Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

411 Adult 3 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

One small box is
One large box is
30 large boxes is
P-R interval is
QRS complex is
Electrical impulses formed in…

A

.04 secs
.20 secs
6 seconds (readable strip)
.12 - .20
.04 - .12
SA node (pacemaker)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Sinus tachycardia boxes
Sinus bradycardia boxes
Supra ventricular tachycardia boxes
What indicates AV block

A

Less than 3
More than 5
Less than 2
PR > .20 secs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Sinus Brady is
Treatment

A

Regular R-R, P for every QRS, rate below 60 bpm
- dose of atroPINE^ 0.5mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Dysrythmias are caused by
Cardioversion is
Defib vs cardiovert vs pacer (uses)

A

CAD, MI, electrolyte imbalance, drug toxicity
- Synchronized shock for unstable tachydysrythmias, synchronize button must be on
- defib stops heart (v fib & v tach)
- cardiovert slows heart (a fib & a flutter)
- pace speeds up heart (bradycardia or block)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

SVT rate
Paroxysmal
Prolonged
If stable what’s the 1st step
Next step (med)
If unstable

A

> 150 to 280
- Doesn’t affect cardiac output
- Decrease in cardiac output
- Vagal patient (ice water, bear down, breath through straw)
- Rapid push ADENOSINE 6mg & flush, repeat 2nd dose 12mg (or cardizem / amiodarone)
- Cardiovert

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A fib is
Risk factors
Characterized by
Treatment
If drugs are unsuccessful

A

Most common dysrhythmia
- CHF, HTN, age > 75, diabetes
- no P before QRS
- cardizem to slow AV conduction, amiodarone (don’t shake)
- cardioversion , anticoagulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Atrial flutter characterized by
Treatments

A

Saw tooth formation , no p waves
- cardioversion, anticoagulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Premature ventricular contraction
Treatments

A

Premature wide & distorted QRS
- oxygen if hypoxic, potassium (20meq) or mag (1-2g in 50ml D5W) electrolyte imbalance, beta blockers (decrease HR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ventricular tachycardia (V tach)
- treatment pulse & stable
- if meds don’t work
Treatment if pulseless

A

No p waves, wide QRS (tombstone)
- first give adenosine 6 & 12mg, vagal patient & give amiodaron
- cardiovert patient
- DEFIBRILLATE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

V fib
If no pulse
Treatment
Order of process
When does Defib save a life

A

Squiggly line
- call a code & Defib
- immediate defibrillation 1st (200J), follow with CPR 2 min, Defib (300J), give epi Q3-5min 1mg IV, CPR, amiodaron
- shock, CPR, shock, drug, CPR, shock, drug)
- within 5-10 min of code

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Torsades de points characterized
Causes
Treatment

A
  • wide bizarre tornado pattern
  • hypomagnesemia (anorexic, malnourished)
  • mag sulfate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Asystole is
Treatment steps
H’s
T’s

A

Dead rhythm, no complex
- check pt, no pulse = call code & initiate CPR, follow w IV epinephrine 1mg Q3 min, find H & T’s
- Hypovolemia, hypoxia, hydrogen acidosis, hyper or hypokalemia, hypothermia
- Toxins, tension pneumothorax, thrombosis, tamponade, trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

AV blocks
1st degree & treatment

A
  • P-R > .20s with QRS , give atropine 0.5mg if unstable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

2nd degree type 1 name
Characteristics
Usually results from
Treatment if symptomatic

A

Mobitz 1, wenckebach
- progressive increase in PR interval followed by missed beat
- MI
- atropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

2nd degree type 2 name
Characteristics
Results from
Treatment if symptomatic

A

Mobitz II
- PR interval is constant, followed by missed beat
- rheumatic heart disease, CAD, digitalis toxicity
- transcutaneous pacemaker 1st, then atropine, dopamine, epi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

3rd degree heart block characteristics
Treatment

A

P waves unassociated with QRS, P moves at its own pace
- Transcutaneous pacing, atropine, dopamine, epi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Transcutaneous pacing
Which 2 heart blocks are always unstable & require pacing

A

2nd degree type 2
3rd degree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Modes of pacing
Synchronous vs
Asynchronous
Pacemaker spike takes place of?
Pacemaker education

A
  • Synchronous is demand pacing based on the clients heartbeat (transvenous)
  • Asynchronous is a fixed rate (used for asystole or profound bradycardia)
  • takes place of P wave
  • no contact sports, don’t get near magnets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Coronary artery disease
Ischemia vs infarction

A

Ischemia leads to insufficient oxygen supply
Infarction is irreversible cell death from prolonged ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Chronic stable angina pectoris (CSA) characterized by
Due to
Treatment

A

Strangling of chest, pain with exertion
- O2 supply & demand imbalance
- MONA , morphine oxygen nitroglycerin aspirin (nitroglycerin 3 tabs every 5 minutes; may cause headaches or hypo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Unstable angina pectoris characterized by
- treatment

A

New onset, occurs at rest, worsening pattern, no change in CK or troponin
- calcium channel blockers (diltiazem)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

NSTEMI due to
STEMI die to
ST during ischemia
ST during infarction

A

Coronary vasospasm, spontaneous dissection, partial occlusion of artery
- rupture of atherosclerotic plaque causing thrombus formation & leading to 100% occlusion of coronary artery
- ST segment depressed
- ST segment elevated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Clinical manifestations of angina

A

Substernal chest pain radiating to left arm
Precipitated by exertion or stress
Relieved by NTG or rest
Lasts less than 15 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Clinical manifestations of MI

A

Substernal pain radiating to left arm
Pain in jaw, back, shoulder, abdomen
Occurs without cause (morning)
Relieved only by opioids
Lasts 30 min or more
Other Associated symptoms

25
Treatment of choice for confirmed MI - pre-op tests Thrombolytic therapy Most effective when Major complication
Percutaneous coronary angioplasty - CBC, chemistry, NPO, glucose Dissolves thrombi to restore blood flow (TPA) - within 6 hours of MI - bleeding, no automatic BP
26
Cardiac catheterization pre-op checks Indications for cardiac cath
Screen renal insufficiency, iodine allergy, diabetes, premed w Benadryl, stop Metformin 24hrs prior - unstable angina, abnormal perfusion, STEMI, NSTEMI
27
Coronary stent nurse interventions Pseudoaneurysm Retroperitoneal bleeding Treatment Pt education
Best rest with insertion site extremely straight, lay flat no Fowlers - damage or rupture of vessel leading to hematoma or ecchymosis - puncture of posterior femoral artery during sheath insertion - surgical repair, anticoag reverse, fluid/blood rescuscitation - cannot be in a pool or jacuzzi, don’t carry anything heavier than milk carton
28
Coronary artery bypass graft indicated Pre-op care Post-op care Complications
Angina w >50% occlusion of coronary artery, ischemia w HF, valvular disease - must Medicate for pain, splint incision - chest tubes for drainage, monitor ECG, urinary catheter to monitor output (30ml/hr) - chest drainage over 150ml/hr, sudden cessation of previously heavy mediastinal drainage, post pericardial syndrome (blood in sac & leads to infection)
29
Activity teaching for patient w CAD
Walk 400ft 3x a day Carry nitroglycerin with you Check pulse before, during, after exercise Stop if pulse increase 20bpm Gradually increase walking distance Avoid straining
30
Left sided heart failure known as Causes Manifestations
Congestive heart failure - HTN, CAD, valvular disease - (LUNGS) dyspnea, pulmonary congestion, pink frothy sputum, breathlessness, oliguria, crackles
31
Right sided heart failure causes Manifestations Significance of weight gain
Left ventricle failure, right ventricular MI, pulmonary HTN (sleep apnea) - JVD, hepatomegaly, ascites, peripheral edema, abdominal girth, weight gain - most reliable indicator of fluid status
32
Heart failure risk factors
CAD, HTN, valve disease, substance abuse, smoking, diabetes, family Hx, hyperthyroidism, obesity
33
Compensatory mechanisms when cardiac output is insufficient Normal BNP value Cardiac Hypertrophy consequences Best diagnostic test / lab What happens to PAWP
Sympathetic nervous system stimulation, RAAS system, BNP chemical rises, myocardial hypertrophy - BNP <100 ; increased lab value indicates Heart failure - poor contractility, high oxygen demand, displaced point of maximum impulse to the left - echocardiogram / BNP lvl - increases with left sided HF
34
What is Afterload Drugs to reduce afterload Acute results
Pressure required to move blood from left ventricle to body - ACE inhibitors (-pril) , ARBs (-artan) - improves cardiac output & decreases pulmonary congestion
35
What is preload Interventions to reduce preload
Blood volume that enters the right atrium - Na restriction (2-3g D), diuretics (loop furosemide - acute acting) (thiazides - long acting) & vasodilators (nitrates)
36
Drugs to enhance contractility Which drugs only given in high stages of CHF Digoxin education
Inotropic drugs - digoxin, dobutamine Beta blockers - carvedilol - primacor & natrecor - therapeutic range 0.5-2.0 , digibind is antidote, can cause digitalis toxicity
37
Indications for worsening HF
Rapid weight gain 3lbs a week or 1-2lbs a day Decrease exercise tolerance Excessive nocturia Dyspnea/angina at rest Increased edema to feet/ankles
38
Valvular heart disease Which murmur is most lethal Systolic murmurs Diastolic murmurs Valve replacement education
Diastolic murmur - mitral regurgitation & Aortic stenosis (MRASS) - mitral stenosis & aortic regurgitation (MSARD) - must be on anticoagulants for life due to production of clots , INR value should be 3-3.5
39
Mitral regurgitation manifestations Aortic stenosis manifestations Aortic regurgitation
Fatigue & weakness, dyspnea on exertion - early pulmonary congestion, late right sided CHF - volume overload, LV compensated by hypertrophy (advanced disease causes dyspnea)
40
Acute cardiac tamponade is Emergency care measures
Cardiac tamponade is an extreme emergency due to increased fluid volume - pericardiocentesis (uses a needle to remove fluids) - pericardiectomy (removes entire pericardium)
41
What is MAP What factors influence MAP What is a normal MAP What lvl indicates shock Cardiac output normal range Central venous pressure normal
Most important factor relating to shock, indicates perfusion of oxygen - total blood volume, cardiac output - normal value around 90 - 60-70 - 4-6 L/min - 2-4 mmHg
42
Cardiovascular manifestations of shock Respiratory manifestations GI manifestations Neuromuscular Kidney
- decreased BP, thready pulse, narrow pulse pressure (normal 40) - increased RR, cyanosis - diminished or absent bowel sounds, N/V, constipation - early anxiety, thirst, changes in LOC - decreased urine output, increased specific gravity due to protein
43
Stages of shock Initial Non-progressive Progressive Refractory
- MAP drops less than 10, HR & RR increase, lactic acid production - MAP drops 10-15, kidney compensates by releasing hormones, hyperkalemia, thirst, tachy (REVERSIBLE) - MAP drops 20+, vital organs hypoxic, life threatening (treated within 1Hr), Anuria <40ml/24hr, 5-20% decrease in O2 - irreversible tissue damage, Rapid loss of consciousness, no palpable pulse, unmeasurable O2
44
Hypovolemia shock common cause Manifestations Management
Hemorrhage, dehydration, trauma - CV collapse, BP changes, increased RR, decreased urinary output, decreased capillary refill & DTRs - must replace fluids, give albumin or blood, vasoconstrictors & inotropics, nitropress
45
Cardiogenic shock causes Manifestations Management
Pump failure, typically MI - systolic <90, narrow pulse pressure, weak thready pulse, S3 & S4, oliguria - nitrates, epinephrine, CABG
46
Distributive shock characterized by Typical causes
Blood is distributed to tissues & cannot circulate to perfuse properly - anaphylaxis & sepsis
47
Septic shock etiology Progression Multiple organ dysfunction syndrome Gold standard to indicate sepsis Interventions
Mostly caused by gram negative bacteria (E. Coli) (urosepsis - check urine) - sepsis leads to systemic inflammatory response syndrome (SIRS), all tissues hypoxic - MODS results from SIRS leading to uncontrolled bleeding & death - lab values ; LACTIC ACID >4mmol (gold standard), hyperglycemia w/o diabetes, C reactive protein - Give O2, Broad spectrum antibiotic therapy, glycemic control (keep below 150 with insulin)
48
Neurogenic shock causes Manifestations If injury below C5 vertebrae If above C3 Neurogenic shock treatment
Damage to CNS leading to low BP & HR (spinal cord, brain, cervical injury) - instant hypotension, warm flushed skin, priapism, bradycardia - diaphragmatic breathing - immediate respiratory arrest - dopamine, vasopressin, atropine
49
Anaphylactic shock onset Anaphylactic shock management
Swollen lips & tongue, respiratory distress, loss of consciousness, N/V, hypotension <90 systolic - immediately asses respiratory status, apply O2, change IV tubing & run NS, Give epinephrine, Benadryl, Albuterol
50
Obstructive shock causes How does pericarditis look on EKG
Impairment of heart to pump, like pericarditis or cardiac tamponade - there is ST elevation on every lead
51
Basic kidney functions
Produce renin to regulate BP, GFR & release aldosterone that promotes reabsorption of water & sodium to restore BP & blood volume Also secretes erythropoietin for RBC production
52
Types of acute renal failure Pre-renal - perfusion reduction causes Intrarenal - kidney damage Postrenal - urine flow obstruction
- fluid loss, hypotensive drugs, MI or CHF, infection, NSAIDs, anaphylaxis - glomerulonephritis, thrombi in kidney, sepsis, ingested toxins - bladder cancer, cervical cancer, prostate cancer, kidney stones, neurogenic bladder
53
Normal kidney lab ranges BUN Cr Specific gravity Treatment of acute renal failure
10-20 0.6-1.2 1.00-1.30 - diuretics to remove fluid, calcium channel blockers if AKI from nephrotoxins, reduce protein intake 40g/day (no dialysis) or 1.5g/kg (dialysis)
54
End stage renal disease involves Defined as presence of What is normal GFR & GFR during last stage Oliguria vs Anuria
Progressive, irreversible loss of kidney function - kidney damage or GFR <60 ml/min for 3+ months - normal GFR 90-125ml/min ; last stage when GFR is <15ml/min - oliguria (<400ml/24hr). Anuria (<40ml/24hr)
55
Chronic kidney disease manifestations Uremic syndrome Metabolic disturbances Electrolyte imbalances Hematologic system Respiratory system
- metallic taste in mouth, anorexia N/V, muscle cramps, uremic frost on skin (shiny skin), fatigue, dyspnea, hiccups, edema - increased BUN & Cr , lethargy or fatigue, can lead to uremic encephalopathy (seizure/coma) - hyperkalemia (most serious electrolyte disorder - can cause cardiac arrest) - anemia (decreased erythropoietin) , bleeding tendencies (no platelets) , bruising, Petechiae - dyspnea , kussmaul respirations (ketosis), pulmonary edema, urine breath
56
Chronic kidney disease management Hyperkalemia HTN Nutritional therapy
- give insulin or D50 - diuretics, Beta blockers, CCBs, ACE inhibitors, ARBs - LOW PROTEIN DIET
57
Dialysis fistula vs graft Fistula Graft
- made of own body, 1st choice (better), lasts 5-10yrs, small chance of infection or clotting, must wait a couple months before use - made of synthetic material, 2nd choice, lasts 2-3yrs, moderate chance of infection or clotting, can be used immediately
58
Caring for vascular access site of dialysis pt Call MD immediately if
- palpate for thrills & listen for bruits, no carrying heavy objects, no sleeping on fistula side, assess distal pulses, assess for bleeding & infection at needle sites - swelling of arm, infiltration of site, absent thrill, prolonged bleeding, cyanotic fingers

411 Adult 3 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions