Exam 1 Flashcards
What are the 5 core nursing values?
Human Dignity, Integrity, Autonomy, Altruism, Social Justice
What does non-maleficence mean?
The principle of not doing harm; AVOIDING an action
What does beneficence mean?
an action you take to benefit someone
What is the straight line on an ECG called?
isoelectric line
The rhythm on an ECG refers to:
electrical flow
The “plumbing” on an ECG refers to:
blood flow
How does the heart’s conduction system work?
SA node to AV node to Bundle of HIS to Bundle Branches to Purkinje fibers
What does the “P” wave represent?
Atrial contraction (depolarization)
What does the “QRS” represent?
Ventricular contraction (depolarization)
What does the “T” wave represent?
Rest (repolarization)
What does it mean if there is a “Q” wave?
Infarct (dead tissue); seen below the isoelectric line
How is a heart rate calculated on a 6 second strip?
Count the QRS x 10
How is a heart rate calculated on a 10 second EKG?
Count the QRS x 6
What is normal sinus rhythm?
60-100 bpm
What is sinus brady?
< 60 bpm
What is sinus tachy?
> 100 bpm
How many seconds is each TINY square on a telemetry strip?
0.04 seconds
How many seconds is 5 TINY scares on a telemetry strip?
0.20 seconds
What does a peaked T wave mean?
Hyperkalemia (high potassium)
What is the nursing intervention for a peaked T wave?
Calcium Gluconate can be administered
What does RISQ stand for?
Rate and Rhythm, Intervals, Segments, Infarct
What is the most important interval on EKG?
The QT interval.
What is the normal time for the QT interval?
440 or 460 depending on gender; greater than 500ms risk for VT (death)
What is the PR interval?
The start of the P to the start of the Q
What is the QT interval?
The start of the Q to the end of the T
What is indicated if the PR interval is too long?
Heart Block
What is the normal time for the PR interval?
less than 220ms
What is the normal time for the QRS interval?
120ms
What is indicated if the QRS is too long (wide)?
bundle branch block
What is the ST segment?
The line between S & T
What is indicated if the line between the S & T is elevated?
STEMI - impending heart attack
What is indicated with T wave inversion?
Ischemia (low blood flow)
What is indicated with a Q wave present?
Damaged tissue; a heart attack has occured
What is cardiac angina?
Chest pain
What is stable angina?
chest pain that goes away with rest and administration of nitro
What is unstable angina?
chest pain that doesn’t go away with rest or nitro
What is the typical size of the heart?
10.6 oz
What are the three layers of the heart?
Endocardium (inner), myocardiam, epicardium
What are the four heart chambers?
Right atrium, Right ventricle, Left Atrium, Left ventricle
What is APEX of the heart?
At the bottom
What is the BASE of the heart?
At the top
Where is the PMI (point of maximum impulse located)?
midclavicular line at 5th intercostal space
What is the normal amount of blood pumped out of the heart per minute?
4-6 L
What is stroke volume?
The amount of blood ejected with each beat from the ventricles; the amount of blood in one ventricle
What is the normal Stroke Volume?
60-130mL per hour
What is ejection fraction?
the fraction of blood pumped out with each contraction
What is normal ejection fraction?
50-70%
What does ejection fraction tell us?
how well the heart is pumping; if low, indicated underlying disease
What is preload?
STRETCH; pressure generated in the ventricles and the resulting stretch of muscle fibers
What is afterload?
the resistance to the ejection of blood
How is cardiac output calculated?
CO=SV x HR
What is the cardiac cycle?
Diastole (all four chambers relaxed; ventricles filling with blood); Atrial systole; Ventricular systole
What is Pericarditis?
inflammation of the pericardium; would hear friction rub
What is Pulmonary Embolism
a blood clot lodged in the artery of the lung; pain worse on inhale
What is normal Potassium lab?
3.5-5 meq/L
What can be caused by Hypokalemia?
dysrhythmias, VT, VF
What is normal Bun & Creatinine?
10-20mg/dl
What is normal calcium?
8.5-10.5
What does calcium indicate in cardiac health?
cardiac nodal cell activity
What is normal magnesium?
1.8-3.0 mg/dl
What does magnesium indicate in cardiac health?
aids in absorbing calcium
What is normal sodium?
135-145
What is normal coagulation PTT?
60-70 seconds
What is blood pressure?
the force of blood pushing against the walls of blood vessels
How is cardiac output calculated?
(pulse x SV) x peripheral resistance
What is primary hypertension?
hypertension with unknown cause
What is secondary hypertension?
hypertension with other related factor
What is the #1 treatment for hypertension?
diurectics
Heart failure class I
Mild; no limitation
Heart failure class II
Mild; slight limitation
Heart failure class III
Moderate; marked limitation
Heart failure class IV
Severe; unable to carry out physical activity
What do ACE inhibitor drug names end in?
-pril
What do beta blocker drugs end in?
-olol
The P wave timing is typically:
Less than 0.11 seconds
The PR Interval timing is typically:
0.12-0.20 seconds
The QRS interval timing is typically:
Less than 0.12 seconds
Normal Na lab value:
135-145 mEq/L
Normal K lab value:
3.5-5 mEq/L
Normal BUN lab level:
7-18 mg/dL
Normal Cr lab level:
0.6-1.2 mg/dL
Normal Ca lab level:
8.5-10.5 mg/dL
With age, the heart becomes thickened and hypertrophic. True or False?
True
What are the six P’s?
Pain, pressure, paralysis, pallor, parenthesia and pulselessness
What are the 6 main cardiac biomarkers?
Troponin, CK, CK-MB, Myoglobin, hs-CRP, BNP
What is troponin? What is it used for diagnostically?
Regulatory protein complex; used to diagnose heart attack and assess degree of damage