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NUR 213 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q 
BNP Levels:
Normal?
Failure? 
Moderate Failure?
Severe Failure?
Where is it produced?
A 
N: 0-100
F: 100-300
MF: >300
SF: >900
Produced in Lft Ventricle when in distress.
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2
Q

Pulmonary Artery Wedge Pressure (PAWP)
Left or Right of the Heart?
Normal?
Sick heart pawp and why?

A
  • Left
  • 6-14
  • 18; Big Floppy heart; Chambers are larger/ stretched out so they need more volume to help fill the added space and not stress the heart out further
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3
Q

Normal CVP?

A

4-6 (0-8)

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4
Q

The primary function of the pulmonary artery catheter is to help evaluate what?

A

Left ventricular pressure/volume & function

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5
Q

Starling’s Law?

A

The more the heart is filled during diastole, the more forcefully it contracts.

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6
Q

Preload=______=_______

A

Preload=Volume=Workload

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7
Q

Things to alter preload?

A
  • Diuretics: Lasix, Bumex, Diuril

- Vasodiltors: Nitrates (Relocate volume to periphery)

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8
Q

Afterload=________

A

Resistance

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9
Q

To alter afterload?

A

Arterial Vasodilators:

ACE/ARBS, Ca Channel Blockers (also Lowers HR), Nipride (IV only)

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10
Q

What are the 4 Determinants of cardiac output?

A
  • Heart Rate
  • Preload/Volume/Workload
  • Afterload/Resistance
  • Contractility/Strength
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11
Q

To alter Contractility?

A

To increase:

  • Beta Adrenergic agonists: Epi, Dopamine, Dobutamine
  • Phosphodiesterase Inhibitors
  • Digoxin

To Decrease:
Beta-blockers

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12
Q

Intra Aortic Balloon Pump (IABP)?

A

a. Decreases afterload
b. Increases coronary perfusion
c. Placed in the aorta
d. Inflates during diastole
e. Deflates during systole
f. Decreases myocardial o2 demand, increases myocardial O2 supply

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13
Q

Ventricular Assist Device (VAD)?

A

a. Can partially or totally support circulation until heart recovers or donor is found
b. Blood is shunted away from the L atrium or ventricle to the VAD, then back to aorta
c. Pts that get VAD: trouble weaning from cardiopulmonary bypass, awaiting transplant or not a candidate, or those w/acute MI w/cardiogenic shock

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14
Q

_______ ________occurs b/c of sustained ischemia causing irreversible myocardial cell death

A

Myocardial Infarction

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15
Q

Does Angina resolve in an MI with rest/drugs?

A

No. There is a total blockage. Pain will not resolve until blockage is cleared.

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16
Q

3 Layers of heart tissue?

A
  • Subendocardium
  • Myocardium
  • Endocardium
17
Q

Zones of Injury in the Heart?

A
  • Infarction: Dead, scarred, cannot be helped
  • Injured: swollen, but can heal, must be protected
  • Ischemic: no permanent damage unless prolonged
18
Q

Diagnosis of an MI:

Serum Markers?

A
  • Troponin: Norm:0-0.1
  • Creat/Kinase (CK): Norm:35-170
  • CK/MB Bands: Norm 0-7 (Specific to cardiac tissue)
19
Q

EKG changes with an MI:
Infarction?
Ischemia?
Old infarction?

A

infarction: Elevated ST segment
ischemia: ST segment Depression

Old MI: Q wave

20
Q

Give these 4 things to manage an MI…

A

Give in this order:

  • Oxygen
  • Nitrate
  • Aspirin
  • Morphine
21
Q

The “King” of antiarrythmics?

A

Amiodarone

22
Q

When is the only time you WANT to see arrythmias?

A

During re-perfusion

:can last 6-12hrs

23
Q

When to stop during thrombolytic Therapy?

A
  1. Increase is HR, fall in BP
  2. GI Bleeding: throwing up blood
  3. Brain Bleed, Stroke: sudden decrease in LOC
24
Q

If >40% of the heart is affected during an MI, then likely going to go into what?

A

Cardiogenic Shock: Reduced and effective CO

25
Q

4 Properties of Cardiac Cells?

A
  • Automaticity
  • Excitability
  • Conductivity
  • Contractility
26
Q

Pacemaker Cell Rates:
SA node?
AV node?

A
  • SA: 60-100

- AV: 35-60

27
Q

The Vagus Nerve, Which is part of the ______ system effects the SA/AV nodes in what way??

A
  • Parasympathetic
  • Decrease rate/Contraction

(Sympathetic system does the opposite)

28
Q

PR Interval:

& Normal?

A

-Time from the beginning of activity until it gets to QRS

  • Norm: 0.12-0.2
  • Longer on Digoxin
29
Q

QRS Interval:

& Normal?

A
  • From end of QRS to end of T

- Norm: 0.04-0.12

30
Q

Normal QT interval?

A

0.34-0.43

31
Q

_____ _____: Secondary pacer sites discharge faster than SA node, causes early beats, occurs where it is not supposed to, typically early

A

Ectopic Beats

32
Q

_____ _____: Occur if SA node pacing too slowly, other pacing sites “kick in”, this is not bad, it is protective

A

Escape Beats

33
Q 
Sinus...
Brady?
Tachy?
A-Fib?
Flutter?
A

-B: 100 BPM
-A-fib: Grossly irregular beats/no P-wave
Flutter: “Saw tooth” flutter waves

34
Q

To stop V-Fib you??

A

De-Fib; Done with no pulse

35
Q

_______: same as defibrillation except shock is synchronized with QRS wave, must shock on the R wave

A

Cardioversion

36
Q

What 4 things are indicators for a Permanent Pacemaker?

A
  • Sinus node dysfunction (SSS sick sinus syndrome)
  • Chornic Afib
  • Bifascicular Bundle Branch block
  • Third degree heart block
37
Q

BUN levels: 10-20

??= dehydration

> ??= renal

A low BUN, ??, & ?? may indicate malnourishment.

A

20-30s= dehydration

> 30= Renal

Low BUN/Protein/Albumin

38
Q

CO=___X___

A

CO= HR X SV

39
Q

Osmolality?

A

285-295

  • the higher; the more concentrated the solutes = vascular dehydration
  • or opposite for hypovolemia

NUR 213 (4 decks)

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