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Lab values > Mark K lecture 3 > Flashcards

Mark K lecture 3 Flashcards

1
Q

Positive inotropy

A
  • Increase cardiac contractile force !
    Ventricles empty more completely !
    Cardiac output improved
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2
Q

Positive chronotropy

A
  • Increase rate of impulse formation at SA
    node ! Accelerate heart rate
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3
Q

Positive dromotropy

A
  • Increase speed that impulses from SA
    node travel to AV node (increase
    conduction velocity)
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4
Q

Negative inotropy

A
  • Weaken/decrease the force of myocardial
    contraction
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5
Q

Negative chronotropy

A
  • Decrease rate of impulse formation at the
    SA node ! decelerate heart rate
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6
Q

Negative dromotropy

A
  • Decrease speed that impulses from SA node
    travel to AV node (decrease conduction
    velocity)
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7
Q

CCBs (Calcium channel blockers) are like

A

Valium for the heart
* They relax and slows down the heart
* In other words, CCBs have negative inotropic, chronotropic, dromotropic effects on the heart

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8
Q

Calcium channel blockers uses

A

Antihypertensive
AntiAnginal drugs (decreasing oxygen demand)
AntiAtrialArrhythmia

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9
Q

Side Effects

A

Headache and hypotension

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10
Q

CCB Name: ends in

A

“dipine” … Not “pine”
* Also, verapimil, Cardizem (diltiazem)
* Cardizem (diltiazem) is given continuous IV drip

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11
Q

What are the parameters to assess before putting a pt on CCBs?

A
  • Assess for BP
  • Hold if SBP <100
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12
Q

A lack of QRS complexes is

A

is asystole—a flat line

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13
Q

P waves (atrial) in the form of saw tooth wave

A

atrial flutter

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14
Q

Chaotic P wave patterns

A

atrial fibrillation

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15
Q

Chaotic QRS complexes

A

ventricular fibrillation

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16
Q

Bizarre QRS complexes

A

ventricular tachycardia (v-tach)

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17
Q

Periodic wide bizarre QRS complexes

A

PVCs

18
Q

Lethal arrhythmias are high priority

A

Asystole and V-fib (ventricular fibrillation)
Both rhythms produce low or no cardiac output (CO), without which there is inadequate or
no brain perfusion. This may lead to confusion and death

19
Q

Potentially Lethal Cardiac Arrhythmia

A

V-tach (ventricular tachycardia) is a potentially lethal cardiac rhythm but it has a CO

20
Q

treatment of ventricular arrhythmia

A

Lidocaine, Amiodarone

21
Q

Supraventricular arrhythmias are

A

Atrial arrhythmias

22
Q

Treatments of Supraventricular arrhythmias

A

“ABCDs”
* Adenocard (Adenosine) … Fast IV push (push in less than 8 seconds and 20 mL NS flush
right after) … These pts will go into asystole for about 30 seconds and out of it
* Beta-blockers (end in -olol)
* CCBs
* Digitalis (digoxin), Lanoxin (another digitalis analog)

23
Q

Beta-blockers treat “A, AA, AAA”

A
  • Antihypertensive
  • AntiAnginal drugs (decreasing oxygen demand)
  • AntiAtrialArythmia
  • Side Effects = Headache and hypotension
24
Q

Treatment of V-fib and Asystole

A
  • Defib for V-fib (Defib = defibrillate = Shock em!)
  • Epinephrine and Atropine for Asystole
25
Q

In a pneumothorax,
chest tube removes

A

air

26
Q

In a hemothorax,
chest tube removes

A

blood

27
Q

In a hemopneumo-
thorax, chest tube removes

A

air and blood

28
Q

Where should the chest tube be placed?

A
  • Apical (top) or Basilar (base)
  • Apical chest tube removes Air
  • Basilar chest tube removes
    Blood or fluid (due to gravity)
29
Q

Always assume trauma and surgery is (in regards to sides affected in pneumothorax)

A

unilateral unless otherwise specified

30
Q

If the water seal of the chest tube breaks

A
  • Clamp
    o Clamping, unclamping, and placing the tube under water must be done in 15 seconds or
    less
  • Cut the tube away
  • Submerge (stick) the end of the tube under sterile water
    o The most important step
  • Unclamp the tube if it was initially clamped, (clamping the tube prevent air to get into the
    chest but does not allow anything from the chest to get out
31
Q

If a chest tube gets pulled out …

A

1.Take a gloved hand and cover the opening (first step)
2.Take a sterile Vaseline gauze and tape 3 sides (best step)

32
Q

Chest tube is bubbling ask the 2 following questions

A

where it is bubbling, and (2) when it is bubbling?

33
Q

Rules for clamping tubes

A
  • Do not clamp a tube for more than 15 seconds without a physician’s order
  • Use rubber tooth (will not puncture tubing), double clamps
  • Therefore, when the water seal breaks, the nurse has no more than 15 seconds to clamp, cut
    the tube, submerge it under sterile water, and then unclamp it
34
Q

What congenital heart defects are Trouble?

A

o Tetralogy of Fallot
o Truncus arteriosus
o Transposition of the great vessels
o Tricuspid atresia
o Totally anomalous of pulmonary vasculature (TAPV)
o Except, Left ventricular hypoplastic syndrome

35
Q

TRouBLe

A

“TRouBLe” congenital heart defect
* “TRouBLe” shunts blood Right to Left
* “TRouBLe” is Blue (cyanotic)
* All “TRouBLe” start with the letter “T”

36
Q

four defects of Tetralogy of Fallot — “PROVe”

A
  • Pulmonary artery stenosis
  • RVH (right ventricular hypertrophy)
  • Overriding aorta
  • VSD (ventricular septal defect)
37
Q

Contact precautions

A
  • Anything enteric (GI, or fecal/oral)
    o C. diff., Hepatitis A, E. coli, cholera, dysentery
  • Staph
  • RSV (droplets fall onto object then pt touches object or put it in mouth)
    Do not cohort 2 RSV pts unless culture and symptoms say that have the same disease
  • Herpes
38
Q

Droplet precautions

A
  • For bugs travelling on large particles through Coughing, Sneezing to less than 3 feet
  • Meningitis
  • H. influenza b
    o Example: epiglottitis (nothing in the throat)
39
Q

Airborne precautions “Air MTV”

A
  • MMR
  • TB
  • Varicella (chickenpox)
40
Q

PPE (Personal Protective Equipment)
* Order to put in on

A

o Gown
o Mask
o Goggle
o Gloves

41
Q

Order to take it off

A

o Gloves
o Goggle
o Gown
o Mask

Lab values (12 decks)

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