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110_Cardiac > Hemodynamics > Flashcards

Hemodynamics Flashcards

1
Q

HR

A

60-100 bpm

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2
Q

Stroke volume

A

vol/beat L = CO/HR
Pumping og the heart each beat.
Volume of blood ejected per beat

Heart pumps liters

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3
Q

Cardiac output

A

volume of blood pumped every min

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4
Q

EF

A

should be greater > 60
60 to above is normal
below 60 heart is failing

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5
Q

EF def

A

is the % of blood force out of LV each beat

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6
Q

EF

A

55 - 75%

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7
Q

Preload

A

the measure of the stretch when blood filing the heart

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8
Q

Afterload

A

force of the ventricles to open semi-lunar valve

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9
Q

SHOCK

A

not enough filing of heart is dehydration

No fluid, we need to give pt. vasopressor to increase contraction or volume of heart.

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10
Q

Pulmonary HTN fix

A

By relaxing the heart; give them vasodilators

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11
Q

Contractility

A

Force of the heart to eject or pump

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12
Q

Left ventricle

A

60 cc only eject and 40 cc is left.
E.g. if heart is ejecting only 50%, then heart is failing leading to HF

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13
Q

PPT #34

EF <60

A

HF

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14
Q

Difficulty of filling/ pumping EF<60

Complications

A

HTN
CAD slide #7

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15
Q

Comorbidities of HF

A

smoking/ diabetes/ obesity/ aging = overuse of heart = ventricles enlarge

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16
Q

2 Types of HR

A

LHF is most common type where ventricles enlarge leading to Pulmonary Edema = congestion in lungs

RHF = Right atrium affected
Lymphatic system edema
Edema in liver

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17
Q

Pt with HTN, Right sided HF, Jugalar vein distention, peropheral edema. Where you see distention in the pt

A

at 30 degress sit pt. up to see the Jugluar vein distention

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18
Q

HF can be chronic

A

but can also become acute

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19
Q

HF is

A

enlarged ventricles
dialated heart chambers

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20
Q

slide#35
Acute decompensated HF (ADHF)

A
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21
Q

slide # 37
Assess before intervention

A

Asculate lungs
Exacerbation listen to lungs
Put oxygen on pt
call HCP

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22
Q

LHF = Pulmonary Edema

A

is life threatening

23
Q

slide #39
Clinical Manifestation of PE (Pulmonary Edema)

A

Cool & Clammy skin ## Exam
Orthopnea #Exam

24
Q

Intervention for Pul Edema

A

Put pt. in 30 deg all the time

25
Q

Manifestations of Pul Edema

A

Cough with frothy blood-tinged sputum
Tachycardia
HTN
Cyanotic

26
Q

1st thing to do with Pul Edema

A

Lasix, Butinamide

27
Q

How do you know Pulmonary Edema is resolved, or drug is effective?

A

Edema is down - better breathing
Crackles gone or reduced
No more tachypnea
Clear breathing sounds
Easy breathing

28
Q

FACES indication for Pulmonary Edema

A

Fatigue
Limitation of Activities
Chest Congestion
Edema
SOB +++++ COUGH

29
Q

CHF hx and having dry cough, Gained weight = assess again CHF exacerbation.

A

Did you gain some weight, look up all data, lab works, «coughing + chest congestion» and edema - lead to type of assessment you do as nurse.

30
Q

Edema common in HF

A

More than 3lb in 2 days

31
Q

Slide #47
Complications of HF

A

Pleural effusion
Dysrhythmia
Thrombus develops in Left Ventricles
Renal Failure

32
Q

Slide # 49
Diagnostic HF

A

Chest X-ray to see how big your heart is.
Echo scheduled and takes time

33
Q

Number 1 indication of HF

A

BNP

34
Q

Slide #52
ADHF Interpersonal Care

A

Check O2 sat always when pt. comes in then supplement with oxygen

End-stage HF, then Mechanical ventilation. Emergency situation when pt pulls out ventilation ## bag the pt.

ET (Endotracheal Tube)

High flowers position when pt is on ventilator

35
Q

Slide #53
Ultrafilteration SOAP extracted from blood

A

like dialysis to take sodium out of blood to control edema

36
Q

Devices that pump the heart while pt. waits for transplant

A

IABP and VAPS for pumping your heart

37
Q

slide#54
LVAD
VAD

A
38
Q

slide#62
Every CHF pt should be on

A

ACE inhibitors / RASS inhibitors
prils like captopril to preserve the heart

39
Q

Slide #55
Reduce circulating volume

A

Lasix, Butenamide 10 mg - 20 mg order of furosemide push in 1-2 mins and then repeat in 1-2 hours.

40
Q

When can you repeat lasix?

A

In 1-2 hours

41
Q

With Lasix monitor

A

BP because lowers BP
Hypokalemia
K anything 3.4 is critical - we have to supplement that

Lasix depletes Na and K
K=3.1 = call you doctor

42
Q

K=3.1- Hypokalemia, s/s pt.

A

Weak
Dizzy
Cardiac Arrhythmia

43
Q

Slide#55
To reduce circulating volume, we also give

A

Nitro (sodium prusside)
Morphine to reduce work load of heart - Reduce preload and Reduce afterload.

Digoxin to force contraction of heart

44
Q

Slide #61 Pt. Teachiing

A

Walk slowly for tolerance, decrease dema, breathing

45
Q

Slide#63
Beta blockers and vasodilation

A
46
Q

Diet of Pt. What to avoid? NCLEX which food pt to avoid?

A
47
Q

CHF exacerbation =

A

Fluid restriction. 500 cc easy to count than 100 cc. Change water give 500 cc

Ask when did you go to bathroom - what comes in = should come out

48
Q

Slide#79 to slide#81
Early detection is better

A
49
Q

Action of the drug
diuretic lab is hypokalemia

A
50
Q

Signs of digoxin toxicity

A

Vomiting, Seeing Halos

51
Q

slide #83
Pt. sick - write all medication - pt slow in thinking as they are sick

A
52
Q

Beta blockers

A

decrease salt substiture

53
Q

Reversible or Heart Transplantation check criteria for age and comorbidities

A
54
Q

slide#95
Post Transplant Rejection

A

Cyclosporin = immunotherapy drugs
Endomyocardial Biopsy (EMB)
Every month to every 3 months.

110_Cardiac (8 decks)

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