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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
HTN treatment
lifestyle modifications drug therapy
26
HTN drug therapy stage 1
non-pharmacological management + one 1st line drug
27
HTN drug therapy stage 2
non-pharmacological management + two 1st line drugs
28
HTN 1st line drugs
thiazide diuretics CCB ACEI or ARB
29
Pulmonary Hypertension
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
Abdominal Aortic Aneurysm (AAA)
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
AAA care
monitoring prevent rupture (decrease CVD risk factors, b/p management) surgical repair
32
AAA Rupture
= 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
2 Cardiac Diseases
Local Coronary Artery Disease (CAD) Acute Coronary Syndrome
34
Coronary Artery Disease (CAD)
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
Chronic Stable Angina (CSA)
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
Acute Coronary Syndrome (ACS)
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
Unstable angina
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
NSTEMI
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
STEMI
total blockage elevated troponin hyperacute T waves or ST elevation
40
Peripheral Artery Disease (PAD)
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
Venous Thrombosis
Local blood clot
42
Venous Thromboembolism (VTE)
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
DVT and PE treatment
anticoagulants thrombolytics thrombectomy IVC filter ambulation
44
Foundational issues
the Engineer/Cardiologist Central and Local cardiomyopathy (dilated, hypertrophic, restrictive) & HTN
45
Vascular issues
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
Electrical issues
the Electrician/Electrophysiology Cardiologist Central dysrhythmias
47
Structural issues
the Carpenter/Structural Heart Team Central & Local valve issues and aneurysms
48
Blood flow map from body
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
If there is a decrease in cardiac output it is a ______ perfusion issue
central
50
cardiomyopathy is the decrease in the ___________ of muscle which leads to ________
decrease in the contractillity leads to decreased cardiac output a central issue, leads to HF
51
High BP is diagnosed by taking BP _____ times on _______
take BP two or more times on both arms on two different occassions
52
elevated BP
120-129/<80
53
stage 1 HTN
130-139/80-89
54
stage 2 HTN
>140/90 or higher
55
hypertensive crisis
>180/120 or higher
56
the biggest things that change BP or CO are
sympathetic/parasympathtic nervous systems and kidney function (RAAS, aldosterone)
57
an ECG/EKG can show if a patient is having _____
an MI, or if it's just angina
58
MONA
morphine oxygen nitro asprin (anti platelet)
59
BB do what to HR?
decrease
60
check BP before and after giving
nitro
61
nitro is administered every
every 5 minutes x 3 doses

Med Surg (11 decks)

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