quiz after after midterm Flashcards
all notes from 10.25-10.28
major assessment for MI
specific cardiac
incisions
chest tubes
neuro for CABG and a fib
veins usually used for CABG
mammary and saphenous vein
HF BNP
high (hormone from atria)
chest tube post CABG should drain how much per hour
<100mL/hr
HF: DVBS
daily vacation bible school
Dyspnea
Venous distention
Bounding pulses
Sensorium decreased
two types of HF
left sided (backs up into lungs)
right sided (backs up into body)
left sided HF
pulmonary edema
dyspnea
orthopnea
hemoptysis – coughing up blood
right sided HF
JVD
hepatomegaly
ascites
peripheral edema
L and R HF
Oliguria
confusion and cheyne stokes
slow cap refill
what is A-fib
atrial quiver rather than contracting normally
first prob in a-fib
35% loss of cardiac output
second prob in a-fib (how does a-fib cause a CVA)
blood pools, clots form in left atria auricle, then left ventricle, kicked out of aorta and up to carotid into brain causing CVA
watchman devise
blocks off auricles
a-fib requires what assessments
neuro and cardiac
heart murmur characterized by….
- swooshing or buzzing
- turbulent flow
- regurgitating valve
- listen at erbs point
- at mitral valve because under most pressure
what is stenosed valve
doesn’t open all the way / narrowed
valve replacements are often …
aortic and mitral
mechanical valves
- cause clicking sound
- pts w this HAVE to be on anticoags
tissue valve replacement
- pig or bovine
- no anti coag req.
- lasts 15 years
S3 ventricular gallop
ken-tuck-y
caused by sudden tensing of ventricular wall as blood enters from atria
S4 atrial gallop
ten-nes-see (S4-S1-S2)
atrial walls contracting
indicates HTN, CAD, or MI
listen with pt on left side
If amplitude of arteries is strong…
can have visible distention and pulsation
if arteries are bounding what does it indicate
fluid overload
when to do allen test
before sticking the radial artery
what is allen test for
arterial blood gas (ABG) and cardiac cath
- checking to see if blood flow to hand via ulnar artery is okay
how is Allen test performed
- raise hand
- make fist
- press arteries until looks pale
check what pulses especially
most distal
amplitude
pulse quality
pulsus alternans
a physical sign of an irregular pulse that alternates between strong and weak beats
- sign of HF
signs of decreased arterial flow
- cool to the touch
- sluggish cap refill
signs of venous problems
redness, warmth, pain (think DVT)
check what at pulse sites
- sign of arterial blood flow such as temperature and cap refill
- most distal pulses
- amplitude
- venous problems such as edema
what does a bruit feel like
buzz or swoosh
- like a murmur but over an artery
cause of a bruit
stenosis, atherosclerosis
bruits over arteries indicate what blood flow
low blood flow
main concern with bruits
can lead to the brain and cause CVA
when is a bruit normal to feel
over AV fistula
abnormalities in veins
- edema
- varicose veins
- spider veins
- medial malleolus
- DVT
edema is a sign of what
venous backup, injury, or fluid overload (could be d/t HF)
brawny edema
form, hard, discolored (fibrosed), unable to be displace fluid, brownish appearance
brawny edema indicates…
edema that has been there for a while
are varicose veins superficial or deep
superficial (very visible)
varicose veins can cause…
chronic venous stasis
chronic venous stasis S&S
hemosiderin staining
brawny edema
stasis dermatitis: dry, flaky, itchy skin
venous stasis ulcers
medial malleolus
most common place for an ulcer to form
thrombophlebitis
- when a vein becomes inflamed and a blood clot forms in the vein blocking off blood flow
- sign of DVT
1 sign of DVT
unilateral edema
biggest concern of a DVT
- pulmonary embolism
- can cause sudden death
- prevents blood from being oxygenated
arterial abnormalities
PAD, raynaud phenomenon, ABI (for PAD)
peripheral arterial diesease
- PAD: decreased O2 out of the body, gradual atherosclerosis, DM is #1 cause, sudden occlusion
S&S of sudden occlusion
- weak or absent pulses
- intermittent claudication
- thin, shiny, hairless skin
- coolness of skin and pale or molting
- dependent rubor
- severe= necrosis or gangrene
raynaud phenomenon
- vasospasm of small arteries of fingers
- seen in cold temps
- increased with autoimmune collagenous disease (lupus and RA)
ankle brachial index
- ABI
- screening for PAD in legs
- pt lies supine for 5 mins
- BP cuff on right and left arms and right ankle
- use doppler to measure SBP on right and left arms, right DP and right PT
- repeat with left DP and PT
- calculate ABI for right leg then left leg
- higher ankle pressure on that side is divided by the higher arm pressure
normal ABI
1.00-1.29
borderline ABI
0.91-0.99
mid to moderate ABI
0.41-0.90
severe ABI
less than 0.40
