Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Med Surg > Exam 2, Deck 2 > Flashcards

Exam 2, Deck 2 Flashcards

1
Q

Hypoxia symptoms (4)

A

Light-headedness
Dizziness
Syncope
Change in LOC

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

Cardiac symptoms (3)

A

Chest pain
Tightness
Palpations

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

Arrhythmia symptoms (6)

Similar to…

A

**Similar to when cardiac output falls:

Decreased LOC
Pale and cool skin
Possible FVE with JVD distention and lung crackles
Decreased urine output
Decreased BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cardioversion / Defibrillation: Mechanism

A

Deliver electrical current to stop the heart; allow the SA node to take over as pacemaker.

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

How much pressure for hand-held defib paddles?

A

20-25 lbs vertically

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

Cardioversion synchronizes and discharges the ___ in order to avoid _______.

A

QRS Complex

To avoid the R on T problem

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

Which requires higher Joule levels: Defib or Cardioversion

A

Defib

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

What is the function of electrophysiological studies

A

To evaluate and treat arrhtyhmias

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

What is mapping and ablation?

A

Mapping: Finding the group of cells that induce anarrhythmia (irritable cells)

Ablation: Destroys the problem cells

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

Coronary artery disease (CAD) : Two pathophysiological causes

A
  • Atherosclerosis

- Atheroma

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

Define atherosclerosis

A

An abnormal accumulation of lipid and fibrous tissue in the vessel wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a danger of atherosclerosis?

A

A rupture signals body to send platelets –> Clot forms –> Further blockage to artery results.

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

Define atheroma

A

Blockage that narrows vessel wall and decreases blood flow to the myocardium. PLAQUE.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the dangers of atheroma?

A
  • Ruptures and clot forms

- Vessel becomes completely occluded: Myocardial infarction

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

Three things that could potentially cause vasospasm of coronary arteries

A
  • Big burst of energy
  • Cold weather or cold beverages
  • Trauma, acute blood loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define acute coronary syndrome

A

Umbrella term for any acute coronary issue from angina to MI

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

Four non-modifiable risk factors for CAD

A
  • Family hx
  • Gender
  • Aging
  • Race
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Risk factors for CAD: Male versus female

A

Prior to menopause, men have 3x more myocardial incidents. After menopause, the numbers are even between men and women.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Seven modifiable risk factors for CAD

A
  • High cholesterol
  • Cigarettes
  • Hypertension
  • DM
  • Lack of physical activity
  • Obesity
  • Stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Define angina pain

A

Pain lasting for less than ten minutes; usually radiates to the neck or left arm and is alleviated by rest and/or nitroglycerine

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

Angina categories (3)

A
  • Classic (“stable”) angina
  • Unstable angina
  • Prinzmetals / variant angina
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Three characteristics of classic angina

A
  • Pain or pressure lasting less than ten minutes (usually 3-5 minutes)
  • Most common type of pain
  • Predictable: Relieved by rest and/or nitroglycerine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Characteristic of unstable angina

A

UNPREDICTABLE. Pain with little or no activity.

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

Two characteristics of Prinzmetals / variant angina

A
  • Second CA Vasospasm

- Not provoked by exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What can precipitate angina pain? (5)

A
  • Physical exertion
  • Exposure to cold
  • Eating a heavy meal
  • Stress, emotional factors
  • Stimulants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are three stimulants that may precipitate angina pain?

A

Cocaine
Coffee
Cold and cough meds with adrenergics in them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What causes angina pain, physiologically?

A

Occurs when the heart receives insufficient blood for oxygen demands at the time, such as in atherosclerosis and arteriosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Nature of angina pain (3)

A
  • Localized
  • Midsternal
  • Possible radiation to shoulders, arms, neck, jaw
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Four other assessments of an angina patient

A

Apprehension
Tightness or choking sensation
Weakness, fatigue
Numbness in arms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Four lab work components done on an angina patient

A

CK-MB
Troponin
Myoglobin
Chem 7

31
Q

What position should an angina patient be in

A

FOWLER’S. Patient will assume this position automatically.

32
Q

What happens to an ECG when a patient is in pain?

A

ST depression indicates ischemia – ST segment will be lower than isoelectric line when patient is in pain.

33
Q

Seven nursing interventions for an angina patient

A

1) Rest
2) O2
3) Nitroglycerine
4) Other meds
5) Patient education
6) Psychological support
7) Stress Reduction

34
Q

ARB Mechanism

A

Block angiotensin II receptors

35
Q

Patient education: Angina: Lifestyle changes (5)

A
  • Stop smoking
  • Lose weight
  • Exercise
  • Take meds as directed
  • Avoid cold weather
36
Q

Patient education: Angina: Dietary changes (6)

A
  • If diabetic, control blood sugar
  • Alcohol in moderation
  • More fruits, veggies
  • More lean meats
  • Less sodium
  • Less trans fats
37
Q

Etiology of Myocardial Infarction (3)

A 
1) Reduced blood flow
or
2) Complete arterial occlusoin
or
3) Reduces cardiac blood flow
38
Q

Two things that could reduce blood flow ending in MI

A

Ateroma

Vasospasm

39
Q

Two things that could cause complete arterial occlusion ending in MI

A

Thrombi

Emboli

40
Q

Two things that could reduce CADIAC blood flow ending in MI

A

Hemorrhage

Shock

41
Q

Takotsubo

A

Broken heart syndrome – death of grief with clear cardiac arteries.

42
Q

Nature of MI pain (5)

A
  • Substernal pressure
  • Crushing
  • Radiating
  • Often not related to exercise / stress
  • Not relieved by rest or nitro
43
Q

How often are MIs “silent”?

A

30% of the time

44
Q

From the onset of chest pain, how long do you have to reverse the damage?

A

Six hours. TIME IS TISSUE.

45
Q

What other symptoms might a patient experience with MI (besides pain) -2

A
  • Anxiety, feeling of impending doom

- NV

46
Q

Leading cause of death from MI

A

Dysrhythmia / arrhythmia 2/2 alteration in function

47
Q

Objective changes provider will observe with MI (6)

A
  • Pulse changes
  • Diaphroetic
  • Pale skin
  • Increased temp and WBCs 2/2 inflammation
  • Change in LOC
  • Signs of cardiogenic shock
48
Q

Two lab indications of an MI

A

Increased CK-MB

Increased Troponin

49
Q

If you’re not sure whether the patient is having an MI, when should you keep them in the hospital anyway?

A
  • Pain unrelieved by nitro
  • Vomiting
  • Diaphoresis
50
Q

What differences would you see on an ECG between angina, a STEMI and a non-STEMI

A
  • Angina only alters ECG when patient is in pain
  • NSTEMI has no changes in ST
  • STEMI has ST segment elevation, T wave changes
51
Q

What do the ECG changes on a STEMI indicate?

A

Severe tissue necrosis and the need for emergency revascularization

52
Q

What interventions constitute emergency re-vascularization?

A
  • PTCA with or without a stent

- CABG

53
Q

Labs for angina vs NSTEMI vs STEMI

A

Angina - normal CK-MB and Troponins

NSTEMI and STEMI - elevated CK-MB and Troponins

54
Q

What four systems are altered by an MI?

A
  • Cerebral
  • Cardiac
  • Peripheral
  • Kidneys
55
Q

Effect of MI: Cerebral

A

LOC

56
Q

Effect of MI: Cardiac (2)

A

Chest pain

Arrhythmias

57
Q

Effect of MI: Peripheral (3)

A

Edema

Decreased pulses

58
Q

Effect of MI: Kidneys

A

Increased creatine

Decresaed urine output

59
Q

Four goals of MI care

A
  • Minimize myocardial damage
  • Prevent complications
  • Restore circulation
  • Reduce myocardial oxygen demand
60
Q

Why should an MI patient avoid Valsalva?

A

Bearing down increases thoracic pressure, decreases BP slightly

61
Q

When can an MI patient have sex again?

A

Once a patient can walk up 2 flights of steps and be asymptomatic –> Ready for sex

62
Q

Medical interventions for an MI (3)

A

1) PTCA
2) Coronary Stent
3) CABG

63
Q

What does PTCA stand for?

A

Percutaneous Transluminal Coronary Angioplasty

64
Q

What patients are candidates for PTCA?

A
  • Must be a CABG candidate
  • Patients who are contraindicated for thrombolitics
  • Patients at hospitals who have this capacity
  • Patients whose vessels are 70-80% occluded
65
Q

How is a PTCA performed? (3)

A
  • Catheter through femoral artery
  • Dye injected to find narrowing
  • Inflate catheter balloon fora few seconds at a time to push plaques to the side
66
Q

What must you have a patient sign before a PTCA is performed?

A

Consent for a CABG

67
Q

Six complications of a PTCA

A
  • Dissection, perforation or vasospasm of the coronary artery
  • MI
  • Dysrhythmias
  • Cardiac arrest
  • Hemorrhage
  • Thrombus
68
Q

Why would PTCA cause an MI?

A

If balloon is inflated for too long

69
Q

Post PTCA (4)

A
  • Observe for 24 hours
  • Assess for chest pain
  • Nitroglycerine
  • Anticoagulants
70
Q

What is the biggest risk with a coronary stent?

A

Clot formation post-placement

71
Q

How is heart stopped for CABG?

A

Cold slurry with a lot of potassium put into chest cavity

72
Q

How is blood oxygenated during CABG?

A
  • Catheter in the vena cava that brings blood to pump to oxygenate
73
Q

How much is patient cooled for bypass?

A

4-6 degrees celsius

74
Q

What vessel is harvested for CABG?

A

Either greater or lesser saphenous vein from leg

Med Surg (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions