP

A

2 to 6 mmHg

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15
Q

Cardiac action potential (depolarization)

A

depolarization = electrical activation of cell caused by influx of sodium into the cell while the potassium exits the cells

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16
Q

Repolarization

A

where the return of cell resting state caused by the reentry of potassium unto the cell while the sodium when the cell exits

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17
Q

refactory period

A

phase in which cells are incapable of depolarizing

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18
Q

relative refactory period

A

phase which cells require stronger than normal action potential

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19
Q

vectors

A

each person has a different mean vector deviated

has an axis deviated to the right or the left

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20
Q

equation for regular heart beats

A

count small blocks, divde into 1500

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21
Q

equation for irregular heart beats

A

6 second strips

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22
Q

causes of sinus brady

A

lower BMR, needs vagal nerve stimulation, athletic training, hypothyroidism, sleep medications, calcium channel blockers, increased ICP, sinus node dysfunction, ca channel blockers, CAD

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23
Q

sinus brady can happen what type if MI?

A

inferior wall MI

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24
Q

trx of sinus brady

A

atropine 0.5mg of IV bolus q 3 to 5 minutes, max dosage of 3 grams

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25
causes of sinus tachycardia
stress, blood loss, anemia, hypovolemia, heart failure, fever, catecholamines, aminophylline, atropine, caffeine nicotine, enchanced automacity of the SA node autonomic dysfunction- spinal cprd injured dt postural orthostatic tachycardia may cause syncope ablation of SA node that causes abnormality if there is issues with quality of life
26
what happens to BP and CO with tachycardia
they can decrease which may cause syncope.. if chronic this may cause pulmonary edema
27
treatment of sinus tachycardia
``` Narrow QRS: Adenosine Beta blockers Ca Channel blockers Wide QRS: Procainamide amioderone sortalol ```
28
if someone with sinus tachy is hemodynaimically unstable what is the trx of choice?
cardioversion
29
why do runners get a fib?
hypertrophy of the left ventricle
30
causes of A fib
``` structural cardiac defects anemia age kidney disease valvular heart disease cardiomyopathy hypertension DM Hyperthyroidism obstructive sleep apnea ```
31
signs of a fib
light headness, chest pain, dizziness, fatigue, breathlessness
32
address what modifiable risk factors for people with a fib
smoking cessation exercise weight management ETOH or drug abuse
33
stroke prevention
untreated a fib can cause thromboembolism anticoags are used to prevent stroke Coumadin- assess for bleeding
34
CHADS 2
which stands for CHF, HTN, age 75 or older DM, prior CVA/TIA, clinical prediction to rule out assessing the risk of stroke in patients with nonvalvular a fib and with our significant aortic or mitral valve disorders The higher the chads score, the higher the stroke risk, anticoags will still be given even if the a fib converts to NSR
35
anticoags used to treat a fib
coumadin jantoven unfractionated heparin LMW Heparin
36
New thrombin and factor Xa inhibitors
antiplatelet drugs, such as clopidorgel (plavix)
37
asprin alone
no longer reccomended to treat a fib
38
electrical cardioversion for a fib
conversion to NSR is shown to decrease symptoms used in new onset a fib younger patients antiarythmic, electrical cardioversion, transesophegeal echocardiogram, patient may be on warfarin for 4wks post procedure does not work for everyone, for the people with serious lifestyle changes
39
medications used to treat persistant A fib
Av conduction blocker Digoxin, cardizem Beta blocker propanolol, atenolol, metoprolol, esmolol calcium channel blockers diltizem, verapamil, do not use if pt has impaired ventricular function
40
COPD
no beta blockers
41
P wave and T wave in patients with a flutter
P wave has a saw tooth pattern | T wave is hidden in the sawtooth pattern
42
medical management of atrial flutter
use vagal manuver administration of adenosine which causes sympathetic block slowing the conduction of the AV node this may eliminate the tachycardia
43
max shock for some one in shock w a flutter
250 joules
44
causes of a PVC
nicotine, caffinee, alchohol | cardiac ischemia, infarction, increased work load, digitalis toxicity, hypoxia, acidosis or hypokalemia
45
trxx of continuous pvcs
amioteriol or sortalol
46
criteria to treat PVCs
multifocal polymorphic occur on the t wave
47
treatment of VT
antiarrythmic medication antitachycardia pacing direct cardioversion or fibrillation procainamuide for those with stable vt and are not having an MI amioderione for pt with impaired cardiac function cardioversion for monophasic VT in a symptomatic patient
48
treatment of choice in v tach with out a pulse
defibrillation
49
if EF is less than 35 % then what in vt pt
implantable cardioverter defibrilator
50
if EF is more than 35 % then what in vt pt
managed by amioderone
51
what is used if a pace maker is needed but their insurance refuses to cover it
a zole life vest | Provides defibrillation if absolutely needed
52
causes in vt
more than 100 bpm pt w large mis pt unresponsive and pulseless tickling ventricles in cardiac cath lab
53
if pt has afib or a flutter and is in vt or vf then what
the p waves are unrecognizable because the contractions in the ventricle are so strong
54
what is a PAC and what does it look like?
p wave comes early on the ECG, the rest of the beat follows
55
characteristics and treatment of of V fib
abscence of heart beat palpabel pulse and abscent respirations death is immanent early defib is critical for survival do CPR Epi after 1st unsucessful defib and every 3 to 5 minutes afterwards vasopressin may be given if cardiac arrest continues mild hyperthermia occurs
56
treatment of asystole
``` CPR intubate IV access bolus IV epi in 3-5 minute intervals vasopressin hypothermia transfer to higher level of care ```
57
nursing care of a patient with a dysrythmia
``` causes assess CO and o2 accurate Hx due to previous condition meds OTCs included patients "perception of dysrhythmia" drugs, nicotine, caffine, ETOH, OTCs any life stycle changes ```
58
physical assessment of someone with a dysrythmia
``` skin is pale and cool signs of fluid retention ex. JVD, lung congestion decreased CO (LOC is first to change) rate, rhythm of apical, pulses heart sounds BP and Pulse pressure ```
59
turn patient one what side helps w dysrhythmias and heart function
Left side
60
AV block, PR intervals is outside the limits of what?
0.2-0.12seconds
61
a small block equals how many seconds?
0.04 seconds
62
A large box (5 little boxes)
0.2 seconds
63
watch youtube video on heart blocks
https: //www.youtube.com/watch?v=XXu36p56ybg https: //www.youtube.com/watch?v=HBChhz-_xz0
64
normal PR interval
0.8-0.20 seconds
65
normal QRS complex
0.08-0.10 seconds
66
normal QT interval
0.4-0.43 seconds

Cardiovascular (5 decks)

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