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Med-Surg 2 > Extra Cardiac > Flashcards

Extra Cardiac Flashcards

1
Q

Function of SA node

A

Initiate electrical conduction

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2
Q

What occurs when the impulse travels to the AV node?

A

Tiny pause

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3
Q

What does a peaked t wave indicate

A

Potassium imbalance

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4
Q

Location of brown electrode

A

4th ICS, RSB

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5
Q

Tele image depends on…

A

Which lead is on (like diff camera angle)

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6
Q

Bad vs good bradycardia

A
  • dec myocardial demand (good)
  • coronary perfusion time adequate bc prolonged diastole (good)
  • coronary perfusion dec (bad)
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7
Q

What can dec coronary perfusion from bradycardia cause?

A

infarct, hypotension, HF

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8
Q

bad vs good tachycardia

A
  • dec diastolic time shortens coronary perfusion (bad)
  • CO and BP inc short term (good)
  • sustained tachy causing dec vent fill and dec CO/BP (bad)
  • inc workload and inc myocardial demand (bad)
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9
Q

Effects of tachycardia that isn’t tolerated

A

infarct and dysrhythmia, dec BP, HF

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10
Q

Key features of sustained tachy and brady

A

angina (dec perfusion)
restless, anx, confused
- pulse deficit
- SOA
- orthopnea and crackles
- pale, diaphoretic
- N/V
- hypotensive
- dizzy and syncope
- palpitations (tachy)
- S3/S4 gallop
- JVD
- weak and fatigue
- dec UO
- inc cap refill

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11
Q

Cause of sinus arrhythmia

A

Intrathoracic pressure with breathing
- normal in young and healthy

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12
Q

sinus brady

A

HR under 60

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13
Q

Cause of sinus brady

A
  • normal in athletes and sleep
  • parasympathomimetic (excess vagal stim like valsalva, carotid massage, vom gag, eyeball pressure)
  • dig tox
  • hypokalemia and MI
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14
Q

brady tx

A

IV atropine 1 mg q3-5 min, 3mg max

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15
Q

Brady tx if meds don’t work

A

transcutaneous pacemaker immediately or permanent pacemaker PRN

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16
Q

Causes of sinus tachy

A

physical, anxious, pain, stress, anemia, hypoxic
- compensatory for dec BP like dehydration, hypovolemia, MI, HF

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17
Q

Tx for sinus tach

A
  • replace fluids, analgesics, antipyretics, anxiolytics
  • beta blocker to dec HR and myocardial demand
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18
Q

Gold standard beta blocker for HF

A

Carvedilol

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19
Q

Which diuretic is often given for HF

A

loop

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20
Q

Why is Dig tox second line drug

A

dysrhythmias, NTI, toxicity is a concern, hypokalemia worsens

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21
Q

What does an LVAD do

A

Prolongs life–subs for a transplant

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22
Q

Considerations for LVAD

A
  • Can’t do CPR until it is turned off
  • need to use a doppler to read BP of someone on LVAD
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23
Q

Do veins or arteries give pulses?

A

Arteries

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24
Q

What helps blood go back up the legs

A

Valves in the veins

25
Causes of PAD
ATHERO, tobacco, DM, diet, inc CRP, HTN, fam, inc lipids
26
Where does PAD often occur
abdominal aorta and lower extremities
27
Pulses in PAD and PVD
PAD - dec or non PVD - present but may be hard to palpate with edema
28
Is cap refill normal in PVD
yes
29
ABI over 0.9 occurs in...
ABI
30
Does edema occur with PAD and PVD
PAD- absent unless legs always dangling PVD - present in lower limbs
31
IS there hair with PVD
Yes
32
PAD ulcers
- on toes, feet, lateral malleolus - rounded, smooth, punched out - minimal drainage - black eschar or pale pink granulation tissue - may hurt
33
PVD ulcers
- near medial malleolus - irregular shape - moderate to large - yellow slough or dark ruddy granulation - will hurt
34
Pain with PAD
IC at site of the occlusion or toothache-like pain at rest
35
Pain with PVD
dull ache/heaviness in calf and thigh
36
Nails with PVD
normal or thick
37
Skin with PAD
- thin, shiny, elevation pallor, dep rubor
38
Skin with PVD
thick, hard induration; warm skin - varicose vein visible
39
Do dermatitis and pruritis occur with PAD and PVD
PAD - not usually PVD - often
40
Is a lower ABI number worse?
Yes
41
How is PAD dx?
ABI
42
Meds for PAD
statins, antiHTN, altiplt
43
First line for IC
cilostazil (of exercise and smoke cessation doesn't work)
44
NC for PAD
- meds to dec risk - walking exercises - good foot care - angioplasty/stent placement
45
Interventional tx for PAD
- cath based in femoral artery - stent, PTA - atherectomy - cyplasty
46
Cryoplasty
PTA and cold therapy
47
Post op tx for PAD
- freq PVS assessment - avoid flexed knee positions - early ambulation - great foot care
48
Tx for small AAA
wait, dec risk fx, dec BP, annual monitoring
49
What to monitor in the ICU for post op AAA surg?
- watch graft patency - BP - CV - infx - ileus - peripheral and renal perfusion
50
Endovascular aneurysm repair
- done in vessel so less invasive - no abdomen incision, just dressing - keep supine for awhile
51
Open aneurysm repair
- large ab incision - clamp artery and sew synthetic graft
52
What disease is Raynaud's often associated with?
SLE and RA
53
Raynaud's dx
2 years of sx
54
What does Raynaud's feel like
Cold, numb then throbbing, ache, tingle, swell
55
First line med for Raynaud's
Slow release Ca-channel blockers
56
NC for Raynaud's
- wear layers, gloves - avoid triggers - immerse hands in warm water to help - avoid alc, caff, stress
57
Risks for endothelial damage
- Caustic or hypertonic IV drugs - Pelvis, hip or leg fracs
58
Risks for hypercoag state
Dehydration or malnutrition inc altitude oral contraceptives pregnancy cancer tobacco use
59
CM of VTE
Unilat leg edema, pain, tenderness with palpation, dilated veins, fullness in thigh and calf, paresthesia, warm skin and erythema, temp over 100.4, PE

Med-Surg 2 (1 decks)

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