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Med Surg (1) > Med Surg (1) > Flashcards

Med Surg (1) Flashcards

1
Q

Myocardial Infarction

A

Death to myocardial cells due to loss of blood flow which affects heart pumping and conduction

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2
Q

Modifiable Risk Factors (MI)

A

Hyperlipidemia, Smoking, Hypertension, Diabetes, Obesity, Metabolic Syndromes

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3
Q

Nonmodifiable Risk Factors (MI)

A

Genetics, History, Race

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4
Q

How does an MI Happen? (Patho)

A

A rupture of plaque which activates platelets and than those platelets form the clot or blockage affecting blood flow

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5
Q

Early Intervention of MI

A

Aspirin

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6
Q

Troponin

A

+key lab (MI)
Rises: 3-6 hours after injury
Peaks: 12-18 hours
Elevated 1-2 weeks

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7
Q

Normal Troponin

A

0-0.04

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8
Q

Creatine Phosphokinase

A

+ key lab (MI)
Rises: 4-6 hours
Peaks: 24 hours
Return: few days

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9
Q

Labs in Identifying MI

A

Myoglobin
Lactic Dehydrogenase
Troponin
Creatine Phosphokinase

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10
Q

Stemi

A

ST Depression
Full Thickness Block

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11
Q

NStemi

A

Non-ST Elevation
Partial Block

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12
Q

Phases of MI

A

Acute= currently happening
*Evolving= a phase of the MI
Resolved= finished

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13
Q

Signs and Symptoms

A

Chest Pain (unrelieved from nitro), Radiating Pain, low-grade fever, Tachypneic, Shock, JVD, SOB, BP, EKG Change (2lds), Decreased Urine Output

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14
Q

MI in Women

A

Vague Symptoms

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15
Q

MI in Elderly

A

Confusion, Low Observation

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16
Q

MI in Diabetics (T1)

A

Neuropathy
Vague Symptoms

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17
Q

MI in Transplanted Heart

A

No Nerve Feeling
No Atropine

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18
Q

Zone of Ischemia

A

ST Depression
T Wave Insertion
(outermost layer)

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19
Q

Zone of Injury

A

ST Elevation (middle layer)

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20
Q

Zone of Infarction

A

Q Wave Develops
(innermost layer)

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21
Q

Transesophageal Echo

A

Determines Ejection Fraction

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22
Q

STEMI Treament

A

12 Lead, Troponin, MONA< Beta Blockers (decrease HR), Statin, anticoag

23
Q

PTCA

A

Stent Placement, Opened by Balloon

24
Q

Special Consideration

A

Allergies to dye or aspirin, INR, Glucose

25
Q

Post Procedure Care (PTCA)

A

Assess bleeding, best rest 4 hours, HOB flat (30 degrees), give acetylcysteine, IOs, Pulses, AKI

26
Q

Feared Fibrinolytic Complication

A

Intracranial Hemorrhage

27
Q

Statin Therapy

A

Lowers Cholesterol and Stabilizes Plaque

28
Q

ACE Inhibitors

A

HR below 40, EF below 40%

29
Q

Thrombolytics Time Frame

A

Within 6 Hours

30
Q

Conduction System

A

SA > AV Node > AV Bundle >Bundle of Branches >Purkinjie Fibers > Ventricles Contract

31
Q

Systolic Dysfunction (HF)

A

Contraction of Heart (Squeezes)

32
Q

Diastolic Dysfunction

A

Filling of the Heart

33
Q

Compensatory Mechanisms of HF

A

lead to left ventricular remodeling and cardiac decompensation

34
Q

HF Manifestations (S/S)

A

Dyspnea, Fatigue, exercise intolerance, fluid retention ,edema

35
Q

EF Calculation

A

CO= HR * SV

36
Q

EF Ranges

A

55-65 = normal
40-55= below normal
<35= life threatening

37
Q

Preload

A

how much the heart fills at the end of diastole (relaxes)

38
Q

Afterload

A

end of systole, high in HF pts because of higher blood pressure

39
Q

PR

A

0.12-0.2 Sec
Atrial Depolarization

40
Q

One Big EKG Box

A

0.2 sec

41
Q

One Little EKG Box

A

0.04

42
Q

QRS

A

.06-0.12
Ventricular Depolarization

43
Q

QT

A

0.32-0.40
Ventricular Depolarization/Repolarization

44
Q

Tachycardia

A

HR above 100
Causes: anemia, hypovolemia, blood loss, hypotension, HF

45
Q

Bradycardia

A

Below 60bpm
Treat: atropine if symptomatic, pacemaker, epi

46
Q

Premature Atrial Contraction

A

Premature ectopic electrical impulse in the atrium before normal SA node impulse

47
Q

Atrial Flutter

A

Treat: control HR (diltiazem, beta-blockers, dig)
Amiodarone
Cardiovert- if new onset
Vagal Maneuvers
Anticoag

48
Q

Atrial Fibrillation

A

Antiplatelet, anticoag, amiodarone, MAZE procedure, beta blockers, dig, heparin

49
Q

PVC

A

Premature ectopic impulse that originates in the ventricle
QRS is wide, ST and T wave changes

50
Q

V-Tach

A

Pulse Present: antiarrhythmic drugs, amio
No Pulse: Defib

51
Q

Torsades de Pointes

A

VT that is preceded by long QT interval, no p wave

52
Q

V-Fib

A

CPR First, Defib if electrical activity
Epi > Amio > Vasopressin > Lidocaine > Sodium bicarb

53
Q

1st Degree Block

A

PR interval is prolonged, no p wave

Med Surg (1) (4 decks)

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