Test 3 Cardiac and Vascular Shi Flashcards
How to identify 1st degree heart block?
PR interval > 0.20
How to classify 2nd degree type 1 heart block (Wenkebach)?
Progressive PR lengthening until QRS drops
May cause dizziness
What can indicate 3rd degree heart block?
No association between P waves and QRS complex
Requires pacemaker
How to classify stage 2 type 2 heart block?
PR constant but then drops Unexpectedly
How to identify a paced rhythm?
spikes before p wave or QRS
What are the lethal rhythms?
VTACH
VFIB
Can Vtach be shocked?
If pulseless, regular defribilition
If there’s a pulse, cardioversion
Does VFIB have a pulse?
NO
Needs to be defibrilated
Can you shock asystole?
NO
Use epinephrine
Atropine
CPR
Can you shock pulseless electrical activity?
NOOO
Initiate CPR and epi
What does pulseless electrical activty look like?
Looks like normal sinus rhythm but has no pulse and not responsive
Conduction is there but there’s no bloodflow
How do you treat AFIB?
Rate control
Anticoagulation
CARDIOVERSION
How to you treat A Flutter?
Rate control
Anticoagulation
Cardioversion
What makes A flutter stand out?
Sawtooth
What are some potential complications arrhythmias?
Cardiac Arrest
Heart Failure
Thromolic events, especially a flutter
Clinical Manifestations of peripheral artery disease?
Intermittent Claudication (leg pain or cramping that occurs during exercise and subsides with rest)
Rest pain
Diminished Pulses
Non healing ulcers
How do we treat PAD?
Meds: Statins, antihypertensives
Procedures: Angioplasty or bypass surgery
Nurse care: Educate on foot care, promote exercise
Keep lower extremities in a neutral or dependent position
What is acute ischemic arterial disorder?
Sudden interruption of arterial blood flow
Leads to ischemia and potential necrosis
How do we treat acute ischemic arterial disorder?
Immediately asses affected limb for 6 P’s: Pain, pallow, pulselessness, paresthesia, paralysis, poikilothermia
Revascularization: Thrombolysis, thrombectomy, bypass surgery
Anticoagulation therapy: Heparin
Pain management
What are vericose veins?
Dilated, darkened, raised, tortuous veins engorged w/ blood which results from improper venous valve function
How do we treat vericose veins?
Apply compression stockings
Encourage frequent ambulation to promote venous return and reduce venous stasis
Encourage leg elevation
What’s chronic venous insufficiency?
Long term condition
Veins in legs fail to return blood to heart due to damaged valves
Manifestations of chronic venous insufficiency
Persistent lower leg edema that gets worse w standing
Brownish skin discoloration
How would we treat chronic venous insufficieny?
Compression therapy
Leg elevation
Venous leg ulcer signs
Shallow irregulat shaped ulcers mostly in inner ankle
surrounding brownish discoloration
Moderate to heavy drainage
Edema and aching pain
How do we treat venous leg ulcers?
Wound care
True or False: AFIB causes a more increased risk of pulmonary embolism?
True
Mnemonic for CVI/ peripheral venous disease
V- Volumptious pulses (warm legs)
E- edema
I- Irregularly shaped sores
N- No sharp pain
Y- Yellow and brown ankles
Mnemonic for PAD
A- Absent pulse (absent hair) cold legs
R- Round, red, smooth sores
T- Toes and feet pale or black
S- Sharp Calf Pain (intermittent claudication)
Types of varicose veins
Primary: Originate in superficial veins
Secondary: Occur in deep and perforating veins
Spider: Mild variation of varicose veins that are common in legs and face
