EXAM 1 Flashcards by Kaleigh Nale

what are three risk factors for previous infective endocarditis?

IV drug use, prior history endocarditis, invasive procedures

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what is infective endocarditis?

infection of inner heart

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what are some common signs and symptoms of endocarditis?

osler’s nodes, janeway lesions, splinter hemorrhage, fever

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what should you do before administering antibiotics?

get a blood culture

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what medicines are used for endocarditis?

IV antibiotics

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what is a common complication of endocarditis?

embolic event (pieces of fragments of vegetation break free from valve and travel to other parts of the body through the blood)

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what are signs and symptoms of myocarditis?

heart failure, dysrhythmias, shortness of breath

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what should you teach your pt with myocarditits?

avoid strenuous activites until released by doctor and take full meds

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what are signs and symptoms of pericarditis?

pleuritic and friction rub with heart

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what is the goal of medicine with pericarditis?

alleviate pain

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what medications are used for pericarditis

aspirin, NSAIDS, anti-inflammatories, colchine

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what is stenosis?

obstructing forward flow due to the stiffening of the valves

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what actions should you do for your pt with pericarditis?

keep HOB elevated

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what is regurgitation?

obstructing backwards flow

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what are the signs and symptoms of valvular disease?

weight gain, edema, cool/pale extremities with weak pulse, murmur, sob, dysrhythmia

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someone with valve replacement will require

anticoagulants for life

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what is coronary artery disease?

obstruction/dysfunction of coronary blood vessels that supply oxygen rich blood to the heart

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what are the signs and symptoms of coronary artery disease?

pain down left arm, jaw, and back, short of breath, fatigue, dizziness, diaphoresis

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what are the types of angina?

stable, unstable, prinzmetals

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what are the modifiable risk factors for coronary artery disease?

smoking, high cholesterol, low hdl, high ldl, high triglycerides, increased bp, diabetes, obesity, sedentary lifestyle, stress, alcohol

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what is ischemia?

imbalance between oxygen supply and oxygen demand

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what is infarction?

cell death from prolonged ischemia

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when does stable angina occur?

with activity

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if a patient gets chest pain when they are mowing the yard, what do they have?

stable angina

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stable angina is alleviated with

rest and or medication

stable angina can progress to

unstable angina

when does unstable angina happen/

at rest

what do you give for unstable angina?

nitroglycerin or aspirin

unstable angina occurs...

rapidly

what does prinzmetal's/variant angina occur from?

coronary artery spasm

when does prinzmetal's angina occur?

at rest or in clusters

when does prinzmetal's angina typically occur?

at night between midnight and 0800

what medicine is used for prinzmetal's angina?

calcium channel blockers (end in pine)

what labs do you get for CAD?

total cholesterol, triglycerides, LDL, HDL, CK, CK-MB, troponin

what is the most important lab to get for heart?

troponin

if you are putting an EKG on someone and they have long hair, what can you do?

clip their hair

what should you teach your pt before they have a stress test?

no beta blockers, npo, no caffiene

what is the gold standard for diagnosing CAD?

coronary angiography/cardiac catheterization

what should you hold before a heart cath?

metformin 24-48 hours before

before an angiography what should you check for?

allergies to shellfish

what should you look at before a heart cath?

CBC, h&h, platelet count, and electrolyte levels, BUN and creatinine

you may need to give what before a heart cath?

fluids

if a pt is allergic to the dye for a heart catheter, what should you do?

give IV benadryl or IV predinosone

what is nitroglycerin used for?

chest pain

how does nitroglycerin work?

improves blood flow and oxygen supply

what route is nitroglycerin given where it works fast?

sublingual

if you are applying nitroglycerin paste, what should you make sure you do/

wear gloves when applying

if your pt needs nitroglycerin, what medicine should you look out for and use caution if they are using this?

sildenafil

what does nitroglycerin + sildenafil do?

lower bp

what should you monitor if you are giving your pt nitroglycerin?

blood pressure

what are some anitplatelets?

aspirin, clopidogrel, dipuridamole, ticlopidine

what is the #1 prescriped antiplatelet?

clopidogrel

what should you monitor when administering antiplatelets?

watch platelet count

if your pt has chest pain and take nitroglycerin after 3 x for 5 minutes they should...

call HCP

what does a left heart cath visualize/

coronaries

how is a left heart cath accessed?

through femoral, brachial, or radial arteries

how is women's chest pain different from mens?

they have fatigue, jaw pain

what is the surgical management of coronary artery disease?

percutaneous transluminal coronary angioplasty

a patient is given what before a heart cath?

mild sedative such as versed or fentanyl

what should you verify before a PCI is performed?

anticoagulants have been stopped

what should you do for a pt after PCI?

have pt on bed rest with HOB no higher than 30 degrees

what should you do to the extremity access site after a PCI?

immobolize it

what should you monitor for after a pci?

bleeding, hematomas, pulses, neurovascular check, ekc, chest pain

what should you teach your pt who has CAD?

stop smoking

what medicines are given for CAD?

nitrate, morphine

what is the pacemaker of the heart?

sinoatrial node

the autonomic nervous system works...

automatically

if your pt has a normal sinus rhythm, what should you do?

continue to monitor them

what is the treatment of sinus bradycardia if they are symptomatic?

atropine or transcutaneous pacemaker

who has sinus bradycardia?

well trained athletes, sleep, beta-blockers, calcium channel blockers, vagal stimulation, hypothyroidism and inferior MI

sinus tachycardia is caused by?

fever, MI, anemia, stress, decrease BP, caffiene, pain

if someone has tachycardia because they are in pain and have a fever, what could fix it/

ibuprofen

what is the treatment of premature atrial contractions?

monitor frequency

what are common complications of atrial fibrilation?

clot formation

what is the treatment of atrial fibrilation?

rate control medicines, antiarrhythmic medications, ablation, cardioversion

what rate control medicines does someone with a fib get?

digoxin, beta blockers ("olol", calcium channel blockers (verapamil, "pine")

what is important to remember about atrial fibrilation?

there is no p wave

what are complications of atrial flutters?

clots

what is the treatment of atrial flutters?

monitor, rate control medicines (digoxin, beta blockers, calcium channel blockers), antiarrhythmic medicines (amiodarone), cardioversion

superventricular tachycardia have a rate of

150 or higher

what is the first treatment of supraventricular tachycardia?

vagal stimulation (bare down)

what medicines are given to someone with SVT/

adenosine, calcium chanel blockers, beta blockers, miodarone

what does the QRS look like on a premature ventricular contraction?

wide and wicked

what does premature ventricular contractions indicate?

irritabliity

what are premature ventricular contractions caused by?

electrolyte imbalances

how do you know if it is a pvd?

drops below the line

what is transcutaneous pacing? when is it used?

used to pace up the heart rate. used in sinus brady

proper function of a pacemaker is indicated by a

pace spike before the complex

what tests would you expect after symptoms like jaw pain, diaphoresis?

ck, ck-mb, and troponin

if the insertion site is bleeding what do you do?

apply manual pressure

what requires nursing intervention?

patient leg is straight, foot is numb, 3 + pulse

treatment of sinus bradycardia is?

atropine

what are the causes of sinus tachycardia?

stress, fever, anemia, hypovolemia, hypotension, caffiene, pain, pulmonary embolism, myocardial infarction

what is the treatment for SVT?

vagal stimulation

what do you prepare for after they give adenosine?

prepare for transcutaneous pacing

a fib is at risk for

clots

what is the first thing you do when doing hemodynamic monitoring?

assess the clinical status of the patient

put these in order

stop physical activity, take nitroglycerin, if not relived after 3 in 5 minutes call HCP

what must stop for coronary artery disease?

smoking

what are the clinical manifestations of endocarditits?

oslers nodes and janeway lesions

what are complicarions of infective endocarditis?

embolic events

what is a clinical manifestation for pericraditis?

scratching "friction rub" sound

what is the medical management of pericarditis?

aspirin, NSAIDS, antiinflammatories, colchicine

what is the drug of choice for pericarditis?

colchine

what are the clinical manifesetations of valvular disease?

weight gain, edema, cool, pale extremities with weak pulse

what angel should the bevel be in an IV?

15 degrees

what are signs a site has phlebitis?

red, warm, tender, hard to palpate

signs of infiltration?

swollen, cool to touch, tight, pallow

what should you do if your site is infiltrated?

stop the infusion

what technique do you use for dressing? sterile or clean?

sterile

for a picc line, what do you need before following a doctor;s orders of given a saline bolus?

x ray to check placement

what do you need to watch out for with heparin?

bleeding