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CCRN > Respy/Cardiac > Flashcards

Respy/Cardiac Flashcards

1
Q

Vital Capacity: what is the minimum for life

A

Maximum amount of air Exhalation
15 ml/kg

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2
Q

What is PA02:Fi02 indicating ARDS

Normal minute ventilation

A

<300 = ARDS

MV: 5-8 L/min

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3
Q

Pulmonary Fibrosis

A

Pulmonary ventilation is reduced
But cardiac output is normal so low VQ Ratio
Pa02/Fi02: low bc of shunting
CT- honeycomb appearance

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4
Q

Acute Hypoxic Resp Failure

A

Inc BP,HR,RR
Dc CO , UO

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5
Q

Normal Vq ratio

A

4L Vent / 5L Perfused - 0.8

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6
Q

Central Line Placement : iatrogenic pneumothorax

A

Thoracostomy and chest tube

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7
Q

Pulmonary contusion + flail chest + rib fx

A

Intubate

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8
Q

Normal tidal volume

A

6-8 ml/kg

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9
Q

Mill wheel heart murmur x tracheal perforation

Position to place them

A

Risk of air embolism
Trendelenburg and left decubitus tilt

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10
Q

Prominent v waves in pa catheter reading

A

Mitral insufficiency

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11
Q

Acute MI murmur

A

Mitral valve regurgitation

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12
Q

Papillary muscle rupture can happen after what (most common)

Where do you hear it the most

A

ACUTE MI *
or infective endocarditis
LOUDEST AT APEX
SURGICAL EMERGENCY
- MVR
- Pulmonary edema
- Cardiogenic shock

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13
Q

Unstable Angina (chest pain when)
- EKG Finding
-Trop Finding

A

CP @ rest
EKG:T wave inversion, ST depression
Troponin: NEGATIVE

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14
Q

NSTEMI
- EKG Finding
-Trop Finding

A

CPCPCPCPCPCP
T wave inversion, ST depression
Trop POSITIVE

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15
Q

STEMI
- EKG Finding
-Trop Finding

A

CPCPCPCPCPCPCP
ST Elevation 2+ leads
Trop POSITIVE

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16
Q

Variant/Prinzmetal

A

Transient ST elevation
Cyclic
Nicotine, cocaine, ETOH
Trop NEGATIVE
NTG relief chest pain and returns to normal ST

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17
Q

Do you give BB to cocaine heads

A

NO

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18
Q

Meds
ASA
AC
AP
BB

A

Aspirin
AC:Heparin/Enoxaparin
AP: Clopidogrel Abciximab Eptifibatide Tirofiban
BB: metope

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19
Q

Inferior MI
What artery is occluded

ST Elevation in what leads

AV conduction disturbance

What murmur2/t papillary muscle rupture

Heart rhythm r/t mortality

A

RCA occluded

v two, v three, aVF

2nd degree type1, 3rd degree, SSS, SB

MVR r/t to papillary muscle rupture

ST higher mortality

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20
Q

How much leads in order to diagnose for PCI and how long should the chest pain be

Door to ballon time
Door to fibrinolytic drug time

A

2 or more leads in ST elevation, or new LBBB. Make sure <12 hours

Door to balloon: 90m minutes
Door to Fibro: 30 minutes

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21
Q

PCI reocclusion s/s

Sheath removal how long to place pressure

Retroperitoneal bleed

A

Chest pain, ST elevation - call PHYSICIAN

Sheath removal:
s/s nausea, yawning, pallor, diaphoresis
- Give Atropine 1st, then 250 cc NS
hold pressure for 20 minutes

sudden hypotension, low back pain: blood + fluids

22
Q

PCI repercussion labs and arrhythmia

PCI complication common x dangerous

A

STUNNING
Elevation of troponin and CKMB
VT,VF *** MOST COMMON
, AIVR

Stent thrombosis within 24 hrs

23
Q

HTN Urgency vs Emergency

Greatest risk of developing _______

Meds
Nitroprusside
Labetalol

A

Urgency: no end organ damage
Emergency: End organ damage (brain heart kidney retina)
STROKE*

Nitroprusside: Dc Preload and Afterload
- Toxicity: Cyanide toxicity restless, lethargic, tachy, seizure, metabolic acidosis. Happens >24 hours , renal impair

Labetalol: IV intermittent push

24
Q

ABI Normal

Bed position, Extremity mvmnt

A

> 0.90 PAD.
Reverse Trendelenburg
Do NOT elevate extremity

25
Q

Carotid Artery Disease

A

Monocular visual disturbances Aphasia Stroke

Test: Angiography

CEA : check neuro, VS

26
Q

WPW
Unstable SVT
AF

Qt Prolongation
Meds, Electrolytes

Treatment

A

SVT - Synchronized cardio version/Adenosine

AF- BB, Amiodarone, Procainamide

QT- Torsades des Pointes
Amiodarone, Quinidine, Haloperidol, Procainamide LOW potassium, magnum , calcium
tx: MAG

27
Q

BNP

EF

A

released by the ventricle related to stress

BNP should be less than 100.

EF : 50-70%

28
Q

Systolic HF

PMI to the left means

A

cannot eject, large left ventricle

high risk of dilated cardiomyopathy
positive inotrope and dilators to pump heart

pulmonary edema, S3 heart sound

PMI left means enlarged heart

29
Q

NYHF Classes

CLASS 4

A

HF at rest, severe limitation

30
Q

Dilated Cardiomypoathy

Systolic or Diastolic?
Filling or ejection problem?

A

SYSTOLIC / Ejecting
Thinning
LV enlarged, Left HF signs and symptoms

VAD / HEART Transplant

31
Q

Hypertrophic Cardiomypoathy

Systolic or Diastolic?
Filling or ejection problem?

A

DIASTOLIC/Filling
Thickening
Syncope, chest pain, palpitations
**Inc risked of sudden cardiac death

32
Q

Diastolic HF

A

Filling problem , thick walls,

S4, pulmonary edema, high BP
CCB, BB, AceARB DIuretic

33
Q

Compensatory Stage

A

Inc HR RR
Resp Alkalosis, Met Acidosis
S3,S4
Cool Skin
Urine output dc
Pulse pressure NARROW

34
Q

IABP
When does it inflate
When does it deflate

A

Inflate at dicrotic notch, beginning of diastole . Increase coronary artery perfusion

Deflate before beginning of systole . Decrease after load

35
Q

CABG Mediastinal Chest Tube

Chest tube greater than ___ for __ hours need intervention

A

SEROSANGUINOUS from operation site
Chest tube lower than patient

> 100 cc for 2 hours

36
Q

TAVR
Transcatheter Aortic Valve Replacement

A

Prosthetic valve collapsible (bovine or porcine) over the diseased valve

Via fem artery
ASA for life, Plavix for 3-6 months s/p procedure

37
Q

Cardiac Tamponade
Where does the fluid accumulate

A

Fluid in the pericardial sac
Muffled heart sounds
Enlarged cardiac silhouette
Narrowed pulse pressure
Pulse paradoxes (SBP drops during inspiration)

38
Q

What valve is most at risk for rupture due to a trauma?

A

AORTIC VALVE

39
Q

Dresslers syndrome r/t pericarditis

A

happens after MI
immune response

40
Q

Pericarditis
EKG ST Elevation

A

Viral, MI, post op

pain worse with inspiration low grade temp, Inc ESR

ST Elevation in ALL leads

watch out for cardiac tamponade

41
Q

Myocardial Contusion

EKG ST Elevation

A

Broken vessels bleed into heart

Death can occur in 48 hours
pain worse with inspiration

ST elevation in area of injury

42
Q

How much mm in aortic aneurysm should you operate

What medication to start

A

> 5 mm

start labetalol

43
Q

Post prandial hypotension should have

A

Low carb meals

44
Q

Post prandial hypotension should have

A

Low carb meals

45
Q

NH pts have high risk of what virus

A

MRSA

46
Q

AVR Replacement high risk rhythm

A

2nd degree type 2

47
Q

Cardiac tamponade diagnosis

A

ECHO

48
Q

Low EF and atrial dysthymia is found with which cardiomyopathy?

A

Dilated

49
Q

Trach perf put them in trendelenburg w left decubitus tilt … this will prevent air going in where

A

Float to left atrium

50
Q

Inc cvp + emphysema =

A

Cor pulmonale , inc pvr and right heart failure

CCRN (5 decks)

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