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NURS 2501 > Final > Flashcards

Final Flashcards

1
Q

Nitroglycerin

A

TX - HTN, chest pain; SE - headache; dilates peripheral vessels and coronary arteries

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2
Q

Morphine

A

TX chest pain (MI, PE) - reduces anxiety, dilates; SE: resp. depression, hypotension

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3
Q

Atropine

A

Anticholinergic - TX bradycardia, heart block, asystole ; SE - increased HR, anxiety, thirst, urinary retention

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4
Q

Isuprel

A

beta-adrenergic; used to increase HR; SE - V-fib

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5
Q

Adenosine

A

antidysrhythmic ; TX PSVT (paroxysmal, supraventricular tachycardia) ; IV push fast; SE - short periods of asystole.

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6
Q

Verapamil

A

CCB; TX SVT, angina ; SE- headache

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7
Q

Cardizem

A

CCB; TX PSVT, A-fib/flutter (with increased HR) , angina

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8
Q

Lidocaine

A

fast sodium channel blocker ; TX ventricular dysrhythmias ; decreases myocardial irritability - PVC, V tach + V fib

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9
Q

Procainamide

A

fast sodium channel blocker; TX atrial. ventricular and supraventricular dysrhythmias

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10
Q

Epinephrine

A

catecholamine; improves perfusion of heart and brain in cardiac arrest - TX profound decreased HR, asystole, pulseless V-tach and V-fib; No sodium bicarb ; TX anaphylactic shock

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11
Q

Sodium bicarbonate

A

TX metabolic acidosis

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12
Q

Mannitol

A

osmotic diuretic ; TX edema of CNS ; use filter needle

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13
Q

Methylprednisolone

A

glucocorticoid; TX edema of CNS

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14
Q

Narcan

A

opiate antagonist; short duration; withdrawal symptoms

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15
Q

Flumazenil

A

reversal agent for benzodiazepine meds - Valium, Versed, Librium.

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16
Q

Dopamine

A

TX hypotension ; sympathomimetic

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17
Q

Norepinephrine

A

catecholamine ; TX hypotension

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18
Q

Dobutamine

A

no vasoconstriction - TX shock states with decreased CO ( increases BP d/t increase in CO)

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19
Q

Nipride

A

TX hypertensive crisis ; measure cyanide levels; keep wrapped with aluminum foil

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20
Q

Lasix

A

loop diuretic ; depletes Na + K

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21
Q

A-line

A

BP, blood, vasoactive meds ; radial or brachial; systolic, diastolic and MAP (min 60); dicrotic notch - closure of aortic valve; Allen’s test (patency of ulnar artery); bag pressure 300; level & calibrate transducer Q8 or position changed - Phlebostatic axis - 4th intercost. space on the right of sternum

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22
Q

Pulmonary artery catheter

A

shows pt fluid status; CVP(preload- RA pressure) ; PAP; PCWP; CO; jugular or subclavian vein ; balloon wedged 8-15 sec - risk for pulmonary infarction

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23
Q

CVP

A

1-8 mmHg

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24
Q

PAP

A

15/5 - 25/15 mmHg

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25
Q

PCWP

A

indirect left atrial pressure - 4-12 mmHg

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26
Q

Cardioversion

A

synchronized shock during QRS wave ; TX A-flutter, A-fib, V-tach (with pulse and fast rhythm); consent + sedate;

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27
Q

Defibrillation

A

asynchronous shock; pulseless V-tach + V-fib ; 2 min of CPR between shocks - Biphasic 200 joules - mono - 360.

28
Q

IABP - intra aortic balloon pump

A

increase CO ( by 40%); femoral artery - descending aorta ; diastole - inflates (block aorta) - blood to coronary artery; systole - deflates - vacuum effect - improves LV ejection + CO; TX HF, MI; HOB < 45; can’t flex legs

29
Q

VAD - ventricular assist device

A

improve CO; TX end stage HF; LVHF - tube pulls blood from LV into pump - aorta

30
Q

CO - blood pumped from left ventricle each minute

A

4-7 L/min

31
Q

SV - stroke volume

A

amount of blood ejected with each contraction

32
Q

Afterload

A

pressure heart must overcome to eject blood during systole

33
Q

Respiratory failure

A

PaO2 < 60 & PaCO2 > 50

34
Q

Endotracheal tube - check placement

A
  1. end-tidal CO2 ( detector)
  2. Breath sounds
  3. X-ray
35
Q

CVP - central venous pressure catheter

A

RA pressure (preload); give fluids, blood samples; subclavian, jugular, femoral veins ( end SVC )

36
Q

Paternalism

A

making decision for pt. ; restriction of autonomy to protect the pt from harm

37
Q

Fidelity

A

keep promises

38
Q

Veracity

A

tell the truth

39
Q

Beneficence

A

prevent harm

40
Q

Nonmaleficence

A

do no harm

41
Q

PR interval

A

P - Q wave; total atrial activity - 0.12-0.2 sec ; * 1 small box - 0.04 ;

42
Q

QRS complex

A

Q-S; ventricular contraction - depolarization ; < 0.12 sec

43
Q

ST interval

A

S-T - T wave - total ventricle relaxation

44
Q

QT interval

A

total ventricular activity

45
Q

U wave

A

follows T wave - recovery of Purkinje fibers

46
Q

Amiodarone

A

emergency tx A-fib, A-flutter, V-fib, V-tach, PVC; SE: AV block, hypotension, bradycardia

47
Q

V-tach

A

HR > 100; wide, uniform, regular QRS , no P waves; TX - pulse - cardioversion, Amiodarone, Lidocaine; no pulse - CPR, defibrilation

48
Q

V-fib

A

wavy pattern - no P or QRS waves - Cardiac arrest - CPR, defibrilation, Amiodarone or Lidocaine

49
Q

Unifocal PVC vs Multifocal PVC (premature ventricular complex)

A

QRS is wide, T opposite to QRS; P is absent - look the same vs look different ( positive + negative PVCs) ; TX: Lidocaine, Amiodarone

50
Q

A-flutter

A

P waves - sharp, sawtooth ; PR interval cant be measured ; TX: Amiodarone, CCB, cardioversion

51
Q

A -fib

A

very irregular, No p waves + PR interval; normal QRS ; microemboli form ( >24 hrs) - transesophageal echocardiogram - emboli ? anticoagulation therapy ; TX- cardioversion, BB, CCB, Amiodarone, Digoxin

52
Q

SVT - supraventricular tachycardia

A

HR > 150 ; difficult to see P waves ; TX: valsalva + vagal maneuvers , Adenosine (HR), BB + CCB, synchronized cardioversion

53
Q

1st degree HB

A

prolonged PR interval ; TX - none - watch

54
Q

2nd degree HB - Morbitz Type 1

A

PR interval gets gradually longer until P fails to conduct and QRS is dropped ; TX - Atropine + temporary pacemaker

55
Q

2nd degree HB - Morbitz Type 2

A

PR intervals are the same until P wave is dropped - no QRS ; TX - Atropine + Permanent pacemaker

56
Q

3rd degree HB - Complete HB

A

P waves unrelated to QRS - pacemaker, Atropine, Dopamine

57
Q

Asystole

A

flat line - verify pulse - CPR - Epinephrine + Atropine - trancutaneous or tranvenous pacing - NO DEFIBRILATION

58
Q

six second EKG strip - determine HR

A
  1. 300 / by number of large boxes between R intervals
  2. 1500/ by number of small boxes between each R interval
  3. least accurate - for irregular rhythm - count R waves ( don’t count first and last ) x 10
59
Q

MI - ECG changes

A
  1. Inverted T waves - ischemia
  2. ST segment elevation - injury
  3. Pathological Q waves - usually permanent even after recovery
60
Q

MI - chest pain + s/s

A

Radiates to back, abdomen, neck, jaw, left arm, shoulder.

SOB + anxiety + impending doom

61
Q

MI - MONA

A

Morphine
Oxygen
Nitroglycerin (SBP > 90)
Aspirin (325 mg chew)

62
Q

STEMI vs NSTEMI

A

ST elevation MI (blood clot completely blocking an artery - tx: angioplasty, stenting, clot busting meds) vs none ST elevation MI ( women, does not extend through the full depth of the heart muscle - clot-busting meds are not effective)

63
Q

MI - DX - cardiac markers (enzymes)

A
  1. Troponin T + I - preferred - cardiac injury - rises 2-6 hrs
  2. Creatinine kinase - MB - peaks 24 hrs - heart muscle enzyme
  3. Myoglobin - rises 3-4 hrs - non-specific
64
Q

Percutaneous Transluminal Coronary Angioplasty can be combined with stent placement

A

invasive but non-surgical technique - under fluoroscopic guidence in the cath lab - balloon tipped catheter - inflates - force the plaque against the vessel wall ; groin or arm;

65
Q

MI - TX + SX

A
  1. Thrombolytic therapy - Streptokinase, Urokinase - first 6 hrs; Bleeding !!! - antidote - Amicar-aminocarproic acid .
  2. Glycoprotein inhibitors - Reopro + Integrilin - target platelet component of thrombus
  3. Angioplasty - with stent
  4. CABG - coronary artery bypass graft sx
66
Q

Ace-inhibitors and MI - Captopril , Lisinopril

A

prevent ventricular remodeling - decreases risk of HF - SE: bradycardia, cough, hyperkalemia ;
inhibit renin-angiotensin-aldosterone mechanism - block conversion of angiotensin I to angiotensin II - prevents peripheral vasoconstriction; reduces blood volume ( inhibit aldosterone )

NURS 2501 (11 decks)

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