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NSER 7210 > Module 3 > Flashcards

Module 3 Flashcards

1
Q

ACS management

A 
ASA
Clopidigrel
Heparin
Nitroglycerin
IV opiods
TNK
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2
Q

ASA/Clopidogrel

A

Antiplatelet ( stops aggregation)

Stops the clot from getting bigger

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3
Q

Heparin

A

Anticoagulation
Works on Thrombin (which acts like plastic wrap)
stops thrombin from sticking to platelets

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4
Q

Nitroglycerin

A

Reduces preload and afterload
DO NOT GIVE TO RT SIDED (Inferior) MI
because it drops the preload

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5
Q

IV opiods

A

decrease preload and stop SNS activations

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6
Q

TNK

A

fibrinolytic

clot buster

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7
Q

NSTEMI

A

ischemia/tissue damage but not death

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8
Q

STEMI

A

STevelvation MI- cell death/Infarct

Needs- fibrinolytic, PCI and maybe Defib

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9
Q

Key features of successful thrombolysis

A

Resolution of CP
Resolution of ST-segment elevations
Reperfusion arrhythmias

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10
Q

Cardiogenic shock

A

Pump problem

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11
Q

Causes of cardiogenic shock

A 
MI
coronary artery dissection
chest trauma
Infection ( pericarditis)
tamponade
arrhythmia
pharmacological OD
Mechanical valve
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12
Q

Cardiogenic shock symptoms

A

CP

Decreased cardiac output
decreased BP
Decreased LOC
Cool extremities
decreased urinary output

Pulmonary edema
Pulmonary crackles
Increased JVD

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13
Q

cardiogenic shock- Preload

A

INCREASED
compensation/consequence

Treatment:
Vasodilation- Nitro,
Diuretics- lasix
Opiods-morphine

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14
Q

cardiogenic shock- Afterload

A

INCREASED- increased SVR
this is compensation- the body feels the decreased cardiac output so it constructs vessels causing an increase in afterload

Treatment: Vasodilation- Nitroglycerine or Nitroprusside

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15
Q

cardiogenic shock- Contractility

A

DECREASES
This is the cause of cardiogenic shock

Treatment:
Increase contractility with positive inoptropes
Dobutamine, Milinone and Dopamine

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16
Q

cardiogenic shock- HR

A

INCREASED
this is compensation for decreased cardiac output

Treatment if needed - negative inotropes to decrease cardiac oxygen demand

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17
Q

Cardiogenic shock- Cardiac output

A

DECREASES
as a consequence

treatment: Intra aortic balloon pump

18
Q

ST segment

A 
reploarization of teh ventricles
J point (measure 1.5 boxes over) to T wave
19
Q

PR

A

< 0.2 seconds

20
Q

Brady rhythms

A

> 50 bpm

decreased cardiac output

21
Q

Pacemakers

A

SA node
AV node
Ventricles

22
Q

SA node rate

A

60-100

AV node

23
Q

AV node rate

A

40 -60

24
Q

Ventricular rate

A

20-40

25
Q

Ventricular rate

A

20-40

26
Q

Things that slow the heart

A

Beta blockers
Vagus nerve
MI
hypoxia

27
Q

Symptoms of brady cardia

A 
Heart failure symptoms
Decreased LOC
hypotension/poor perfusion
CP
weakness/fatigue
28
Q

Why do we give EPI

A

Alpha 1- vasoconstriction
Beta1- contractility
Beat 2 Bronchodilation

29
Q

EPI dose

A

1mg Q 3-5 mins IV

30
Q

Drug for brady rhythms

A

Atropine

31
Q

Atropine

A 
anticholinergic
stops parasympathetic
stops vagus nerve
only works at atria
0.5-1mg Q3-5 mins ( max 3 mg)
32
Q

Hs

A 
Hypothermis
Hypoxia
Hydrogen
Hypo/Hyperkalemia
Hypovolemia
33
Q

Ts

A 
Tension pneumo
Tamponade
Toxins
Thrombosis (pulm)
Thrombosis (cardiac)
34
Q

Reasons for PEA

A

No mechanical activity caused by

hypoxia- heart can contract
Hypovolemia- no preload

35
Q

unstable tachycardia symptoms

A

CP >20 mins
SOB or new or worsening CHF
Low BP
Signs of shock

36
Q

Synchronized cardioversion

A

For persistent unstable tachyarrhythmia

Shock on R
Consider sedation

37
Q

Adenosine

A

Pauses conduction through the AV node
Only treats irritability/reentry near the AV node (party close to the border)
Does not work on Atrial irritability (doesn’t treat afib or flutter)

38
Q

Antiarrhythmics

A

Procainamide (works on Na/CL)

Amioodarone (works on all channels)

39
Q

1st 4 steps in a PEA arrest

A

CPR while putting pads on/monitor
rhythm check asap (if its shockable we need to know so we can intervene asap)
CPR x 2 mins- give epi 1mg while doing CPR
Rhythm check
CPRx2mins

40
Q

ROSC - what to do next

A

Airway- intubate
Breathing-oxygenate
Circulation- BP low (pt has no vascular tone) give fluid bolus 1-2. start vasopressors. ECG
Differential diagnosis. labs, cath lab, SX, CXR
Disability (34-36 C) targeted temperature management

Keep afebrile x24h b/c we want to decrease O2 demand
aggressive
ROC infusion

NSER 7210 (8 decks)

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