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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
Post Procedure Care (PTCA)
Assess bleeding, best rest 4 hours, HOB flat (30 degrees), give acetylcysteine, IOs, Pulses, AKI
26
Feared Fibrinolytic Complication
Intracranial Hemorrhage
27
Statin Therapy
Lowers Cholesterol and Stabilizes Plaque
28
ACE Inhibitors
HR below 40, EF below 40%
29
Thrombolytics Time Frame
Within 6 Hours
30
Conduction System
SA > AV Node > AV Bundle >Bundle of Branches >Purkinjie Fibers > Ventricles Contract
31
Systolic Dysfunction (HF)
Contraction of Heart (Squeezes)
32
Diastolic Dysfunction
Filling of the Heart
33
Compensatory Mechanisms of HF
lead to left ventricular remodeling and cardiac decompensation
34
HF Manifestations (S/S)
Dyspnea, Fatigue, exercise intolerance, fluid retention ,edema
35
EF Calculation
CO= HR * SV
36
EF Ranges
55-65 = normal 40-55= below normal <35= life threatening
37
Preload
how much the heart fills at the end of diastole (relaxes)
38
Afterload
end of systole, high in HF pts because of higher blood pressure
39
PR
0.12-0.2 Sec Atrial Depolarization
40
One Big EKG Box
0.2 sec
41
One Little EKG Box
0.04
42
QRS
.06-0.12 Ventricular Depolarization
43
QT
0.32-0.40 Ventricular Depolarization/Repolarization
44
Tachycardia
HR above 100 Causes: anemia, hypovolemia, blood loss, hypotension, HF
45
Bradycardia
Below 60bpm Treat: atropine if symptomatic, pacemaker, epi
46
Premature Atrial Contraction
Premature ectopic electrical impulse in the atrium before normal SA node impulse
47
Atrial Flutter
Treat: control HR (diltiazem, beta-blockers, dig) Amiodarone Cardiovert- if new onset Vagal Maneuvers Anticoag
48
Atrial Fibrillation
Antiplatelet, anticoag, amiodarone, MAZE procedure, beta blockers, dig, heparin
49
PVC
Premature ectopic impulse that originates in the ventricle QRS is wide, ST and T wave changes
50
V-Tach
Pulse Present: antiarrhythmic drugs, amio No Pulse: Defib
51
Torsades de Pointes
VT that is preceded by long QT interval, no p wave
52
V-Fib
CPR First, Defib if electrical activity Epi > Amio > Vasopressin > Lidocaine > Sodium bicarb
53
1st Degree Block
PR interval is prolonged, no p wave

Med Surg (1) (4 decks)

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