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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
Q

Causes of PAD

A

ATHERO, tobacco, DM, diet, inc CRP, HTN, fam, inc lipids

26
Q

Where does PAD often occur

A

abdominal aorta and lower extremities

27
Q

Pulses in PAD and PVD

A

PAD - dec or non
PVD - present but may be hard to palpate with edema

28
Q

Is cap refill normal in PVD

A

yes

29
Q

ABI over 0.9 occurs in…

A

ABI

30
Q

Does edema occur with PAD and PVD

A

PAD- absent unless legs always dangling
PVD - present in lower limbs

31
Q

IS there hair with PVD

A

Yes

32
Q

PAD ulcers

A
  • on toes, feet, lateral malleolus
  • rounded, smooth, punched out
  • minimal drainage
  • black eschar or pale pink granulation tissue
  • may hurt
33
Q

PVD ulcers

A
  • near medial malleolus
  • irregular shape
  • moderate to large
  • yellow slough or dark ruddy granulation
  • will hurt
34
Q

Pain with PAD

A

IC at site of the occlusion or toothache-like pain at rest

35
Q

Pain with PVD

A

dull ache/heaviness in calf and thigh

36
Q

Nails with PVD

A

normal or thick

37
Q

Skin with PAD

A
  • thin, shiny, elevation pallor, dep rubor
38
Q

Skin with PVD

A

thick, hard induration; warm skin
- varicose vein visible

39
Q

Do dermatitis and pruritis occur with PAD and PVD

A

PAD - not usually
PVD - often

40
Q

Is a lower ABI number worse?

A

Yes

41
Q

How is PAD dx?

A

ABI

42
Q

Meds for PAD

A

statins, antiHTN, altiplt

43
Q

First line for IC

A

cilostazil (of exercise and smoke cessation doesn’t work)

44
Q

NC for PAD

A
  • meds to dec risk
  • walking exercises
  • good foot care
  • angioplasty/stent placement
45
Q

Interventional tx for PAD

A
  • cath based in femoral artery
  • stent, PTA
  • atherectomy
  • cyplasty
46
Q

Cryoplasty

A

PTA and cold therapy

47
Q

Post op tx for PAD

A
  • freq PVS assessment
  • avoid flexed knee positions
  • early ambulation
  • great foot care
48
Q

Tx for small AAA

A

wait, dec risk fx, dec BP, annual monitoring

49
Q

What to monitor in the ICU for post op AAA surg?

A
  • watch graft patency
  • BP
  • CV
  • infx
  • ileus
  • peripheral and renal perfusion
50
Q

Endovascular aneurysm repair

A
  • done in vessel so less invasive
  • no abdomen incision, just dressing
  • keep supine for awhile
51
Q

Open aneurysm repair

A
  • large ab incision
  • clamp artery and sew synthetic graft
52
Q

What disease is Raynaud’s often associated with?

A

SLE and RA

53
Q

Raynaud’s dx

A

2 years of sx

54
Q

What does Raynaud’s feel like

A

Cold, numb then throbbing, ache, tingle, swell

55
Q

First line med for Raynaud’s

A

Slow release Ca-channel blockers

56
Q

NC for Raynaud’s

A
  • wear layers, gloves
  • avoid triggers
  • immerse hands in warm water to help
  • avoid alc, caff, stress
57
Q

Risks for endothelial damage

A
  • Caustic or hypertonic IV drugs
  • Pelvis, hip or leg fracs
58
Q

Risks for hypercoag state

A

Dehydration or malnutrition
inc altitude
oral contraceptives
pregnancy
cancer
tobacco use

59
Q

CM of VTE

A

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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