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Med surg 2 > Test one > Flashcards

Test one Flashcards

1
Q

How much fluid does the pericardium hold?

A

10-15ml

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2
Q

What is end diastolic volume?
End systolic volume?
Stroke volume? measured as what?

A

Amount of blood in the ventricle right before contraction
Amount of blood in ventricle after contraction
Amount of blood in mL ejected from the ventricle with one heartbeat ml/beats

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3
Q

What is systemic vascular resistance?

A

the force opposing the movement of blood

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4
Q

What are the two factors that influence BP?

what is the equation?

A

CO and SVR

BP+ COx SVR

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5
Q

How to calculate MAP

what do we need in order to perfuse organs?

A

SBP+2DBP/3

Above 60

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6
Q

What is pulse pressure?
What is normal?
What would an increased pulse pressure indicate?
Decresed?

A

difference between SBP and DBP
one third difference
exercise, atherosclerosis, of larger arts
heart failure or hypovolemia

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7
Q

What is cardiac output.\?
How is it measured?
How do we calculate it?
What is normal?

A

The amount of blood pumped by each ventricle in one min
measured in L/min
CO+SVx HR
4 to 8 L/min

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8
Q

What is stroke volume?

measured?

A

Amount of blood pumped by the vent in one beat (ml/beat)

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9
Q

What is cardiac index?
calculate?
Normal?

A

It adjust the CO to the body size
CO divided by body surface area
2.8-4.2L/min/meter squared L/min/m2

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10
Q

How high can a hr be for a short period of time?

A

180

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11
Q

What is preload?

A

the volume of blood in the vents at the end of diastole it determines the amount of stretch placed on myocardial fibers

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12
Q

What can increase preload?

A

myo infarct, aortic stenosis, hypervolemia

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13
Q

What is after load?
What affects after load?
what happens to the heart if their is high bp

A

peripheral resistance against which the left vent must pump
size of ventricle, wall tension, arterial bp
Ventricular hypertrophy with no increase in CO or size of chambers so just the mm

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14
Q

What is postprandial hypotension?

A

Decrease in BP of at least 20mmHg within 75min after eating

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15
Q

What about BP and HR with laying and standing

A

Should not decrease/increase more than 20

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16
Q

What is a bruit

A

A buzzing or humming sound over a vessel that is from a narrowed or bulging wall

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17
Q

What is the angle of louis?

A

Manubrim and sternum it is where the second rib is located

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18
Q

What are the points to listen to the heart and where are they? and what should you hear?

A 
Ape to Man 
Aortic r 2nd
Pulmonic l 2nd
Erbs- r3rf s1 and s2 equally
Tri- l 5th 
Matrial-5 midclavicular
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19
Q

what is the best part of the stethoscope to listen to s1 and s2?

A

The diaphragm because they are high pitched noises

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20
Q

What is s3?

A

low intensity vibration of vent walls associated with decreased compliance of the vents during filling

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21
Q

What is s4

A

Low frequency vibration caused by atrial contractions.

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22
Q

4 things about troponin

A

detectable within 4-6 hours of myocardial injury
peak at 10-24 and can be detected for 10-14 days
It is the biomarker of choice in diagnosis of MI

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23
Q

Creatine kinase (CK)- MB levels and where are they found

A

Rises in 3-6 hours, peaks in 12-24 hours, returns to baseline within 12-48 hours
Sk mm, Brain, heart

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24
Q

what are the Cardiac Natriuretic Peptide Markers

A

atrial natriuretic peptide (ANP) from the atrium
b-type natriuretic peptide (BNP) from the ventricles
c-type natriuretic peptide from endothelial and renal epithelial cells.

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25
Q

how do you distinguish between cardiac or respiratory dyspnea?

A

BNP

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26
Q

Name one thing that would suggest heart fail

A

N-terminal pro-brain natriuretic peptide (NT-pro-BNP)

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27
Q

When diastolic blood pressure increases (e.g., heart failure),

A

BNP and NT-pro-BNP are released and increase natriuresis (excretion of sodium in the urine).

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28
Q

2 things about CRP

A

produced by the liver during acute inflammation and elevated is independent risk for CAD

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29
Q

What is Homocysteine

A

Hcy an amino acid that is produced during protein catabolism from hereditarynor dietary b deficiencies that increases risk of CAD, PVD, and stroke

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30
Q

HDL and cholesterol ratio

how to do it. what is good?

A

Set up proportion with HDL and Cholesterol and make HDL equal to one and solve.
<3.5-1

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31
Q

What is ejection fraction?

A

percentage of end diastolic blood volume that is ejected from left vent during systole

32
Q

What drug do they give with a stress echo? 2

A

Dobutamine or dipyridamole

33
Q

What is TEE what aare some considerations?

A

Transesophageal echocar
endoscope with a probe
they need to be sedated and no one with radiation therapy to the chest wall

34
Q

What is one thing you would expect to find in an older patient

A

a systolic murmur

35
Q

What are heaves?

A

sustained lifts of the chest wall in the precordial area. Usually indicative of hypertrophy in the left vent

36
Q

What is Point of maximal impulse?

A

Apical pulse mid clavicular line 4th or 5th space if below it may be enlarged patient needs to be supine

37
Q

thrills

A

Abnormal vibration possibly do to a valve disorder

38
Q

What side of the stethoscope is best for s1 and s2? and why? s3 and s4?

A

The diaphragm because they are high pitched the bell because they are low pitched

39
Q

What are the best patient positions for auscultating aortic and pulmonic areas and mitral

A

aortic and pulmonic lean forward while sitting

mitral left side laying

40
Q

What are the points for palpating arteries?

A

carotid, brachial, radial, ulnar, femoral, popliteal, post tib, dorsalis pedis

41
Q

What are the two heart dysrhythmias we need to call a code on

A

Ventricular tachy w/o pulse and ventricular fib

42
Q

Name two more biomarkers and why

A

c reactive prot- made by liver during inflamation may indicate early MI
and homocysteine- Amino acid made during protein catabolism vit b deficiency higher risk for CAD, peripheral disease, stroke. Testing is recommended for predisposition to CAD

43
Q

What is CXR and what will it show?

A

Chest XR

Heart enlargement, displacement, contour, fluid, pulm congetsion

44
Q

Nuclear studies show

A

Stress perfusion imaging

45
Q

What will a ct show and one thing about it

A

heart anatomy, coronary circulation and great blood vessels calcium scoring
may need contrast

46
Q

Two things about exercise stress test

A

Good for people with pacemaker for diagnostic reasons and measure BP and ECG

47
Q

s3 and s4 states

A

3 kentucky 4 tenesse

48
Q

The vagus nerve

A

Slows heart rate

49
Q

Timeline on MI

A

20min cell death, 4 hours full mm 12 if partial block

50
Q

What are the complications of MI

A

DysR, cardiogenic shock- severe L vent fail, Papillary mm dysfunction, Ventricular aneurism, Acute pericarditis, dresslers

51
Q

After MI heart healing

A

10-14 days scar tissue still weak and person is more active it takes 6 weeks to be considered healed

52
Q

What is Sudden cardiac death?

What are the dysR that cause it 2

A

Unexpected death from a cardiac issue where there is sudden disruption in the cardiac output causing loss of CO and cerebral blood flow
vent tachy and vend fib

53
Q

What two groups do people fall in with SCD? because of CAD

A

NO acute MI no symptoms and yes acute MI symptoms -Death within one hour

54
Q

What lab values are indicative of MI and one for heart fail

A

Troponin, c reactive protein, lipoptrotein, phosoholipase A2-M!, CK-MB
BNP

55
Q

3 signs of sinus bradycardia

A

Confusion, disorientation, SOB

56
Q

One thing to do with PVC

A

apical radial pulses should be checked

57
Q

What do we need to do with 3rd degree block?

A

Pacemaker

58
Q

What do we do with vent tachy vs vent fib?

A

Vent tachy- unstable no pulse cpr defib

Vent fib -CPR and defib

59
Q

What do we like to defib

A

VFib and V tachy

60
Q

2 Thinks about defib

A

Within 2 mins

and start CPR right away

61
Q

When do we use Sync? and one thing not to do

A

VT with a pulse or supraventricular tachy aka a fib with rapid vent response
Use on t wave

62
Q

What to remove before sync 5

A

Metallic objects, dentures, trans derm patch, hair

63
Q

PR interval

A

time of spread of electrical impulse right before vent contraction

64
Q

ST segment

A

Time from vent depolarization to repolarization

65
Q

t wave

A

ventricular repolarization

66
Q

What is a premature atrial contraction mean and one thing that shows up

A

Location other than SA node distorted p wave

67
Q

Atrial flutter 2 things

A

saw tooth and cant measure PR interval

68
Q

A fib

A

Disorganized electrical activity from multiple ectopicfoci

Chaotic waves replace p waves so no p wave

69
Q

AV block

A

no atrial pulses to vents p wave and qrs have no relationship
cant measure pr

70
Q

PVC

A

early QRS that are wide and bizzare no p wave with pvc

71
Q

Vent tachy

A

3 or more PVC in a row

72
Q

vent fib

A

Cant measure anything

73
Q

What is ACS 2 and three groups

A

Ischemia that is prolonged and not immediately reversed. It is a coronary art that is part or all the way occluded with thrombus.
UA, STEMI and NSTEMI

74
Q

One thing about chest pain with NSTEMI

A

20 mins or longer

75
Q

s/s of NSTEMI

A

maybe s3 s4 heart fail issues valve dysfunction issues

76
Q

order of management for ACD and what is gold star for diagnostic test

A

12 lead, semi fowler, 02, Nitro asa, morphine, troponin

Angiography

77
Q

Treatment for STEMI or NSTEMI

A

PCI STENT - reperfuses the myocardium,
PCI in cath lab
CABG- PCI fail or 3 or more injured vessels
thrombolytics- 1 hr to 8 hr given IV w/o clab

Med surg 2 (18 decks)

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