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adult health > exam 4 cont > Flashcards

exam 4 cont Flashcards

1
Q

60-100

A

sa node

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2
Q

40-60

A

av node

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3
Q

20-40

A

perkingje fibers

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4
Q

.12-.20 (>.20 = AV block)

A

pr

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5
Q

.04- .10

A

qrs

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6
Q

st depression

A

ischemia

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7
Q

st elevation

A

mi

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8
Q

if what is prolonged it can cause dysrhythmias

A

qt interval

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9
Q

analyzing strip what do you ask

A

o Rate- fast or slow?
o Rhythm- regular or irregular? (obtain fastest with counting QRS for 6 sec x 10)
o P waves- one before every QRS?
o QRS complex- do they look the same? Follow P wave?

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10
Q

sinus brady

A

atropine ; hr is <60

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11
Q

tachycardia

A

IV Adenosine or Lopressor (Metoprolol)

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12
Q

PSVT tx

A

vagal down first then IV adenocard, Cardizem, Digoxin, Amiodarone, Adenosine

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13
Q

a fib meds to slow the rate

A

Cardizem (Diltiazem), Metoprolol, Digoxin, Amiodarone, Synchronized Cardioversion,

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14
Q

a fib meds to anticoagulate

A

warfarin and heparin

pt: 11-14
ptt: 25-35
inr: 0.8-1.2

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15
Q

digoxin toxicity

A

n/v and halos

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16
Q

pulseless v tach

A

cpr and defibrillation ; unstable

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17
Q

pulse v tach

A

amiodarone ; stable

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18
Q

no cardiac out put

A

ventricular fib

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19
Q

tx for v fib

A

CPR, Defibrillation (d/t no pulse), ACLS Protocol, Amiodarone, Epi

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20
Q

important with heart failure

A

bnp

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21
Q

Represents the time to pass from the SA node through the atria & AV node to the ventricles.

A

pr interval

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22
Q

pr greater than .20 means

A

communication is no longer between SA node and AV node

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23
Q

5x5 on ekg is

A

.20 seconds

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24
Q

pr intervals should be how big on ekg

A

5 boxes. anymore than that=prolonged pr interval

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25
Q

analyzing the strips what 4 questions do you want to ask yourself

A

rate: fast or slow; count T wave
regular or irregular
p wave before QRS
do every QRS look the same and have a P wave before?

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26
Q

rate of 100 to 150

A

sinus tachy; normal rhythm just really fast

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27
Q

albuterol, dehydration, exercise, hypovolemic shock, fever, hyperthyroidism

A

sinus tachy

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28
Q

questions to ask every patient

A

dizzy/lightheadedness, LOC impaired, low bp, dyspnea, chest pain, hypotension

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29
Q

tx for sinus tachy

A

tx the cause. vasovagal response, iv adenosine or metoprolol but give a CCB instead

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30
Q

1 intervention for sinus tach

A

find the cause and fix the cause

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31
Q

150-250 hr

A

PSVT

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32
Q

Paroxysmal

A

means it starts and stops spontaneously

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33
Q

premature atrial contractions so p waves are abnormal

A

PSVT

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34
Q

Causes: caffeine, stress, stimulants, dig toxicity, CAD

A

PSVT

35
Q

tx for PSVT

A

vagal response, adenosine, cardizem, digoxin, amiodarone

SLOW HR

36
Q

when giving adenosine to PSVT pt what do you need to do

A

give it in a proximal IV because the half life is only 10 seconds; 18 gauge is better because the med will go in faster. RAPID IV PUSH FOLLOWED BY FLUSH

37
Q

what do you do for a premature atrial contraction- PAC

A

wear a holter monitor
for healthy heart- no big deal
pt w underlying issue- should go see doc
tx:ccb

38
Q

ventricular rate is 60-180

A

a fib

39
Q

a fib- atrial is quivering

A

its not pushing all the blood through so blood sits and clots there then when the blood does move through it pushes the clot out to the rest of the body

40
Q

why does a fib affect hr

A

ventricles are trying to keep up w the atria

41
Q

tx for a fib

A

slow the rate and treat the clotting risks

42
Q

anticoagulant for a fib

A

warfarin- takes 2-3 days to become therapeutic; pt goes home on this. INR
heparin- starts quick. people dont go home on this- ptt

43
Q

tx for a fib

A

cardizem, digoxin, metoprolol, amiodarone, synchronize cardioversion ; cardioversion can be done with meds or with pads

44
Q

a flutter

A

a little more of a contraction than a fib; less risk for blood clots

45
Q

normal slow rhythm

A

sinus brady

46
Q

meds that cause sinus brady

A

betablockers and ccb

47
Q

crackles and fluid volume overload

A

think HEART FAILURE

48
Q

med for sinus brady

A

atropine and oxygen

49
Q

prolonged pr interval

A

1st degree heart block

50
Q

how to treat first degree

A

usually no treatment but monitor for new changes; usually a precursor for dysrhythmia

51
Q

Complete AV Heart Block Atrial and ventricular rhythms regular, but independent of each other

A

third degree heart block

52
Q

third degree heart blocks will progress to

A

asystole

53
Q

tx for third degree

A

transcutaneous pacemaker until transvenous pacemaker can be inserted. Atropine, epinephrine, dopamine.

54
Q

post op for permanent pace makers

A

Don’t lift arm above head
Antibiotic therapy
Monitoring of rhythm
Pacemaker function checked frequently

55
Q

premature ventricular contraction

A

like the pac but in the ventricles; QRS depression

56
Q

not a problem in a healthy heart but if they happen more frequently or together then this is a problem

A

pvc

57
Q

stable v tach

A

they have a pulse

58
Q

unstable v tach

A

no pulse

59
Q

v tach and no pulse

A

cpr and shock patient; epi /amiodarone

60
Q

v tach and pulse

A

amiodarone and lidocaine

61
Q

shockable rhythms

A

v tach no pulse and v fib

62
Q

asystole

A

epi and cpr

63
Q

will never have a pulse because there are no contractions

A

v fib ; shock/epi/cpr

64
Q

drug of choice for ventricular dysrhythmias

A

amiodarone

65
Q

how is amiodarone give

A

pulse- iv drip

no pulse- iv push

66
Q

what to do for v fib

A

cpr, amiodarone, defibrillation, epi

67
Q

pea

A

pulseless electrical activity

68
Q

electrical shock

A

v tach and v fib

69
Q

people who survive sudden cardiac death or dysrhythmias get

A

automatic implantable cardioverter defibrillator

70
Q

Area that is causing dysrhythmias is burned

A

ablation

71
Q

digoxin toxicity

A

potassium level

72
Q

prolonged pr interval is what

A

an AV block

73
Q

chronic heart failure weight gain

A

> 3-5lb in a week, >3lb in 2 days, or >2lb in a day

74
Q

intervention for endocarditis

A

get blood cultures quickly

75
Q

triggers for dvt

A

venous stasis, endothelial damage, hypercoaguability

76
Q

immobility, obesity, long surgery, prolonged bed rest, varicose veins, heart failure, stroke

A

venous stasis

77
Q

abdominal and pelvic surgery, trauma, indwelling catheter, iv meds, iv drug abuse, prior dvt, fractures of hip, leg, or pelvis

A

endothelial damage

78
Q

pregnancy, estrogen therapy, oral contraceptives, cancer, inherited coagulopathies, antithrombin, polycythemia, dehydration

A

hypercoagulability

79
Q

complications of dvt

A

pe; bleeding from thrombolytic therapy

80
Q

what causes rheumatic fever

A

strep infections

81
Q

intermittent claudication- pain triggered by exercise and relieved with rest, & thin shiny skin

A

PAD

82
Q

5 p’s in pad

A

Pain, Pallor, Pulselessness, Paresthesia, Paralysis

83
Q

intervention for aortic dissection

A

blood pressure control to prevent tear from getting worse

adult health (10 decks)

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