Heart

Question 1

What is the function of calcium channel blockers and what are the common names?

Answer 1

Given to slow the electricity going in and out of the heart. It allows the heart to fill better and if it rests a bit more it can contract better

• cardiazime
• percardia
• verapamil

Question 2

What is preload?

Answer 2

The volume of blood in the ventricles at the end of diastole. This is partially dependent on the elasticity of the myocardial tissue

Increased in:

• Hypervolemia
• Regurgitation of cardiac valves

Question 3

What is afterload

Answer 3

The resistance (diastolic pressure) that your left ventricle must overcome to circulate blood.

increased in

• hypertension
• vasoconstriction

Question 4

What are the changes to the cardiac system with aging?

Answer 4

• increased stiffness of valves
• conduction breakdown/insufficiency in arrhythmias
• Myocardium strength reduces
• signals from the baroreceptors slow

Question 5

Modifiable risk factors for heart disease include

Answer 5

• cigarette smoking
• physical inactivity
• obesity
• psychological (stress etc)
• chronic disease

Question 6

• For what are thrombolytics used and what are the medications?

Answer 6

• Anticlotting
• TPA
• redovase
• adavase
• trypto(vase?)

Question 7

What is Homan’s sign and what is a positive response?

Answer 7

• Sign of deep vein thrombosis
• Forced dorsiflexion of the foot
  
  • increased resistance
  • involuntary flexure of the knee
  • pain in the calf

Question 8

What is a normal sinus rhythm?

Answer 8

s1, s2

lubb dubb

Question 9

What is the heart sound for beginning heart failure?

Answer 9

s1, s2, s3

lub lub dub or lub dub dub

Question 10

What are the heart sounds for extreme heart failure?

Answer 10

s1, s2, s3, s4

lub lub dub dub

Question 11

where do you listen for the tricuspid valve

Answer 11

4th costal space left of breastbone

Question 12

where do you listen for the aortic valve

Answer 12

2nd costal space, rt of breastbone

Question 13

Where do you listen for the pulmonic valve?

Answer 13

2nd intercostal space left of the breastbone

Question 14

where do you listen for the mitral valve?

Answer 14

5th intercostal space at juncture of ribs

Question 15

what is a myocardial infarction

Answer 15

blood clot, closing of the vessel, lack of blood to the heart causing death of tissue

Question 16

What is the lab test that most accurately indications infarction of cardiac tissue?

Answer 16

• Creatinine Kinase (CK, CK-MB)
• 4 hours before cells will appear in a blood test
• Peak 12-24 hours
• return to normal 3-4 days
• non-specific, also found in skeletal muscle and brain

Question 17

The protein that can give you an indication of prior MI events is

Answer 17

• Troponin I and T
• they are cardiac specific
• earliest rise 3-4 hours
• peak 10-24 hours
• return to normal 3-4 weeks

Question 18

What are some priorities when getting an MRI?

Answer 18

• No metal may be in the examination room including
  
  • jewelry
  • hair clips
  • hearing aids
  • magnetic strips
  • magnetic devices/implants/hardware in the body
• Those with claustrophobia may not tolerate the procedure
  *

Question 19

Priorities when giving a stress test include:

Answer 19

• Exercise stress testing
  
  • NPO for 4 hrs prior
  • avoid tobacco and caffeine prior
  • some medications may not be taken (beta-adrenergic blockers)
  • Monitor for 10-15 min after testing
  • have crash cart available
• Pharmacological testing
  
  • NPO - chocolate, caffeine (from all sources), tobacco,
  • stop meds 24-48 hr prior
  • takes up to 3 hours

Question 20

What are the signs and symptoms of valve disease?

Answer 20

• murmur
• chest pain or palpitations
• shortness of breath
• difficulty catching your breath
• fatigue
• weakness
• lightheadedness or LOC
• swollen ankles, feet or abdomen

Question 21

vasoconstrictors are

Answer 21

adregenic agonists & anticholinergics