Test 1 Flashcards
Normal Cardiac Output (CO)
4-8 L/min
Preload definition
End diastolic VOLUME that stretches the right or left ventricle of the heart
Afterload definition
PRESURE/RESISTANCE against which the heart must work to eject blood during systole
Contractility definition
Muscle function presence
Normal Cardiac Index (CI)
2.5-4
Mean Central Venous Pressure (CVP) in right atria
2-10 mmHg
Normal SVR
800-1200
Normal PVR
100-250
MAP Formula
(2 x diastolic + systolic)/3
Normal MAP
70-100
Phlebostatic axis is where?
4th intercostal space, midaxillary line
Dicrotic Notch on wave form represents:
Closing of aortic valve
Pulmonary Artery Catheter (AKA Swan Ganz) measures:
Left heart pressures
Pulmonary artery diastolic pressure (PAD, PAOP) represents pressure on which side of the heart?
Left side
Pulmonary artery systolic pressure (PAS) represents pressure on which side of the heart?
Right side
What causes increased CVP?
Over-hydration, HF, positive pressure breathing (anything ventilator related)
What causes decreased CVP?
Hypovolemia, negative pressure breathing (retractions while breathing)
Normal Pulmonary Artery Pressure
Systolic: 20-30
Diastolic: 8-12
Right ventricular pressure
Systolic: 30-40
Diastolic: 5
Normal PAOP (Wedge pressure)
6-12 mmHg
What is the clutching of the chest accompanied with chest pain called?
Levine’s sign
Name and describe the three types of angina
Stable: predictable
Crescendo: pain with minimal exertion, no enzyme change
Variant (Prinzmetal): caused by vasospasm
What is the clinical difference between Non-ST-segment elevation ACS and Non-ST-segment elevation MI?
There is a presence of cardiac enzymes in NSTEMI (troponin-death of cardiac tissue).
What is the difference between a STEMI and NSTEMI?
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
What arrhythmia is common with right coronary artery occlusion?
Bradycardia
Name 6 nursing interventions for decreased cardiac perfusion:
O2, ASA, morphine, NTG, continuous EKG, anxiety reduction
What are supportive therapies for post-MI hypothermic Tx?
Monitoring
Labs- Potassium (hypokalemia is treated)
Shivering- use of paralytics to prevent
How do you know TPA has worked?
- Arrhythmias (Vtach, PVCs, Idioventricular)
- Decreased ST
- Pain resolution
- CK levels increase (“washout”)
PCA complications (8)
Allergic reactions, arrhythmias, CA rupture, re-occlusion, bleeding in groin area, CVA, renal issues (due to contrast dye), oversedation
What is the difference between an aneurysm and a dissection?
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.
What is the first line Tx for aneurysms and dissections?
Beta Blockers
Systolic dysfunction is AKA
Low ejection fraction HF
Diastolic dysfunction is AKA
Normal ejection fraction HF
Which lab is the only lab which is diagnostic of HF?
BNP
Left sided HF (backward effects) S&S:
SOB, hypoxia, crackles in lungs, tripoding positioning
Left sided HF (forward effects) S&S:
Oliguria, fatigue, tachycardia, restlessness, faint pulses
Right sided HF (backward effects) S&S:
Edema (pedal, JVD), decreased CO, hepatomegaly, splenomegaly
Right sided HF (forward effects) S&S:
Oliguria, fatigue, tachycardia, restlessness, faint pulses
What is a hallmark of systolic dysfunction?
Decrease in left ventricular EF
What is a hallmark of diastolic dysfunction?
Decreased cardiac output
What are the determinants of stroke volume (SV)?
Preload, afterload, and contractility
What are the effects of IABP balloon inflation?
Increased coronary perfusion
What are the effects of IABP balloon deflation?
Decreased afterload, cardiac workload, myocardial o2 consumption, and increased cardiac output
Describe the pacing error: failure to sense
Pacemaker doesn’t sense the QRS complex so it sends electrical impulse anyway on top of patient’s own rhythm
Describe the pacing error: failure to capture
No mechanical movement (no pumping) even with an electrical impulse (basically asytole)