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Perfusion Flashcards

1
Q

cardiac assessment

A

family history/modifiable risk factors
heart tones
vitals
cerebral perfusion (orientation, movement, sensation, speech)
lung sounds
pulses
skin (temp, color, edema)
cap refill (<2 seconds)
pain?

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2
Q

Cardiac diagnostics

A

labs: troponin (10-12 days), CK-MB (1-2 days), C-reactive protein
ECG/EKG
ECHO
CTA
Stress Test

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3
Q

Cardiac Interventions

A

thrombolytics
cardiac catheterization or coronary angiogram
surgery

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4
Q

3 types of CMP (Central-Cardiomyopathy)

A

Dilated
Hypertrophic
Restrictive

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5
Q

Dilated CMP (Central Cardiomyopathy)

A

enlargement of atria or ventricle (not enlargement of the muscle), muscle stretched out and thin so increased preload can take more blood but can’t pump it out

s/s: fatigue, dyspnea, cough, dysrhythmia/palpitations, N/V, murmur, crackles, edema, abnormal S3 and S4

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6
Q

Hypertrophic CMP (Central Cardiomyopathy)

A

enlargement of left ventricle wall muscle becomes stiff and decreases ventricle size, restricted pumping ability

most common in active young adults

s/s: asymptomatic, dyspnea, fatigue, angina, syncope

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7
Q

Restrictive CMP (Central Cardiomyopathy)

A

impairment of diastolic filling and stretch (stiff ventricle wall)

s/s: fatigue, dyspnea, angina, syncope, palpitations

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8
Q

Heart Failure

A

Central

The heart can not pump (systolic) or fill (diastolic) adequately

types: systolic vs diastolic, left vs right, acute vs chronic

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9
Q

Left HF

A

Central

casues: filling/pumping issues- HTN, anemia, infection, hormone imbalance, dysrhythmias, bacterial endocarditis, OSA, PE, hypervolemia, nutritional deficiencies

s/s: Pulmonary- tachy, crackles, S3 and S4 sounds, pleural effusion, changes in cognition, weakness/fatigue, mood disorders, dyspnea, paroxysmal noctural dyspneak/orthopnea, dry cough

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10
Q

Right HF

A

Central

causes: Left HF, RV infarct, PE, cor pulmonale

s/s: Systemic- murmurs, JVD, edema, weight gain, tachy, ascites, ansarca, heptomegaly, fatigue, mood disorders, anorexia/nausea/GI bloating

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11
Q

HF complications

A

plueral effusion (fluid sits around the lungs), dysrhythmias, LV thrombus, hepatomegaly (enlargement of liver), renal failure (from failure of perfusion)

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12
Q

HF diagnostics

A

labs, CXR, 12 lead ECG, echo, nuclear imaging studies, cardiac cath

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13
Q

HF Nursing interventions

A

treat underlying cause
drug therapy
sodium/fluid restrictions
procedures/surgeries: pace maker/defibrillator, LVAD, heart transplant
respiratory support
monitoring (vitals, I/O, weight)

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14
Q

Endocaraditis (IE/Infective Endocarditis)

A

Central

infection of the inner most layer of the heart (endocardium) and valves

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15
Q

IE risk factors

A

valve disease (prosthetics), heart lesions, IV drug use, intravascular devices

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16
Q

IE disease progression

A

bacteremia
adhesion
vegitation

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17
Q

IE complications

A

emboli & HF

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18
Q

IE clinical manifestations

A

symptoms of sepsis, possible murmur, possible symptoms of vascular blockages

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19
Q

IE diagnosis

A

blood cultures, labs - inflammation markers: ESR (Erythrocyte Sedimentation Rate) & CRP (C-reactive protein), echocardiogram (vegitation)

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20
Q

IE interprofessional treatment

A

prophylactic, medications (IV antibiotics, NOT ORAL), valve repair/replacement

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21
Q

Hypertension (HTN)

A

Local/Tissue

High B/P
Primary HTN = no known cause
Leads to decreased perfusion, CVD (MI, HF, Stroke, Renal disease)

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22
Q

HTN clinical manifestations

A

asymptomatic

fatigue, dizziness, palpiations, anginea, dyspnea

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23
Q

HTN complications

A

organ dysfunction

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24
Q

HTN diagnosis

A

B/P management

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25
Q

HTN treatment

A

lifestyle modifications
drug therapy

26
Q

HTN drug therapy stage 1

A

non-pharmacological management + one 1st line drug

27
Q

HTN drug therapy stage 2

A

non-pharmacological management + two 1st line drugs

28
Q

HTN 1st line drugs

A

thiazide diuretics
CCB
ACEI or ARB

29
Q

Pulmonary Hypertension

A

Central

high B/P in the arteries of the lungs

s/s: fatigue, dyspnea, exertional chest pain, dizziness, syncope, S3

management: drug therapy, surgery

30
Q

Abdominal Aortic Aneurysm (AAA)

A

Local

dilation of the vessel wall (arch, thoracic, or abdominal areas)

s/s:
thoracic: often asymptomatic until it bursts, possible chest pain & SOB
abdominal: often asymptomatic, possible pulsatile mass or bruits

31
Q

AAA care

A

monitoring
prevent rupture (decrease CVD risk factors, b/p management)
surgical repair

32
Q

AAA Rupture

A

= exsanguination

severe back pain and bruising leading to shock

treatment: immediate resuscitation and surgical intervention

post surgical interventions: maintain b/p, check perfusion (neuro, peripheral and renal), GI involvement, infection prevention

33
Q

2 Cardiac Diseases

A

Local

Coronary Artery Disease (CAD)

Acute Coronary Syndrome

34
Q

Coronary Artery Disease (CAD)

A

Local

hardening of arteries in the heart due to fat deposits

asymptomatic or have Chronic Unsable Angina

Care: antilipidemic, antiplatelet (NOT ANTICOAGULANT), B/P meds, lifestyle changes

35
Q

Chronic Stable Angina (CSA)

A

chest pain comes and goes, intermitant, caused by certain things, same duration, same intesity, gets better with rest (but not changing position)

PQRST

care: meds

vs Unstable Angina

increased demand for bloodflow, plaque forms, vessel is unable to dilate enough to allow adequate blood flow to meet the myocardial demand

36
Q

Acute Coronary Syndrome (ACS)

A

Unstable Angina or MI

STEMI or NSTEMI

s/s: pain, diaphoresis, tachy, elevated B/P, vasoconstriction, distant heart tones, N/V, fever

care: MONA (morphine, oxygen, nitro, asprin), meds, intervention

complications: dysrhythmias & HF

37
Q

Unstable angina

A

the plaque ruptures and a thrombus forms around the ruptured plaque, causing partial occlusion of the vessel, angina pain occurs at rest or progesses rapidly over a short period of time, sudden, lasts much longer

normal troponin

normal waves, inverted T waves, or ST depression

38
Q

NSTEMI

A

the plaque rupture and thrombus formation causes partial occlusion to the vessel that results in injury and infarct to the subendocardial myocardium

elevated troponin

normal waves, inverted T waves, or ST depression

39
Q

STEMI

A

total blockage

elevated troponin

hyperacute T waves or ST elevation

40
Q

Peripheral Artery Disease (PAD)

A

Local

slow progression

s/s: intermittent claudication, burning, heaviness, pressure, soreness, tightness, weakness, paresthesia, skin is thin and shiny and taught, loss of hair, pallor vs redness, decreased to absent pulses

diagnostics: BP & ankle-brachial index

complications: delayed wound healing

treatment: CVD risk factor modification, meds, foot care, surgery

41
Q

Venous Thrombosis

A

Local

blood clot

42
Q

Venous Thromboembolism (VTE)

A

Local

Superficial: firm vein, itchy, painful, red and warm, edema, varicose veins, temp and WBC elevation. U/S. NSAIDs & anticoagulants

Deep Vein Thrombosis (DVT): edema, pain, tenderness, fullness, paresthesia, erythema, temp & CBC elevation. Labs, duplex U/S, CT, MRI

Pulmonary Embolism (PE): CP w/breathing, lightheadedness, palpitations, tachy, sob, dry cough, fever. Labs, CTA, VQ scan

43
Q

DVT and PE treatment

A

anticoagulants
thrombolytics
thrombectomy
IVC filter
ambulation

44
Q

Foundational issues

A

the Engineer/Cardiologist

Central and Local

cardiomyopathy (dilated, hypertrophic, restrictive) & HTN

45
Q

Vascular issues

A

the Plumber/Interventional Cardiologist (coronary arteries)

Local

Acute Coronary Syndrome (ACS) (group of conditions when blood flow to the heart is suddenly reduced or blocked, STEMI or NSTEMI)

46
Q

Electrical issues

A

the Electrician/Electrophysiology Cardiologist

Central

dysrhythmias

47
Q

Structural issues

A

the Carpenter/Structural Heart Team

Central & Local

valve issues and aneurysms

48
Q

Blood flow map from body

A

Body
SVC
RA
Tricuspid valve
RV
Pulmonic valve
Pulmonic artery (the only artery carying deoxygenated blood)
Lungs
Pulmonary vein
LA
Bicuspid valve
LV
Aortic valve
Aorta
Body

49
Q

If there is a decrease in cardiac output it is a ______ perfusion issue

50
Q

cardiomyopathy is the decrease in the ___________ of muscle which leads to ________

A

decrease in the contractillity

leads to decreased cardiac output

a central issue, leads to HF

51
Q

High BP is diagnosed by taking BP _____ times on _______

A

take BP two or more times on both arms on two different occassions

52
Q

elevated BP

A

120-129/<80

53
Q

stage 1 HTN

A

130-139/80-89

54
Q

stage 2 HTN

A

> 140/90 or higher

55
Q

hypertensive crisis

A

> 180/120 or higher

56
Q

the biggest things that change BP or CO are

A

sympathetic/parasympathtic nervous systems

and kidney function (RAAS, aldosterone)

57
Q

an ECG/EKG can show if a patient is having _____

A

an MI, or if it’s just angina

58
Q

MONA

A

morphine
oxygen
nitro
asprin (anti platelet)

59
Q

BB do what to HR?

60
Q

check BP before and after giving

61
Q

nitro is administered every

A

every 5 minutes x 3 doses

Med Surg (10 decks)

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