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Complex Exam 1 > HF > Flashcards

HF Flashcards

1
Q

Class 2 HF

A

Mild
Slight limitation of physical activity
Comfortable at rest but ordinary physical activity results in fatigue, palpitation, or dyspnea

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2
Q

Class 3 HF

A

Moderate
Marked limitation of physical activity
Comfortable at rest but less than ordinary physical activity causes fatigue, palpitations, and dyspnea

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3
Q

Class 4 HF

A

Severe
Unable to carry out any physical activity without discomfort
Symptoms of cardiac insufficiency at rest

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4
Q

Cardiopathies result from

A 
HTN
CAD
Substance abuse
MI
congenital defects
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5
Q

Filling disorders caused by

A

Mitral or aortic valvular disease
Cardiac tanponade
Restrictive pericarditis

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6
Q

AVblock first degree

A

All sinus impulses eventually reach the ventricles
AV conduction is slow

PR interval > 0.20 seconds

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7
Q

Causes for AV first degree block

A

AV node ischemia
Electrolyte imbalance
Drugs
Excessive vagal stimulation

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8
Q

Symptoms for AV first degree block

A

Usually aysomtomatic

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9
Q

Tx for AV first degree block

A

Usually none unless Rhythm due to drug therapy (withhold drug)

If symptoms are bradycardia then give oxygen and atropine

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10
Q

AV block second degree type 1

A

Successive sinus impulses take a little longer to reach ventricles; eventually blocked = dropped beat

More p waves than QRS complexes

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11
Q

Causes for AV second degree type 1 block

A

Drugs
Myocarditis
Inferior wall MI

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12
Q

Symptoms for AV second degree type 1 block

A

Asymtomatic unless cardiac output effected
Symptom bradycardia give oxygen and atropine
Maybe needs pacemaker

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13
Q

AV block second degree type 2

A

Infranodal
Occurs below the bundle of HIS
QRS is wide
Dropped beats

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14
Q

Causes for second degree block type 2

A

Anterior wall MI
Conduction problem
Rheumatic heart disease
Degenerative disease of conduction system

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15
Q

Symptoms for AV second degree block type 2

A

Bradydysthmia (decreased CO)

Can rapidly turn into third degree block

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16
Q

Tx for AV second degree type 2 block

A

Temporary pacing

Oxygen atropine and isoproterenol (isuprel)

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17
Q

AV Block third degree

A

Complete heart block
None of the sinus impulses reach the ventricles
An independent pacemaker paces the ventricles
Atrial and ventricle rhythms regular but independent
More P than QRS
PR interval not consistent

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18
Q

Causes for third degree AV block

A 
CAD
MI
degenerative disease of conduction system 
Hypoxia
Aortic stenosis
Congenital defects 
Drugs
Electrolyte imbalances 
Heart surgery
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19
Q

Symptoms of third degree AV block

A

Confusion lighthead syncope myocardial ischemia HF hypotension cardiac arrest VT VF asystole

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20
Q

Tx for their degree AV block

A

Oxygen and atropine
Isoproterenol (isuprel)
Pacemaker

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21
Q

Bundle branch block

A

Can be temporary or permanent
Conduction delay or block below the bundle of HIS

USUALLY no symptoms
Give oxygen and pacemaker if block progresses

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22
Q

Temporary pacing

A

Synchronous (demand) pacing

Asynchronous (fixed rate) pacing

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23
Q

Complications of temporary pacemakers

A

Discomfort
Skin irritation
Loss of capture
Inappropriate pacing

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24
Q

Heart failure manifestations

A 
Increased intravascular volume 
Displaced PMI
precordial heave/lift
Breath sound changes
Extra heart sound
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25
Q

Left side HF

A

Dyspnea orthopnea cough crackles extra heart sounds Cheyenne stokes
Weakness fatigue difficulty concentrating decreased exercise tolerance palpitations anxiety restlessness

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26
Q

Right side HF

A 
Progressive fatigue 
Difficulty concentrating 
Peripheral edema 
Weight gain 
Increased abdominal girth (helatomeagly, ascites, jaundice)
JVD
anorexia, nausea, nocturia, weakness
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27
Q

Grade 1 edema

A

Infection up to 1/4 and quickly returns to baseline

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28
Q

Grade 2 edema

A

Intention 1/4-1/2 returns to baseline in 10-15 seconds

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29
Q

Grade 3 edema

A

Intention 1/2-1 inch returns to baseline in 1-2 mins

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30
Q

Grade 4 edema

A

Intention more than 1 inch and returns to baseline longer than 2 mins

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31
Q

Normal ejection fraction

A

> 50%

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32
Q

Heart failure ejection fraction

A

<40%

33
Q

Severe heart failure ejection farction

A

<30%

34
Q

Dynamic cardiomyopasty

A

Surgery to wrap a flap of skeletal muscle around failing heart- conduction of the muscle to perform as cardiac muscle

35
Q

Ventricular assist device

A

Receive blood from failing left ventricle and pump the blood to the aorta

36
Q

Only cure for heart failure

A

Transplantation

37
Q

Cardiogenic shock

A

Vicious cycle of death
Failure of heart to pump forward
40% loss of ventricular myocardium function
Decreased tissue perfusion and cell death
Decreased myocardial functioning
Increased release of myocardial suppressant factor leading to depression and death

38
Q

Indications for worsening HF

A 
Weight gain 
Decrease in exercise tolerance 
Excessive awakening at night to urinate 
Development of dyspnea or angina at rest 
Cough lasting more than 3-5 days
39
Q

Coronary artery bypass graft

A

Areas of the myocardium are revascularized by implantation of the internal mammary artery or bypassing of the coronary occlusion with saphenous vein graft or radial artery graft

40
Q

Check neuro how many times after patient wakes up from surgery

A

Every 30-60 mins until awake and then every 2-4 hours according to policy

41
Q

Cardiac output=

A

Stroke volume x heart rate

42
Q

Each smallest square equals

A

.04 second

43
Q

Each large block equals

A

.20 seconds

44
Q

P wave

A

Atrial depolarization

45
Q

PR interval

A

Impulses conducted across Atria from SA to AV node (0.12-.20)

46
Q

QRS complex

A

Ventricular depolarization (0.06-0.10 seconds)

47
Q

St segment

A

Beginning of ventricular depolarization

48
Q

T wave

A

Ventricular depolarization

49
Q

QT interval

A

Ventricular depolarization and re polarization

50
Q

R to R interval

A

Total time between ventricular contractions

51
Q

How to analyze strip rate rhythm

A 
P wave present?
QRS present?
P-QRS ratio 1:1?
QRS complex same configuration?
Rate # p/QRS Complex in 6 seconds
Rhythm of R-R regular?
52
Q

Normal sinus rhythm

A 
Rate 60-100
P waves: small round 
P-QRS ratio- 1:1
R-R- equal 
QRS complex- narrow 
Regular rhythm
53
Q

Sinus bradycardia

A 
Rate 40-59
P wave- sinus 
p-QRS ratio- 1:1
QRS normal configuration (0.6-.12)
R-R- equal 
Regular rhythm
54
Q

Sinus tachycardia

A 
Rate 101-160
P waves sinus 
P-QRS ratio- 1:1
QRS complex- normal 
R-R- equal 
Regular rhythm
55
Q

Sinus arrhythmia

A 
Rate: 45-100
P waves: sinus 
P-QRS ratio: 1:1
QRS complex: normal 
R-R: irregular 
Rhythm: irregular
56
Q

Atrial flutter

A 
Rate: atrial 250-350; ventricular variable 
P waves: saw tooth 
P-QRS ratio: inconsistent 
QRS complex: narrow 
R-R: equal
Rhythm is usually regular
57
Q

Atrial fibrillation

A 
Rate: atrial 400-650; ventricular variable 
P wave: not present "wavy baseline"
P-QRS ratio: indeterminate 
QRS complex: normal
Rhythm: usually irregular
58
Q

Premature ventricular contractions (PVCS)

A 
Rate: variable 
QRS complex: obviously different wide 
P wave: visible only with normal complex
P-QRS ratio: 1:1 with normal cycles 
R-R: irregular 
Rhythm: irregular

Can be bigeminy, trigeminy, or quadrigeminy

59
Q

V tach

A 
Rate: ventricular 100-220
P wave: obscured if present 
QRS complex: wide
R-R ratio: variable 
Rhythm: regular or irregular 
Life threatening!
60
Q

V fib

A 
Rate: unattainable 
P wave: obscured if present 
QRS complex: not apparent 
R-r: unattainable 
Rhythm is irregular

Life threatening
Can have course or fine v fib

61
Q

Idioventricular rhythm

A 
Rate: 20-40 
P wave: absent 
QRS complex: wide 
R-R: regular 
Rhythm: regular

Life threatening

62
Q

Artififact common causes

A

Muscle tremor or movement
Loose electrode
Broken lead wire
Respiratory artifact

63
Q

Causes for sinus tachycardia

A

Stress
Exercise
Stimulants (caffeine and smoking)

Also fever, anemia, hyperthyroidism, hypoxemia, heart failure, shock

64
Q

Treatment for sinus tachycardia

A

Directed at eliminating the underlying cause
Sedation, oxygen, digitalis, and diuretics if heart failure is present

Give beta blockers if caused by thyrotoxicosis

65
Q

Causes for sinus bradycardia

A

Can be healthy

Sleep, severe pain, inferior wall MI, acute spinal cord injury, certain drugs

If too low or diseased heart treat with atropine or cardiac pacing

66
Q

Causes for sinus arrhythmia

A

Caused by irregularity in sinus node discharge often in association with phases of the respiratory cycle
Sinus node increases with inspiration and decreases with expiration

Seen in young people who are healthy and active

67
Q

Tx for sinus arrhythmia

A

Nothing since it doesnt hint to underlying disease

68
Q

Atrial flutter causes

A

CAD, cor pulmonale, and rheumatic heart disease

Can Quickly lead to pulmonary embolism, cerebral embolus, or MI because atrial kick cannot prevent thrombi from forming

69
Q

Atrial flutter tx

A

Reestablish sinus rhythm or to achieve ventricular rate control

If pharmacological conversion is not successful than electrical cardioversion can be used

Long term management is ablation, pacing, and implantable devices

70
Q

Atrial fib causes

A

Atrial muscle disease or atrial distention
Heart failure, ischemia, rheumatic heart disease, congenital heart disease

Same with atrial flutter these patients have lose their atrial kick which causes them to be at risk for thrombi formation leading to embolisms and MI

71
Q

Tx for atrial fib

A

Same as with atrial flutter
The goal is to achieve rate control and convert the rhythm to sinus
Chronic patients need anticoagulant therapy just like a flutter. If drug therapy fails then cardioversion is indicated

Ablation, pacing, and implantable devices

72
Q

Causes for PVC

A

People with myocardial disease (ischemia or infarction), or with myocardial irritability (hypokalemia, increased levels of catecholamines)

Pvcs are signs of ventricular irritability and can lead to v tach or v fib

73
Q

Tx for PVCS

A

In emergency situations amiodarone, and lidocaine can be used

74
Q

V tach causes

A

Common complication of MI

V TACH is a precursor to V fib

75
Q

V tach tx

A

If the patient is hemodynamically stable than lidocaine can be used if the patient is unstable then use synchronized cardioversion

In emergency situations use unsychronized defibrillation

Long term management can be ICD

76
Q

V fib causes

A

Myocardial ischemia and infarction, catheter manipulation in the ventricles,

There is no pulse and NO CO

77
Q

Tx for v fib

A

Rapid defibrillation
Cardiopulmonary resuscitation and drugs

ICD for long term management

78
Q

Class 1 HF

A

Mild
No limitation of physical activity
Ordinary activity does not cause fatigue, palpitation, or dyspnea

Complex Exam 1 (1 decks)

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