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NURS 428: Evolution > Patient Assessment: Cardiovascular System > Flashcards

Patient Assessment: Cardiovascular System Flashcards

Exam 2

1
Q

Anatomy and Physiology:

What does the veins carry? What do arteries carry?

A

Vein= deoxygenated blood

Artery= oxygenated blood

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2
Q

Automaticity:

A

The ability of specialized cells in the heart known as pacemaker cells to spontaneously generate an action potential, thus causing depolarization.

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3
Q

Conductivity:

A

the ability of cardiac cells to conduct action potentials, thus transmitting the electrical signal from one cell to another.

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4
Q

Contractility:

A

the ability of cardiac muscle to shorten in response to depolarization.

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5
Q

Excitability:

A

the ability of cardiac tissue to respond to a stimulus and generate an action potential

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6
Q

Rhythmicity:

A

Rhythmicity: the ability of cardiac cells to spontaneously generate an action potential at a regular rate

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7
Q

What occurs during depolarization?

A

Contraction occurs

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8
Q

What occurs during repolarization?

A

relaxation of the heart muscle occurs

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9
Q

Ventricular repolarization:

A

relaxation of the ventricles. The cells become negatively charged.

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10
Q

Atrial depolarization

A

contraction of the atria

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11
Q

Cardiac output

A

amount of blood, in liters, ejected from the left ventricle each minute

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12
Q

Cardiac output formula:

A

CO = Stroke volume (L/beat) x Heart Rate (beats/min)

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13
Q

Stroke Volume

A

The amount of blood pumped in one heart beat.

*—volume of blood ejected per ventricular contraction

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14
Q

Heart Rate

A

Number of beats a minute (beats/min)

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15
Q

An increase in either stroke volume or heart rate will result in what?

A

An increase in cardiac output

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16
Q

What is end diastolic volume?

A

The volume of the blood in the heart after diastole or filling.

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17
Q

What is end systolic volume?

A

The volume of blood remaining in the ventricles after systole or contraction.

Ex; blood is filled with 100ml of blood at diastole. It then ejects 60mL of blood. What remains in the heart is 40mL. 40mL is the end systolic volume.

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18
Q

What is the formula for stroke volume?

A

EDV- ESV

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19
Q

What is stroke volume dependent on?

A

Contractility

Preload

Afterload

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20
Q

What is the normal CO for an adult?

A

Normal CO for an adult ranges from 4 to 8 L/min.

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21
Q

What is cardiac index (CI):

A

accounts for body size;

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22
Q

What is the ranges for cardiac index (CI):

A

ranges from 2.8 to 4.2 L/min/m2

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23
Q

What is the formula for cardiac index:

A

CI = CO (L/min)/ body surface (m^2)

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24
Q

What is the most common symptom of cardiovascular disease?

A

Chest pain

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25
Q

When taking a history, what do you need to ask the patient about?

A

Chief complaint and history of present illness

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26
Q

History:

Chief complaint and history of present illness:

What does this include?

A

Chest pain

Dyspnea

Edema of the feet and ankles

Palpitations and syncope or dizziness

Cough and hemoptysis

Nocturia

Cyanosis

Extremity pain or paresthesias

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27
Q

History:

Chief complaint and history of present illness:

What is the most common symptoms of cardiovascular disease (CVD)?

A

Chest pain

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28
Q

History:

Chief complaint and history of present illness:

Chest pain: What should be determined about it?

A

Determine if pain is cardiac in origin

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29
Q

History:

Chief complaint and history of present illness:

Chest pain: OPQRST

A

Onset,

Precipitating/Palliative factors,

Quality/Quantity,

Region/Radiation,

Severity,

Time

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30
Q

History:

Chief complaint and history of present illness:

Dyspnea: how?

A

Exertional, at rest, lying flat

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31
Q

History:

Chief complaint and history of present illness:

Edema of the feet and ankles: What to ask?

A

Dependent, timing and duration

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32
Q

History:

Chief complaint and history of present illness:

Edema of the feet and ankles: Dependent, timing and duration

What does dependent edema mean?

A

positional and based on gravity.

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33
Q

History:

Chief complaint and history of present illness:

Palpitations and syncope or dizziness: What to ask?

A

Onset and duration

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34
Q

History:

Chief complaint and history of present illness:

Cough and hemoptysis: What to ask about it?

A

Quality and frequency;

blood streaked,

frothy,

frank

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35
Q

History:

Chief complaint and history of present illness:

Nocturia: What to ask about it?

A

Frequency of urination at night

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36
Q

History:

Chief complaint and history of present illness:

Cyanosis: What to ask about it?

A

Central or peripheral

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37
Q

History:

Chief complaint and history of present illness:

Extremity pain or paresthesias: What to ask about it?

A

Severity, frequency, at rest, with exercise

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38
Q

Past Health History

A

Childhood illnesses and other previous illnesses

Past surgeries

Previous diagnostic tests and interventions

Medications

Allergies

Transfusions

Family history

Personal and social history

Review of other systems

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39
Q

Past Health History

Family history: What to ask?

A

Age and cause of death of immediate family members

Presence of cardiovascular problems

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40
Q

Past Health History

Personal and social history: What to ask?

A

Smoking, drinking, occupation

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41
Q

Past Health History

Review of other systems: What to ask?

A

Total health status;

impact of CVD on the function of other body symptoms

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42
Q

Physical Examination

A

Inspection

Palpation

Percussion

Auscultation

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43
Q

Physical Examination:

What are you Inspecting?

A

General appearance

Jugular venous distention

Chest

Extremities

Skin

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44
Q

Physical Examination:

What are you Palpating?

A

Pulses

Precordium

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45
Q

Physical Examination:

What are you Percussing?

A

Cardiac size

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46
Q

Physical Examination:

What does jugular vein distention indicate?

A

indicates back up of blood in the superior vena cava or the heart itself and is a common symptom of heart failure.

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47
Q

Physical Examination:

Auscultation: What are the heart sounds to be heard?

A

First heart sound (S1)

Second heart sound (S2)

Third heart sound

Fourth heart sound

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48
Q

Physical Examination:

Auscultation: First heart sound (S1)

What does it indicate?

A

Closure of the mitral and tricuspid valves

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49
Q

Physical Examination:

Auscultation: First heart sound (S1)

What is it?

A

Beginning of systole

“LUB”

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50
Q

Physical Examination:

Auscultation: Second heart sound (S2)

What does is it indicate?

A

Closure of aortic and pulmonic valves

“DUB”

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51
Q

Physical Examination:

Auscultation: Second heart sound (S2)

What is it?

A

Beginning of diastole

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52
Q

Physical Examination:

Auscultation: Third heart sound

Who is it in?

A

Normal finding in children and young healthy adults

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53
Q

Physical Examination:

Auscultation: Fourth heart sound

When is it heard?

A

Heard late in diastole just before S1

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54
Q

Physical Examination:

Auscultation: Fourth heart sound

What does it indicate?

A

Blood being forced into a noncompliant ventricle

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55
Q

Auscultation (cont.):

Summation gallop: What is it?

A

Fusion of S3 and S4

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56
Q

Auscultation (cont.)

Heart murmurs: What are the types?

A

Systolic murmurs

Diastolic murmurs

Friction rubs

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57
Q

Auscultation (cont.)

Heart murmurs:

Systolic murmurs: What does this represent?

A

Mitral regurgitation/aortic stenosis

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58
Q

Auscultation (cont.)

Heart murmurs:

Diastolic murmurs: What does this represent?

A

Mitral stenosis/aortic regurgitation

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59
Q

Auscultation (cont.)

Heart murmurs:

Friction rubs: What does this represent?

A

Inflamed pericardium

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60
Q

Auscultation (cont.)

Heart murmurs:

Friction rubs: How to listen for it?

A

Use bell of stethoscope at the apex of the heart to hear summation of gallop

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61
Q

Cardiac Laboratory Studies include?

A

Hematologic studies

Coagulation studies

Blood chemistries

Common electrolytes

Other blood chemistries

Serum lipid studies

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62
Q

Enzyme Studies include:

A

Creatinine kinase -

Biochemical markers:

Neurohumoral hormones:

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63
Q

Enzyme Studies:

Creatinine Kinase

A

Found in heart muscle

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64
Q

Enzyme Studies:

Biochemical markers: broadly, what are they?

A

myocardial proteins

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65
Q

Biochemical markers:

Biochemical markers: What do they include?

A

Troponin-I,

troponin-T,

troponin-C

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66
Q

Biochemical markers:

Biochemical markers: When is it detectable?

A

Detectable in blood 2–3 hours after MI damage and remains high up to 6 days

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67
Q

Biochemical markers:

Neurohumoral hormones:

A

brain-type natriuretic peptide

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68
Q

Biochemical markers:

Neurohumoral hormones: What do these values do?

A

Evaluates heart failure

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69
Q

Coagulation and Electrolytes:

Coagulation measurements include?

A

Platelet

Prothrombin time

Partial thromboplastin time

Activated partial thromboplastin time

Activated clotting time

Fibrinogen level

Thrombin time

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70
Q

Coagulation and Electrolytes:

Serum electrolytes include?

A

Sodium

Potassium

Chloride

Magnesium

Calcium

Phosphorus

Carbon dioxide

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71
Q

Cardiac Diagnostic Studies include:

A

Standard 12-lead electrocardiogram

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72
Q

Cardiac Diagnostic Studies:

Standard 12-lead electrocardiogram: What does it record?

A

Records electrical impulses traveling through the heart

73
Q

Cardiac Diagnostic Studies:

Standard 12-lead electrocardiogram: What does it detect?

A

Detects abnormal conduction

74
Q

Cardiac Diagnostic Studies:

Standard 12-lead electrocardiogram: What does it identify?

A

Identifies dysrhythmia

75
Q

Cardiac Diagnostic Studies:

Standard 12-lead electrocardiogram: What does it detect?

A

Detects left ventricular enlargement

76
Q

Cardiac Diagnostic Studies:

Standard 12-lead electrocardiogram: What is it diagnostic for?

A

Diagnostic for acute MI

77
Q

If some one is complaining of cardiac issues, what is the first thing to complete?

A

EKG is important to complete as the first thing if someone is complaining about cardiac issues.

78
Q

Nursing Assessment and Management: What do you do?

A

Obtain ECG

79
Q

Nursing Assessment and Management: When is an ECG done?

A

Change in patient’s status

Chest pain

 -Before and after sublingual nitroglycerin

Explain procedure to the patient.

80
Q

Cardiac Catheterization, Coronary Angiography, and Coronary Intervention:

What is the procedure?

A

Contrast is injected into heart chambers and coronary arteries under flouroscopic guidance.

81
Q

Gold standard for evaluating coronary artery lumen?

A
82
Q

Cardiac Catheterization, Coronary Angiography, and Coronary Intervention

Left heart catheterization

A

Evaluates aorta, coronary arteries, aortic and mitral valve and wall motion of left ventricle

83
Q

Cardiac Catheterization, Coronary Angiography, and Coronary Intervention

Right heart catheterization

A

Evaluates right heart pressures, pulmonic valve and pulmonary artery pressures

84
Q

Electrocardiogram includes:

A

P wave

P R interval

P R segment

Q R S complex

Q R S interval

T wave

Q T interval

85
Q

Waveforms and Intervals

P wave:

A

Depolarization of the atria

86
Q

Waveforms and Intervals

PR interval:

A

Onset of atrial depolarization to the onset of ventricular depolarization

87
Q

Waveforms and Intervals

QRS complex:

A

Ventricular depolarization

88
Q

Waveforms and Intervals

ST segment:

A

The time from the end of ventricular depolarization to the beginning of ventricular repolarization

89
Q

Waveforms and Intervals

T wave:

A

Ventricular repolarization or recovery

90
Q

Waveforms and Intervals

U wave: When is it rarely and commonly seen?

A

Rarely seen, small positive deflection after T wave

Typically seen with hypokalemia

91
Q

Waveforms and Intervals

QT interval

A

Varies with heart rate

Need table to calculate

92
Q

Evaluation of Rhythm Strip: What do you need?

A

Electrocardiogram paper

93
Q

Evaluation of Rhythm Strip: How far apart are lines?

A

Horizontal and vertical lines 1 mm apart

94
Q

Evaluation of Rhythm Strip: How big are squares?

A

Each horizontal small square is equal to 0.04 seconds.

95
Q

Evaluation of Rhythm Strip: How big are large squares?

A

Each large square (5 small squares) is 0.2 seconds.

96
Q

Evaluation of Rhythm Strip: Distance between two vertical markings?

A

The distance between two vertical markings is 3 seconds.

97
Q

Calculation of Heart Rate- how?

A

Count the number of QRS complexes in 6-second strip × 10.

98
Q

Calculation of Heart Rate

With a regular rhythm: How to estimate ventricular heart rate?

A

The ventricular heart rate is estimated by dividing 300 by the number of large boxes on the ECG paper between two R waves.

99
Q

Calculation of Heart Rate

With a regular rhythm: How to estimate atrial heart rate?

A

The atrial rate is calculated by dividing 300 by the number of large boxes on ECG paper between two P waves (the PP interval) or 1500 by the number of small boxes between two P waves.

100
Q

Dysrhythmias Originating at the Sinus Node

A

Sinus tachycardia

Sinus bradycardia

Sinus dysrhythmia

Sinus arrest and sinoatrial block

Sick sinus syndrome

101
Q

Dysrhythmias Originating at the Sinus Node

Sinus Tachycardia: What drugs can cause this?

A

Drugs, such as atropine, which block vagal tone, and the catecholamines (e.g., epinephrine and dopamine) also can produce this rhythm.

102
Q

Dysrhythmias Originating at the Sinus Node

Sinus Tachycardia: Describe it

A

the sinus node accelerates and initiates an impulse at a rate of 100 times per minute or more

103
Q

Dysrhythmias Originating at the Sinus Node:

Sinus Tachycardia: What may cause it?

A

It may be caused by fever, stress, exercise, caffeine, hypoxia, or dehydration

104
Q

Dysrhythmias Originating at the Sinus Node:

Sinus Tachycardia: What is treatment?

A

Treatment is to eliminate the underlying cause.

Administer oxygen, diuretics if heart failure is present, and antibiotics for fever or infection; give lactated ringers bolus to treat dehydration

Treatment of sinus tachycardia is usually directed at eliminating the underlying cause. Specific measures may include sedation, oxygen administration, digitalis, and diuretics if heart failure is present, or beta-blockers if the tachycardia is caused by thyrotoxicosis.

105
Q

Dysrhythmias Originating at the Sinus Node:

Sinus Bradycardia: Describe it?

A

Sinus bradycardia is defined as a rhythm with impulses originating at the sinus node at a rate of less than 60 beats/min

The rhythm (RR interval) is regular, and all other parameters are normal.

106
Q

Dysrhythmias Originating at the Sinus Node:

Sinus Bradycardia: What is the cause?

A

It may be associated with sleep or severe pain.

107
Q

Dysrhythmias Originating at the Sinus Node:

Sinus Bradycardia: What are symptoms?

A

Symptoms- Dizziness, syncope, SOB, confusion, diaphoresis, hypotension, anginal pain.

108
Q

Dysrhythmias Originating at the Sinus Node:

Sinus Bradycardia: What is treatment?

A

Treatment: If the pulse is very slow and patient is symptomatic, give Atropine to increase the heart rate.

109
Q

Dysrhythmias Originating at the Sinus Node:

Sinus Bradycardia: Atropine is given for slow heart rate; if you give atropine and heart doesn’t speed up, what do you do?

A

You may need to put in a pacemaker

110
Q

Dysrhythmias Originating at the Sinus Node

Sinoatrial Block: When is treatment done?

A

Treatment is indicated if the patient is symptomatic.

111
Q

Dysrhythmias Originating at the Sinus Node

Sinoatrial Block: What is the goal of treatment? What is treatment?

A

The goal is to increase the ventricular rate, which may require the use of atropine or, in the presence of serious hemodynamic compromise, a pacemaker.

112
Q

Dysrhythmias Originating at the Sinus Node

Sick Sinus Syndrome: What is it?

A

Sick sinus syndrome is a form of chronic node disease.

113
Q

Dysrhythmias Originating at the Sinus Node

Sick Sinus Syndrome: What does management include?

A

Management includes control of the rapid atrial dysrhythmias and control of slow heart rates with a permanent pacemaker.

114
Q

Atrial Dysrhythmias include:

A

Premature atrial contraction

Paroxysmal supraventricular tachycardia

Atrial flutter

Atrial fibrillation

Multifocal atrial tachycardia

115
Q

Atrial Dysrhythmias include:

Premature Atrial Contractions (PACs): What are causes?

A

Causes of PAC include hypoxia, excessive stimulant ingestion, infections, digoxin toxicity, and coronary artery disease.

116
Q

Atrial Dysrhythmias include:

Premature Atrial Contractions (PACs): What is the treatment?

A

No treatment is necessary in most cases.

Continue to monitor patient.

117
Q

Atrial Dysrhythmias include:

Paroxysmal Supraventricular Tachycardia: What is it?

A

PSVT involves rapid stimulation of the atrial tissue to 150 – 250 beats/min.

118
Q

Atrial Dysrhythmias include:

Paroxysmal Supraventricular Tachycardia: What are causes?

A

Causes are the same as PACs

119
Q

Atrial Dysrhythmias include:

Paroxysmal Supraventricular Tachycardia: What is the treatment?

A

Administer IV Adenosine to decrease the heart rate if vagal nerve stimulation is unsuccessful in terminating the PSVT.

120
Q

Atrial Dysrhythmias include:

Atrial flutter: What is it?

A

Abrupt onset in which the atria fires at 250-350 beats/min.

121
Q

Atrial Dysrhythmias include:

Atrial flutter: What is the goal of treatment?

A

The treatment goal is to return to sinus rhythm.

122
Q

Atrial Dysrhythmias include:

Atrial flutter: What is done to treat this?

A

Give Cardizem, Amiodarone.

Synchronized cardioversion is especially useful in the prompt treatment of atrial flutter.

123
Q

Atrial Dysrhythmias include:

Atrial Fibrillation: What is it?

A

Common in clinical settings.

Atrial fibrillation has the absence of definable P waves.

124
Q

Atrial Dysrhythmias include:

Atrial Fibrillation: What is the goal of treatment?

A

The treatment goal is to return to sinus rhythm.

125
Q

Atrial Dysrhythmias include:

Atrial Fibrillation: What is treatment?

A

Anticoagulants should be given to those at risk for emboli if prescribed.

If drug therapy fails, cardioversion is indicated for rhythm control.

126
Q

Atrial Dysrhythmias include:

Multifocal Atrial Tachycardia: What is it?

A

Rapid atrial rhythm with varying p-waves

The atrial rate exceeds 100 beats/min, and the rhythm is usually irregular. Seen in patients with severe pulmonary disease.

127
Q

Atrial Dysrhythmias include:

Multifocal Atrial Tachycardia: What is treatment?

A

Treat the pulmonary disease.

128
Q

Junctional Dysrhythmias:

What does this include:

A

Junctional Rhythm

Premature junctional contraction:

129
Q

Junctional Dysrhythmias:

Junctional rhythm: What is it?

A

a rhythm originating in the AV node.

When the SA node fails to fire, the AV node usually takes control, but the rate is slower.

130
Q

Junctional Dysrhythmias:

Junctional rhythm: What are the different types?

A
  1. A junctional rhythm in which the inverted P wave appears before a normal QRS complex.
  2. A junctional rhythm in which the inverted P wave is buried inside the QRS complex.
  3. A junctional rhythm in which the inverted P wave follows the QRS complex.
131
Q

Junctional Dysrhythmias:

Premature junctional contraction: What is it?

A

is an ectopic impulse from a focus in the AV junction, that occurs prematurely before the next sinus impulse.

132
Q

Junctional Dysrhythmias:

Premature junctional contraction: What are the symptoms?

A

Although usually asymptomatic, patients may experience a “skipped beat.”

133
Q

Junctional Dysrhythmias:

Premature junctional contraction: What is treatment?

A

Treatment for PJCs is not necessary.

134
Q

Ventricular Dysrhythmias include:

A

Premature ventricular contractions

Ventricular tachycardia

Torsades de pointes

Ventricular fibrillation

Accelerated idioventricular rhythm

135
Q

Ventricular Dysrhythmias include:

Premature Ventricular Contractions (PVCs): What is it?

A

A PVC is an ectopic beat originating prematurely at the level of the ventricles

A compensatory pause often follows the premature beat as the heart awaits the next stimulus from the sinus node.

136
Q

Ventricular Dysrhythmias include:

Premature Ventricular Contractions (PVCs):

Where does this beat originate? What is the result of this?

A

The beat is ventricular in origin and results in no electrical activity in the atria. As a result, no P waves appear.

137
Q

Ventricular Dysrhythmias include:

Premature Ventricular Contractions (PVCs): Describe it?

A

a wide QRS complex with a T wave that is opposite in direction to the QRS complex.

A compensatory pause often follows the premature beat as the heart awaits the next stimulus from the sinus node.

138
Q

Ventricular Dysrhythmias include:

Premature Ventricular Contractions (PVCs):
Ventricular Bigeminy: What is it?

A

(Every other beat is a PVC.)

139
Q

Ventricular Dysrhythmias include:

Premature Ventricular Contractions (PVCs):
Multiformed/Multifocal PVCs: What is it?

A

PVCs with 2 or more shapes (they are shaped differently)

140
Q

Ventricular Dysrhythmias include:

Premature Ventricular Contractions (PVCs):
Couplet: What is it?

A

(two PVCs in a row)

140
Q

Ventricular Dysrhythmias include:

Premature Ventricular Contractions (PVCs):
Triplet: What is it?

A

(Three PVCs in a row; a short run of VT

141
Q

Ventricular Dysrhythmias include:

Ventricular Tachycardia: What is it? Describe it?

A

VT is recognized by wide, bizarre QRS complexes occurring in a fairly regular rhythm at a rate greater than 100 beats/min

P waves are not usually seen and, if seen, are not related to the QRS complex.

VT may be a short, nonsustained rhythm or longer and sustained.

142
Q

Ventricular Dysrhythmias include:

Ventricular Tachycardia: What rate usually?

A

Ventricular Tachycardia (V-Tach) occurs usually at a rate greater than 100 beats/min.

143
Q

Ventricular Dysrhythmias include:

Ventricular Tachycardia: How is it defined?

A

It is defined as three or more PVCs)in a row.

144
Q

Ventricular Dysrhythmias include:

Ventricular Tachycardia: it is life threatening, why?

A

VT can be a life-threatening dysrhythmia as a result of the significant reduction in CO that can occur.

145
Q

Ventricular Dysrhythmias include:

Ventricular Tachycardia: What is treatment if patient is hemodynamically stable?

A

Treatments include administering Amiodarone or Lidocaine for ventricular tachycardia in hemodynamically stable patients.

146
Q

Ventricular Dysrhythmias include:

Ventricular Tachycardia: If patient becomes unstable, what is done?

A

If the patient becomes unstable, synchronized cardioversion is indicated

147
Q

Ventricular Dysrhythmias include:

Torsades De Pointes (”twisting of the points”) : What is it? What is present?

A

– is a specific type of ventricular tachycardia. A long QT interval is present.

148
Q

Ventricular Dysrhythmias include:

Torsades De Pointes (”twisting of the points”) : What is the rate?

A

The rate of tachycardia is 100 to 180 beats/min but can be as fast as 200 to 300 beats/min.

149
Q

Ventricular Dysrhythmias include:

Torsades De Pointes (”twisting of the points”) : What can cause this?

A

Hypokalemia, hypomagnesemia, and hypocalcemia can precipitate Torsades de Pointes

150
Q

Ventricular Dysrhythmias include:

Torsades De Pointes (”twisting of the points”) : What is treatment?

A

Treat Torsades de pointes with magnesium sulfate.

151
Q

Ventricular Dysrhythmias:

Ventricular Fibrillation: What does it indicate?

A

V-fib indicates CAD.

152
Q

Ventricular Dysrhythmias:

Ventricular Fibrillation: What are symptoms?

A

Loss of consciousness occurs within seconds, with no pulse and no cardiac output.

153
Q

Ventricular Dysrhythmias:

Ventricular Fibrillation: What is management?

A

Management includes CPR and defibrillation

154
Q

Ventricular Dysrhythmias:

Accelerated Idioventricular Rhythm: what is the rate?

A

AIVR occurs at 50-100beats/min

155
Q

Ventricular Dysrhythmias:

Accelerated Idioventricular Rhythm: What are the symptoms?

A

Patients are not usually symptomatic.

156
Q

Ventricular Dysrhythmias:

Accelerated Idioventricular Rhythm: What is the treatment if hemodynamically unstable?

A

If the patient is hemodynamically compromised, the sinus rate is increased with atropine or atrial pacing to suppress the AIVR.

157
Q

Atrioventricular Blocks include:

A

First-degree atrioventricular block

Second-degree atrioventricular block—Mobitz I (Wenckebach)

Second-degree atrioventricular block—Mobitz II

Third-degree (complete) atrioventricular block

158
Q

Atrioventricular Blocks include:

First-Degree Heart Block: What is it?

A

The AV node is slow, prolonging the PR interval to greater than 0.20 seconds.

159
Q

Atrioventricular Blocks include:

First-Degree Heart Block: What causes it?

A

Digitalis, beta-blockers, calcium channel blockers, or CAD can cause it.

160
Q

Atrioventricular Blocks include:

First-Degree Heart Block: What is treatment?

A

Administer O2 as prescribed to accelerate the AV conduction.

161
Q

Atrioventricular Blocks include:

Second-Degree Heart Block: Mobitz Type I (Wenckenbach)- What is it?

A

It occurs above the Bundle of HIS.

There is progressive prolongation of the PR interval followed by a dropped beat (missing QRS complex) and a pause.

162
Q

Atrioventricular Blocks include:

Second-Degree Heart Block: Mobitz Type I (Wenckenbach)- What is it caused by?

A

It can be caused by digitalis, myocarditis, or inferior wall MI.

163
Q

Atrioventricular Blocks include:

Second-Degree Heart Block: Mobitz Type I (Wenckenbach)- What is treatment?

A

Discontinue the offending drug.

164
Q

Atrioventricular Blocks include:

Second-Degree Heart Block: Mobitz Type II:
What is it? How does it compare to Type I?

A

Is usually in or below the bundle of HIS. It is more dangerous that Mobitz I.

165
Q

Atrioventricular Blocks include:

Second-Degree Heart Block: Mobitz Type II:

What is treatment?

A

Immediately notify the provider and monitor for progression to third degree heart block.

Atropine and a permanent pacemaker may be required.

166
Q

Atrioventricular Blocks include:

Third-Degree Heart Block: What is it?

A

Third-degree or complete heart block. None of the sinus impulses conduct to the ventricles.

167
Q

Atrioventricular Blocks include:

Third-Degree Heart Block: How does it appear on EKG?

A

P waves and QRS are both present, but there is no relationship between the two.

168
Q

Atrioventricular Blocks include:

Third-Degree Heart Block: What are the causes?

A

Causes are the same as others.

The patient may be symptomatic due to low CO.

169
Q

Atrioventricular Blocks include:

Third-Degree Heart Block: What is treatment?

A

A temporary pacemaker is usually needed immediately until the patient is stabilized for permanent pacemaker implantation.

170
Q

Electrolyte Abnormalities on ECG:

What does this include?

A

Hyperkalemia

Hypokalemia

Hypercalcemia

Hypocalcemia

171
Q

Electrolyte Abnormalities on ECG:

Hyperkalemia: How does it appear?

A

Tall, narrow, peaked T waves

172
Q

Electrolyte Abnormalities on ECG:

Hypokalemia: How does it appear?

A

U waves

173
Q

Electrolyte Abnormalities on ECG:

Hypercalcemia: How does it appear?

A

Shortened QT interval

174
Q

Electrolyte Abnormalities on ECG:

Hypocalcemia: How does it appear?

A

Prolonged QT interval

175
Q

Hemodynamic Monitoring: How is it done?

A

Arterial,

central venous, and

pulmonary artery catheters

176
Q

Hemodynamic Monitoring: What does it evaluate?

A

Evaluates intracardiac and intravascular volume, pressures, and cardiac function

Evaluates patients’ response

177
Q

Hemodynamic Monitoring: What does it aid in?

A

Aids in diagnosis of CV disorders

Guides therapy

178
Q

Hemodynamic Monitoring: What kind of patients are candidates for hemodynamic monitoring?

A

Patients in cardiogenic shock, severe HF, septic shock, MSOD, ARDS are candidates for hemodynamic monitoring

NURS 428: Evolution (17 decks)

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