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Critical Care > Test 1 > Flashcards

Test 1 Flashcards

1
Q

Normal Cardiac Output (CO)

A

4-8 L/min

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2
Q

Preload definition

A

End diastolic VOLUME that stretches the right or left ventricle of the heart

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3
Q

Afterload definition

A

PRESURE/RESISTANCE against which the heart must work to eject blood during systole

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4
Q

Contractility definition

A

Muscle function presence

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5
Q

Normal Cardiac Index (CI)

A

2.5-4

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6
Q

Mean Central Venous Pressure (CVP) in right atria

A

2-10 mmHg

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7
Q

Normal SVR

A

800-1200

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8
Q

Normal PVR

A

100-250

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9
Q

MAP Formula

A

(2 x diastolic + systolic)/3

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10
Q

Normal MAP

A

70-100

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11
Q

Phlebostatic axis is where?

A

4th intercostal space, midaxillary line

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12
Q

Dicrotic Notch on wave form represents:

A

Closing of aortic valve

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13
Q

Pulmonary Artery Catheter (AKA Swan Ganz) measures:

A

Left heart pressures

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14
Q

Pulmonary artery diastolic pressure (PAD, PAOP) represents pressure on which side of the heart?

A

Left side

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15
Q

Pulmonary artery systolic pressure (PAS) represents pressure on which side of the heart?

A

Right side

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16
Q

What causes increased CVP?

A

Over-hydration, HF, positive pressure breathing (anything ventilator related)

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17
Q

What causes decreased CVP?

A

Hypovolemia, negative pressure breathing (retractions while breathing)

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18
Q

Normal Pulmonary Artery Pressure

A

Systolic: 20-30
Diastolic: 8-12

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19
Q

Right ventricular pressure

A

Systolic: 30-40
Diastolic: 5

20
Q

Normal PAOP (Wedge pressure)

A

6-12 mmHg

21
Q

What is the clutching of the chest accompanied with chest pain called?

A

Levine’s sign

22
Q

Name and describe the three types of angina

A

Stable: predictable
Crescendo: pain with minimal exertion, no enzyme change
Variant (Prinzmetal): caused by vasospasm

23
Q

What is the clinical difference between Non-ST-segment elevation ACS and Non-ST-segment elevation MI?

A

There is a presence of cardiac enzymes in NSTEMI (troponin-death of cardiac tissue).

24
Q

What is the difference between a STEMI and NSTEMI?

A 
STEMI:
-Clot has fully occluded coronary artery
-ST segment elevation
-Elevated enzymes (super high)
NSTEMI:
-Clot has partially occluded
-No ST segment elevation
-Elevated enzymes
25
Q

What arrhythmia is common with right coronary artery occlusion?

A

Bradycardia

26
Q

Name 6 nursing interventions for decreased cardiac perfusion:

A

O2, ASA, morphine, NTG, continuous EKG, anxiety reduction

27
Q

What are supportive therapies for post-MI hypothermic Tx?

A

Monitoring
Labs- Potassium (hypokalemia is treated)
Shivering- use of paralytics to prevent

28
Q

How do you know TPA has worked?

A
  • Arrhythmias (Vtach, PVCs, Idioventricular)
  • Decreased ST
  • Pain resolution
  • CK levels increase (“washout”)
29
Q

PCA complications (8)

A

Allergic reactions, arrhythmias, CA rupture, re-occlusion, bleeding in groin area, CVA, renal issues (due to contrast dye), oversedation

30
Q

What is the difference between an aneurysm and a dissection?

A

Aneurysm is a localized area of dilation of the vessel wall which results in disturbed blood flow.

Dissection is a tear in the layers of the aortic wall which results in a “false” lumen.

31
Q

What is the first line Tx for aneurysms and dissections?

A

Beta Blockers

32
Q

Systolic dysfunction is AKA

A

Low ejection fraction HF

33
Q

Diastolic dysfunction is AKA

A

Normal ejection fraction HF

34
Q

Which lab is the only lab which is diagnostic of HF?

A

BNP

35
Q

Left sided HF (backward effects) S&S:

A

SOB, hypoxia, crackles in lungs, tripoding positioning

36
Q

Left sided HF (forward effects) S&S:

A

Oliguria, fatigue, tachycardia, restlessness, faint pulses

37
Q

Right sided HF (backward effects) S&S:

A

Edema (pedal, JVD), decreased CO, hepatomegaly, splenomegaly

38
Q

Right sided HF (forward effects) S&S:

A

Oliguria, fatigue, tachycardia, restlessness, faint pulses

39
Q

What is a hallmark of systolic dysfunction?

A

Decrease in left ventricular EF

40
Q

What is a hallmark of diastolic dysfunction?

A

Decreased cardiac output

41
Q

What are the determinants of stroke volume (SV)?

A

Preload, afterload, and contractility

42
Q

What are the effects of IABP balloon inflation?

A

Increased coronary perfusion

43
Q

What are the effects of IABP balloon deflation?

A

Decreased afterload, cardiac workload, myocardial o2 consumption, and increased cardiac output

44
Q

Describe the pacing error: failure to sense

A

Pacemaker doesn’t sense the QRS complex so it sends electrical impulse anyway on top of patient’s own rhythm

45
Q

Describe the pacing error: failure to capture

A

No mechanical movement (no pumping) even with an electrical impulse (basically asytole)

Critical Care (6 decks)

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