Med Surg Cardiac Flashcards
For a pt with a cardiac disorder, what components of the abdominal assessment is necessary!
Abdominal distention, indicates ascites which develops with right ventricular or biventricular HF
Hepatojugular reflux, performed when right or biventricular HF is suspected a positive test aids in confirming HF.
Bladder distention, urine output is a imp indicator of cardiac function, reduced urine output may indicate inadequate renal perfusion or less serious problems.
What are findings frequently identified with patients with cardiac disorders?
Hemoptysis
Cough
Crackles
Wheezes
What is kyphoscoliosis and what does it do
A spinal deformity that occurs in many older adult patients,it,any move the cardiac apex downward so that palpation of the apical impulse is obscured
What is orthostatic hypotension
A result of impaired barks receptor function that normally regulates BP Places older adults adults at risk for falls
What is the diagnosis of MI made on
Evaluating the history and physical examination, the 12 lead electrocardiogram and the results of laboratory tests,that measure serum cardiac biomarkers
Wha is measured to evaluate CAD
Cholesterol
Triglycerides
Lipoproteins
What is the normal level of cholesterol
Less than 200
What is cholesterol required for
Hormone synthesis and cell membrane formation
It is found in large quantities in brain and nerve tissue
What are the 2 major sources of cholesterol
Animal products
The liver, where it is synthesized
What are normal LDL levels
Less than 160
They are the primary transporters of cholesterol and triglycerides into the cell
What is the harmful effects of LDLs
The depositing of these substances in the walls of the arterial vessels
In ppl with known CAD and diabetes what is the primary goal level of LDLs
Less than 70
What is the HDL normal range in men
35-70
What is the normal range of HDL for woman
35-85
Wha does HDL do
Transport cholesterol away from tissues and cells of the arterial wall to the liver for excretion
In pt with CAD what is the secondary level of HDLs
More than 40
What is the normal range for triglycerides
100 to 200
They are composed of three fatty acids and glycerol. Are stored in the adipose tissue and as a source of energy
Triglyceride levels are affected by what
They increase after meals and are affected by stress
Diabetes alcohol use and obesity can increase levels
What is BNP
Brain B type natriuretic peptide which helps regulate BP and fluid volume
It is primarily excreted from the ventricles in response to increased preload with resulting elevated ventricular pressure
The levels of BNP,in the blood increase as a result of,what
As the ventricular walls expand from increased pressure making it a helpful tool in diagnosing HF
What other conditions can elevated BNP levels result from
PE
MI
Ventricular hypertropthy
What is CRP
c reactive protein
It is a protein produced in the liver in response to systemic inflammation.
Ppl with high he CRP levels of 3 mg/ml or,higher are at risk for what
CVD
Homocysteine
An amino acid linked to the development of atherosclerosis because it can damage the lining of the endothelium lining of arteries and promote thrombus formation
An elevated level of what is linked to the development of what
CAD
STROKE
PVD
What are assoc with higher levels of homocysteine
Genetic factors
Diet low in folate, vit B12
How long must a pt fast before receiving a accurate serum measurement
12hour fasting
What are the test results for a homocysteine
Less than 12 optimal
12-15 borderline
Greater than 15 high risk
What is a chest X-ray useful for
To determine the size, contour, and position of the heart
It reveals cardiac calcification sand demonstrates physiologic changes in pulmonary circulation
Correct placement of pacemakers and pulmonary catheters are also confirmed
Fluoroscopy
An x Ray imaging technique that allows visualization of the heart on screen it shows cardiac and vascular pulsations and unusual cardiac contours it uses a movable X-ray source
What is a lead
A specific view of the electrical activity of the heart
The standard lead is composed of what
12 lead or 12 different views of the heart
BUN
10-20
Are end products of protein metabolism excreted by the kidneys
Elevated bun reflects reduced renal perfusion from decreased cardiac output or intravascular FVD
Ca
8.6- 10.2
Necessary for blood coagulability, neuromuscular activity, and automaticity of the nodal cells ( sinus and atrioventricular nodes)
What might a elevated BUN and normal creatinine indicate
Intravascular FVD
PTT
60-70s
Therapist of range for INR
2-3.5
Normal range of platelets
150,000- 450,000
HCT
Men. 42-52%
Woman. 35-47%
Represents the percentage of of RBC found in 100ml of whole blood
Low hbg and HCT levels indicate what
They have serious consequences for ppl with cardiovascular diseases, such as more frequent angina episodes or acute myocardial infarction
What meds inhibit platelet function
Aspirin, clopidogrel ( plavix), and intravenous glycoproteins IIb/ IIIa inhibitors, abciximab, eptifibatide, and tirofiban. Whe these meds are administered it is essential to monitor for Thrombocytopenia ( low platelet counts)
The CBC is carefully monitored in who
Ppl with cardiovascular disease
What is used to monitor the levels of anticoagulation with warfarin
PT
A 5 lead system provides how many different lead selections
7 unlike telemetry and hardwire cardic monitoring the 5 lead can monitor the activity of the anterior wall of the left ventricle
