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Critical Care > Exam #1 > Flashcards

Exam #1 Flashcards

1
Q

What are some causes of Bradycardia

A

Sleep
Athletic pt

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2
Q

What is the tx for bradycardia

A

Treat the cause

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3
Q

What are some causes of sinus tachycardia? 5

A

-Physiologic stress
-Medications
-Stimulants
-Illicit drugs
-POTS (autonomic dysfunction)

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4
Q

What is the golden rule for sinus tach treatment?

A

TREAT THE CAUSE

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5
Q

Why and when is sinus tach bad?

A
  • Decreases Cardiac Output
  • Increases Cardiac Workload
  • May lead to ischemia/HYPOtension
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6
Q

What arrhythmia occurs as extra & abnormal electrical activity ABOVE ventricles and AV node
**Reentering of electrical signals FROM vents to atria

A

Supraventricular Tachycardia

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7
Q

What are some causes of SVT

A

-High levels of stress
-Electrolyte imbalance

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8
Q

What are the treatments for SVT
** SVT and ABCD**

A
  • Start with Vagal Treatment
  • If vagal does not work:
    *Adenosine
    *Beta-blockers
    *Cardiac Ablation
    *Digoxin
    Synched Cardioversion
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9
Q

Electrical impulse starts in the atria but not the SA node. A premature impulse before the SA even fires. – What arrhythmia is this?

A

Premature Atrial Contraction

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10
Q

What are some causes of PACs?

A

-Caffeine, nicotine, alcohol
-HYPERvolemia
-anxiety
-HYPOkalemia
-Atrial Ischemia

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11
Q

What are the treatments of PACs?

A
  • Treatment is not usually needed
  • If this happens frequently, treat the cause
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12
Q

The heart’s electrical signals spread through the atria, which are beating too quickly though at a regular rhythm – This describes which arrhythmia?

A

Atrial Flutter

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13
Q

Patient’s with atrial flutter are at risk for:

A

Pooling in the heart – Clotting

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14
Q

What are some causes of Atrial Flutter?

A

-CAD
-HTN
-HF
-Valvular Disease/Disorders
-HYPERthyroidism
-Lung disease
-Cardiomyopathy

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15
Q

What are the treatment options for a new diagnosis of A-flutter

A

Adenosine
Cardioversion

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16
Q

What are the treatment options for an old diagnosis of A-flutter?

A

-Anticoagulants
-Cardioversion
-Antiarrhythmic (Amiodarone)

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17
Q

Uncoordinated electrical activity in the atria that causes rapid and disorganized “fibbing” of muscles in the atrium – quivering instead of contracting – Describes which arrhythmia

A

Atrial Fibrillation

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18
Q

What are patients who have A-fib most as risk for?

A

Pooling in the heart – Clotting

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19
Q

What are some of the causes of A-fib?

A

-HF
-COPD
-HTN
-Ischemic heart disease

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20
Q

What are the treatment options for A-fib?

A
  • Anticoagulants
    Short term: Heparin drip
    Long term: Coumadin, Rivaroxaban, Apixaban
  • Antiarrhythmic Meds (Amiodarone)
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21
Q

Early/Premature conduction of QRS complex. – Impulse starts in the ventricle before next normal beat fires from the SA node – this describes which arrhythmia?

A

Premature Ventricular Contraction

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22
Q

What are some of the causes of PVCs?

A

-Caffeine, nicotine, alcohol
-Cardiac ischemia
-Hypoxia
-Tachy
-Acidosis
-Dig. Toxicity
-HF
-Electrolyte imbalance

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23
Q

What are the treatment options for PVCs?

A

Treatment not usually needed – if frequently occurring, treat the cause

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24
Q

-The signal starts in the AV node, not the SA node – AV is now acting as the pacemaker of the heart
-P-wave can be→ inverted in front of QRS, buried in QRS, inverted behind QRS— This describes which kind of arrhythmia?

A

Junctional rhythms

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25
Q

How do you treat Junctional Rhythms?

A

If symptomatic, treat like bradycardia

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26
Q

Waveforms are irregular, coarse, and of different shapes. Ventricles are QUIVERING. No contraction. No Cardiac Output. CAN BE FATAL. – This describes which arrhythmia?

A

Ventricular Tachycardia

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27
Q

What are the common causes of ventricular tachycardia?

A

-MI
-Electrolyte imbalance

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28
Q

How do you treat V-tach with a pulse?

A

-Amiodarone
-Lidocaine
-Mag- Torsades
**If these do not work, cardiovert

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29
Q

How do you treat pulseless V-tach?

A

Start CPR and get the dfib!!

30
Q

A rapid disorganized pattern of electrical activity in the ventricle in which electrical impulses arise from different foci – this describes which arrhythmia?

A

Ventricular Fibrillation

31
Q

What are some of the common causes of Vfib?

A

-Untreated Vtach
-Electrolyte imbalance
-Cardiac Injury

32
Q

What are the treatments for Vfib?

A

-DFIB THE VFIB
**NO PULSE → start CPR asap

33
Q

What does asystole look like on an EKG?

A

Flatline

34
Q

What is the treatment for Asystole?

A
  • CPR and epi
    THIS IS A NON-SHOCKABLE RHYTHM
35
Q

Which rhythm shows the last bit of activity from the ventricles before a patient dies?

A

Idioventricular Rhythm

36
Q

If a patient has an Idioventricular Rhythm WITH a pulse, how would you treat this?

A

Epi and vasopressors

37
Q

If a patient has an Idioventricular Rhythm WITHOUT a pulse, how would you treat this?

A

Treat like asystole – cpr and epi

38
Q

Which arrhythmia can look like any arrhythmia, but there is NO HR/ PULSE

A

pulseless electrical activity

39
Q

How do you treat PEAs?

A

-Treat like asystole – CPR and Epi
-Hs & Ts

40
Q

What are the Hs in Hs&Ts
- Hypov______
- Hypox______
-Hydrogen Ions (acidosis)
- Hypo/Hyper_______
- Hypog________
-Hypot______

A
  • Hypovolemia
  • Hypoxia
  • Hydrogen Ions (acidosis)
  • Hypo/Hyperkalemia
  • Hypoglycemia
  • Hypothermia
41
Q

What are the Ts in Hs&Ts
-Tox_______
-Tam_______
-Thro_____
-Tension _______
-Tra______

A

-Toxins
-Tamponade
-Thrombosis
-Tension pneumo
-Trauma

42
Q

Which arrhythmia shows prolonged PR intervals?

A

1st Degree Heart Block

43
Q

What is the common treatment for 1st degree heart block?

A

Pacemakers (permanent/temporary)

44
Q

Cardioversion is a _________ _________ of electrical current through a defibrillator. It must be synched with the patient’s ___ ________

A

timed delivery
QRS complex

45
Q

Defibrillation is used to give an electrical current in hopes to break an arrhythmia. It should not be ________ because the pt will not have a pulse

A

Synched/timed

46
Q

Chest pain (angina pectoris) is a syndrome characterized by episodes of pain or pressure in the anterior chest caused by insufficient __________ _______ _____ .

A

Coronary Blood Flow

47
Q

What are treatments of Angina?

A
  • Nitro
  • Beta-blockers (metoprolol)
  • Calcium Channel Blockers (Diltiazem)
  • Antiplatelet/anticoag (asp, heparin)
48
Q

This is caused by a partial block of one of the arteries causing reduced blood flow of oxygen to the heart muscle - this describes what?

A

NSTEMI
Non-St Elevation MI

49
Q

What are the treatment options for NSTEMIs

A

-Medications to prevent blood clots such as (Heparin, Coumadin, Aspirin)
-In some cases CABG
-The goal is to reduce cardiac muscle ischemia and prevent further complications

50
Q

cardiac muscle death. Caused by a full blockage of a major artery from plaque – Describes a:

A

STEMI

51
Q

What are the treatment options for a STEMI?

A

-Coronary angioplasty
-Straight to cath lab within 60 minutes
-Slow heart rate (beta blocker IV)
-Reduce BP: nitro drip
-Thrombolytics within 30 minutes of onset of symptoms

52
Q

What are cardiac cath tips for a pt postop?

A

-Monitor catheterization site for bleeding or hematoma
-Inactivity for 2-6 hours post procedure
-Evaluating color, cap refill, and pulses
-Monitoring for arrhythmias and chest pain in the patient

53
Q

Systolic HF: left ventricle unable to _______ enough blood resulting _____ drop. This also causes blood to back up in the _________ system.

A

PUMP
EF (Ejection Fraction)
Pulmonary

54
Q

Diastolic HF: left ventricle does not ______ properly resulting _______ _______ to decrease. This causes blood to back up in the ______ ventricle.

A

FILL
Stroke Volume
Left

55
Q

___ __________ (Lisinopril): vasodilation, decreases afterload, prevents progression

A

ACE Inhibitor

56
Q

_____________ ___ (Losartan): prescribed as an alternative for ACE; works similarly

A

Angiotensin II

57
Q

_____ __________ (Metoprolol): prescribed in addition to ACE; improves capacity to exercise

A

Beta Blockers

58
Q

___________ consent means that the patient or their proxy has been fully informed of the risks, benefits, and alternatives to a proposed treatment and has given their permission for the treatment to proceed.

A

Informed

59
Q

________ Consent: This is when a patient is unable to provide consent and there is an emergency situation.

A

Implied

60
Q

__________ _________ of ______ ________ of ________: creates rules and regulations for nursing practice. (Ex: complaint filed against nurse, NCSBN will investigate. They can also revoke nursing licenses.

A

National Council of State Boards of Nursing

61
Q

________ __________ ___: primary legal document governing nursing practice and sets standards of nursing care.

A

Nursing Practice Act

62
Q

__________ _________: legal documents that state a person’s wishes regarding their medical care in the event that they are unable to communicate those wishes themselves.

A

Advanced Directives

63
Q

__________ ______ : spouse, children, parent, siblings, other relative or close friend. This is someone you trust to make decisions for you if you were unable to communicate.

A

Healthcare Proxy

64
Q

An __________ is a localized dilation of an artery which enlarges __x the size of its normal diameter

A

aneurysm
2

65
Q

dilation affecting the entire circumference of the artery – this is what type of aneurysm?

A

Fusiform

66
Q

outpouching affecting only a distinct portion of artery – this describes which type of aneurysm?

A

saccular

67
Q

formed when blood accumulates in the wall of an artery – which type of aneurysm is this?

A

Dissecting

68
Q

sudden tear of the intima of aorta – which type of aneurysm is this?

A

Aortic dissection

69
Q

Where are the 2 most common locations for aneurysms?

A

-Abdominal Aorta Aneurysm **most common
-Thoracic Aorta Aneurysm

70
Q

What is the emergency treatment for an aneurysm rupture?

A

-Place 2 large IV bores
-Reduce and manage blood pressure
-Treat pain
-Prepare for surgery

71
Q

D/C instructions following surgical repair of aneurysm :
- Cannot climb ______
- Should not _____
- Avoid _________/_________ activities
- Don’t life anything >_____ lbs

A

Stairs
Drive
Pushing/pulling
10

72
Q
A

Critical Care (6 decks)

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