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NUR 103 > Unit 3 > Flashcards

Unit 3 Flashcards

1
Q

antiarrhythmic drug which means it helps to get the heart back to a normal rhythm. specifically used to tx SVT.

A

adenosine

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2
Q

What kind of monitoring is needed for Adenosine?

A

ECG, HR, BP, perfusions

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3
Q

What should you have ready when giving adenosine?

A

the crash cart

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4
Q

Avoid what when taking adenosine?

A

methylxathines

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5
Q

What to know about the IV when giving adenosine?

A

Large bore IV’s

as proximal as possible to the body

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6
Q

What dpes adenosine do to the AV node?

A

restarts it!

its the pace maker of the heart

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7
Q

Promotes the movement of calcium
Causes vascular relaxation
Used for the suppression and prevention of SVT arrythmias

A

CAlcium channel blockers

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8
Q

Diet for calcium channel blockers

A

lean meats, no fried foods, low sodium,

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9
Q

If pt is already taking nitrates for angina pain can they continue taking thier nitrates?

A

yes if angina does not change.

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10
Q

Calcium channel blockers cannot be what?

A

crushed, chewed, or split when SR capsules.

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11
Q

Why should pts on antabuse avoid expectorant syrup

A

it contains alcohol

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12
Q

FLuid intake for pt’s taking pt’s taking an expectorant

A

1500-2000 mL per day

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13
Q

IV contrast dye is used to find what?

A

if there is a blockage in the brain or the heart

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14
Q

Withold what medication when giving IV contrast dye to diabetics and for how long?

A

antidiabetics, 48 hrs

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15
Q

If pt is getting IV contrast dye testing done what allergy would alarm you?

A

seafood; fish

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16
Q

Medication given for angina pain; a vasodialator; a nitrate

A

nitroglycerin

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17
Q

If a pt is taking ED medications need to be told what when taking nitro?

A

not to take their ED medications with their nitrates

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18
Q

If pt is taking nitro and angina pain does not subside after 5 min

A

call the provider

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19
Q

What VS is important to monitor when taking nitro?

A

BP

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20
Q

If a pt taking nitro SL and complains of fizzing or burning what do you tell them?

A

it is normal

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21
Q

Electrolyte replacement, can burn blood vessels, monitor potassium, and HR

A

IV potassium

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22
Q

How should IV potassium be given?

A

SLOWLY and with a dilutant

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23
Q

If pt is prescribed potassium via pill but cannot swallow should you crush it?

A

NO

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24
Q

Can a potassium pill be melted in water?

A

yes

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25
Q

People taking certain BP medications that are potassium sparring because if they are using a

A

salt subsitute

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26
Q

What labs should be drawn before and during IV potassium therapy?

A

Kidney function- BUN Creatinine, and serum potassium

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27
Q

A statin that helps lower cholesterol; keeps blockages from forming and allows blockages to break up slowly

A

Simvastatin

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28
Q

What kind of labs need to be drawn before and during Simvastatin therapy?

A

Liver function

Cholesterol levels

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29
Q

If muscle pain occurs when taking simvastatin what labs should be drawn?

A

CPK or CK

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30
Q

used to help prevent a pt from having a vagel response during a bowel movement who are having cardiac issues

A

Stool softeners

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31
Q

a blood thinner that helps PREVENT clots or helps a clot dissolve on its own SLOWLY

A

warfarin/coumadin

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32
Q

What labs are you closly monitoring for pt’s taking warfarin or coumadin?

A

PTNINR

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33
Q

warfarin antidote

A

Vitamin K

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34
Q

Vitamin D foods

A 
Canned salmon, sardines, tuna
Cereals
Fish
Fish liver oils
Non fat dry milk
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35
Q

surgical removal of emoblus or thrombus to restore blood flow and oxygenation to the tissue distal to the occlusion. If not tx can lead to ischemia and necrosis. This is an emergency surgery.

A

embolectomy and thrombectomy

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36
Q

a surgery that involves the use of either autographs such as the pts own saphenous vein, or synthetic graft material. The graft is anastomosed to the artery proximal to the occlusion and tunneled past the occlusion. There, the distal end of the graft is anastomed to the artery. The graft is assessed for patency and infection

A

vascular bypasses and grafts

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37
Q

Arteriosclerotic plaques are dissected from the lining of the arterial wall and removed in a procedure called an

A

endarterectomy

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38
Q

Earmy S/S of ARDS

A 
nasal flaring
Head bobbing
Anxiety
Lethargy
Decreased rate of resposiveness
Retractions
Wheezing and stridor
Use of accessory muscles
Increased use of energy and effort needed to breathe
Feeding problems and refusal to eat
Tachypnea hypernea
Hypoxia
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39
Q

Late S/S of ARDS

A 
Poor perfusion
Bradycardia
Decreased air movement and diminished braeth sounds
Expiratory grunting
Apnea
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40
Q

Classis S/S of MI

A

Crushing vice like chest pain with radiation to arm shoulder neck jaw or back

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41
Q

Atypical MI S/S

A 
adsence of chest pain
fatigue
cramping in the chest
anxiety
feeling of impending doom
falling
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42
Q

Common S/S of MI in women

A 
epigastric of abdominal pain
chest discomfort, pressure, burning
Arm shoudler neck jaw or back pain
discomfort/pain between shoulder blades
Shob
fatigue
indegestion or gas pain
nausea or vomiting
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43
Q

minimally invasive technique that are used to open up plaque-blocked arteries.

A

angioplasty

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44
Q

these are placed inside a artery to keep them open

A

stents

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45
Q

_________ are used to generate an electrical impulse when there is a problem with the heart’s conduction system. Permanent pacemakers are used for symptomatic bradycardia and third-degree AV block (complete dissociation between atrial and ventricular activity). Pacemakers can be temporary (epicardial, transcutaneous, transvenous) or permanent. When a patient is in a paced rhythm, a small spike (vertical line) is seen on the ECG at the start of the paced beat. This spike is the electrical stimulus. It can precede the P wave, QRS complex, or both depending on what is being paced. Patients may have 100% paced beats, a mixture of their own beats and paced beats, or 100% their own beats. Pacemakers should not fire during a patients’ own beat.

A

cardiac pacemaker

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46
Q

Issues with cardiac pacemakers

A

Failure to sense a patient’s own beat
Failure to pace because of a malfunction of the pulse generator
Failure to capture, which is the heart’s lack of depolarization

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47
Q

What to report when you have a pace maker

A

Any change in heart rhythm, reports of chest pain, or changes in vital signs are reported immediately. The patient may have outpatient surgery or remain in the hospital overnight.

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48
Q

a _______________________ is placed into the chest of a patient who experiences life-threatening arrhythmias or is at risk for sudden cardiac death.

A

implantable cardioverter defibulator

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49
Q

low sodium diet

A 
baked or broiled poultry
canned pumpkin
cooked turnips
egg yolk
fresh vegetables
fruit
grits (not instant)
honey
jams and jellies
lean meats
low-calorie mayonnaise
macaroons
potatoes
puffed wheat and rice
red kidney and lima beans
sherbet
unsalted nuts
whiskey
50
Q

PT/coumadin/warfarin

A

10-13 sec

51
Q

APTT/Heparin

A

25-35

52
Q

INR levels for no anticoag tx

A

0.9-1.1

53
Q

INR for pts recieving tx for clots

A

2.5-3.5

54
Q

If pt is allergic to _______ they cannot have IV contrast dye

A

shellfish

55
Q

How long before IV contrast dye should metformin be stopped and how long after

A

2 weeks before and 48 hrs after

56
Q

the following are S/S of what?

dyspnea, fatigue, and fluid volume overload, tachycardia, jugular vein distension while sitting or standing, congestion- wheezing, crackles, decreased o2 sat., SOB, fatigue, weight gain, chest tightness, chest pain.

A

Heart failure

57
Q

LDL is

A

bad cholesterol

58
Q

HDL is

A

Good cholesterol

59
Q

LDL desired level

A

less than 100

60
Q

HDL desired level

A

more than 60

61
Q

desired triglycerides

A

less than 150 mg

62
Q

LDL health risk level

A

more than 159

63
Q

HDL health risk level

A

less than 40

64
Q

Triglycerides health risk level

A

more than 199

65
Q

___________ is precipitated by exertion or stress. Relieved by rest or nitroglycerin. Manifestations last less than 15 min. Not associated with nausea, epigastric distress, dyspnea, anxiety or diaphoresis

A

stable angina

66
Q

___________ Can occur without cause, often in the morning after rest. Relieved only by opioids. Manifestations last more than 30 min. Associated with nausea, epigastric distress, dyspnea, anxiety and diaphoresis.

A

MI

67
Q

The following are S/S of what??

Tachycardia
Tachypnea
Wheezing
Hypotension
Cyanosis
Oliguria 
Altered mental status 
Can have urticaria, pruritus, angioedema, laryngeal edema, severe bronchospasm.
If conscious, can be extremely apprehensive.
A

anaphylactic shock

68
Q

____________________ Occurs when the heart fails as a pump and decreases cardiac output. It requires immediate treatment to prevent death

A

cardiogenic shock

69
Q

The following are S/S of what?
Sudden numbness or weakness of face, arm, or leg, especially on one side of the body. Sudden confusion or trouble speaking or understanding. Sudden trouble seeing in one or both eyes. Sudden trouble walking, dizziness, loss of balance, or coordination. Sudden severe headache with no known cause.

A

CVA

70
Q

a women is presenting with the following:

hallucinations, chest pain, hiccups, palpitations, SOB, facial pain.

what do you suspect the dx is?

A

CVA

71
Q

S/S of CVA in women

A

hallucinations, chest pain, hiccups, palpitations, SOB, facial pain.

72
Q

S/S of CVA

A

Sudden numbness or weakness of face, arm, or leg, especially on one side of the body. Sudden confusion or trouble speaking or understanding. Sudden trouble seeing in one or both eyes. Sudden trouble walking, dizziness, loss of balance, or coordination. Sudden severe headache with no known cause.

73
Q

S/S of anaphylactic shock

A 
Tachycardia
Tachypnea
Wheezing
Hypotension
Cyanosis
Oliguria 
Altered mental status 
Can have urticaria, pruritus, angioedema, laryngeal edema, severe bronchospasm.
If conscious, can be extremely apprehensive.
74
Q

cause of chest pain

A

ischemia resulting from a reduction in coronary artery blood flow and oxygen delivery to the heart muscle.

75
Q

Early manifestations of CF

A

wheezing, rhonchi, dry, nonproductive cough.

76
Q

S/S of increased involvement of CF

A

dyspnea, paroxysmal cough, obstructive emphysema and atelectasis on chest x-ray

77
Q

S/S of advanced involvement of CF

A

cyanosis, barrel-shaped chest, clubbing of fingers and toes, multiple episodes of bronchitis or bronchopneumonia.

78
Q

What diet should be used to help improve cardiac health

A

DASH diet for HTN (low sodium, high potassium, high calcium), decreasing sodium intake, high fiber, limit caffeine

79
Q

Cranial nerve 1

A

olfactory smell

80
Q

cranial nerve 2

A

visual activity, visual feilds

81
Q

cranial nerve 3

A

eye movement

82
Q

cranial nerve 4

A

trochlear, verticle eye movement

83
Q

cranial nerve 5

A

light touch sensation to the face. Jaw opening chlenching chewing

84
Q

Cranial nerve 6

A

abducens; lateral movement of eyes

85
Q

cranial nerve 7

A

facial taste (salty/sweet), saliva, facial movements

86
Q

Cranial nerve 8

A

auditory hearing and balance

87
Q

cranial nerve 9

A

glossopharyngeal; taste (sour/bitter) on posterior third or tongue. Swallowing, speech, sounds, gag reflex

88
Q

cranial nerve 10

A

vagus; gag reflex, swallowing, speech quality

89
Q

Cranial nerve 11

A

spinal accessory; turning head, shrugging shoulders

90
Q

Canial nerve 12

A

hypoglossal tongue movement.

91
Q

cranial nerve that controls olfactory smell

A

cranial nerve 1

92
Q

cranial nerve that controls visual activity, visual feilds

A

cranial nerve 2

93
Q

cranial nerve that controls eye movement

A

cranial nerve 3

94
Q

cranial nerve that controls verticle eye movement

A

cranial nerve 4

95
Q

cranial nerve that controls light touch sensation to the face. Jaw opening chlenching chewing

A

cranial nerve 5

96
Q

cranial nerve that controls lateral movement of eyes

A

cranial nerve 6

97
Q

cranial nerve that controls taste (salty/sweet), saliva, facial movements

A

cranial nerve 7

98
Q

cranial nerve that controls auditory hearing and balance

A

cranial nerve 8

99
Q

cranial nerve that controls taste (sour/bitter) on posterior third or tongue. Swallowing, speech, sounds, gag reflex

A

cranial nerve 9

100
Q

cranial nerve that controls gag reflex, swallowing, speech quality

A

cranial nerve 10

101
Q

cranial nerve that controls turning head, shrugging shoulders

A

cranial nerve 11

102
Q

cranial nerve that controls tongue movement.

A

cranial nerve 12

103
Q

Type of angina that occurs with moderate exertion in a pattern that is familiar to the patient. The pain is predictable and only lasts a few hours. Can be relieved by resting and using NTG

A

stable angina

104
Q

the kind of angina that increases unpredictable in frequency or that occurs with less exertion, at rest or during sleep. Is not relieved by rest or medication. Blood clots that form in response to injury to the artery from athersclerosis cause a reduction in blood flow leading to unstable angina. This is a serious condition that can lead to MI

A

unstable angina

105
Q

this type of angina is caused by coronary artery spasms and is serious. The pattern of occurrence is often cyclical, with the pain happening about the same time each day. The pain lasts longer than stable angina. Can occur with exercise or at rest often occurs at night.

A

Variant or vasospastic angina

106
Q

this kind of angina spasms in the walls of the tiniest arteries of the heart reduce coronary blood flow and result in microvascular angina. Compared with other types of aninal pain this pain may be more severe and last longer

A

microvascular angina

107
Q

node at the junction of the superior vena cava and right atrium, regarded as the starting point of the heartbeat.

A

Sinoatrial Node

SA node

108
Q

node that is located in lower right atrium; receives an impulse from the sinoatrial node and relaus it to the ventricles

A

avioventricular node

AV node

109
Q

the contraction of the atria

A

atrial systole

110
Q

the period of relaxation of the two ventricles

A

ventricular diastole

111
Q

a bundle of fibers from the impulse-conducting system of the heart originates in the AV node

A

the bundle of his

112
Q

the contraction of the two ventricles

A

ventricular systole

113
Q

an arrythmia that Originates in the SA node. Regular rhythm, less than 60 HR. P waves are rounded upright, precede each QRS complex alike. Can decrease BP, cause resp distress, diminished or absent peripheral pulses, fatigue, or syncope can occur. Happens in well conditioned athletes bc their hearts work so efficiently. Usually an under lying cause and once tx it goes away

A

sinus brady

114
Q

an arrythmia with Reguar rhythm, HR 101-180. Causes incluse physical activity, hemorrhage shock, medications such as epinephrine, atropine, or nitrates, dehydration, fever, MI, electrolyte imbalance, fear, anxiety. Tachy cardia occurs as a compensatory mechanism for hypoxia to help produce cardiac output to deliver oxygen to tissues. Can cause angina, dyspnea, syncope, or tachypnea. Older adults become symptomatic more rapidly than younger pts. Pt’s with I may not tolerate a rapid HR

A

sinus tachy

115
Q

an arrythmia that has An early beat. Premature beat interrupts underlying rhythm where it occurs. HR depends on the underlying rhythm; if NSR 60-100 bpm. Usually not serious. Often no tx is required other than correcting the cause.

A

premature atrial contrctions

116
Q

an arrythmia Atrial rhythm regular; ventricular rhythm regular or irregular depending on consistency of AV conduction of impulses. HR: ventricular rate varies. Can be caused by rheumatic or ischemic heart disease, CHF, HTN, pericarditis, PE, and postoperative coronary artery bypass surgery. Can also be caused my medications..

A

atrial flutter

117
Q

Irregularly Irregular rhythm; HR: atrial rate not measurable; ventricular rate under 100 BPM is controlled response greater than 100 bpm is rapid ventricular response. “extremely rapid and chaotic” AF increases with age (65 and above) esp in those w/ heart disease. Can be caused by cardiac surgery, HF, HTN, heart valve disease, MI, MI, hyperthyroidism, emphysema, sleep apnea, and some meds. Most pts can feel the irregular rhythm they describe it as palpitation, racing heart, or a heart skipping a beat. Can cause shob, dizziness, chest discomfort, faint radial pulse. Can cause left sided HF

A

A fib

118
Q

AV block, SA node impulses are blocked and do not reach the ventricles to stimulate them to contract. Can be caused by cardiac ischemia or infarction, hyperkaemia, infection, antiarrythmic medications or digoxin toxicity. Can cause dizziness, chest pain, fatigue, dyspnea, severe chest pain, hypotension or syncope. This is a medica emergency. Oxygen needs to be given. If caused by toxicity it will resolve after toxicity is resolved.

A

THird degre

CBH

119
Q

an arrythmia caused by caffine, alcohol, anxiety, hypokalemia, cardiomyopathy, ischemia, and MI. Usually interrupts rhythym. This can lead to dizziness, fatuige, or more arrythmias Pt may describe this as skipped beat or palpitations. Only require tx if more than 6 per min.

A

premature ventricular arrythmias

120
Q

The occurrence of three or more PVC’s ina row. Usually a regular rhythm my have some irregularity 150-250 ventricular bpm; slow VT is below 150 bpm. Pt is aware of a sudde onsetof rapid HR. Pt may experience dyspnea, palpitations, and light-headedness. Angina commonly occurs. Seriousness of VT is determined by duration of the arrythmia..Can cause pulseless or not breathing…You better know you are supposed to do CPR.

A

v tach

121
Q

The ventricle “quivers”. If rhythm is not corrected immediately death occurs. Can be caused by hyperkalemia, hypomagnesemia, electrocution, CAD, MI, placement of intracardiac catheters, and cardiac pacing wires. Rhythm is described as chaotic and extremely irregular. HR not measurable. Pt’s experiencing VF lose consciousness immediately. There are no heart sounds, peripheral pulses, or blood pressure readings. These are all indicative of circularoty collapse. Respiratory arrest, cyanosis, and pupil dialation occur. IMMEDIATE defibrillation is require CPR until defibrillator is available. Intubation may be required.

A

v fib

122
Q

The silent heart or the absence of electrical activity in the heart. THIS IS CARDIAC ARREST. Can be caused by hyperkalemia, VF, loss of majority of functional cardiac muscle due to MI. VF usually precedes asystole. VF must be reversed immediately to help prevent asystole. No HR, no pulse, no RR, no BP, no. CPR REQUIRED Intubation helps with RR???

A

asystole

NUR 103 (5 decks)

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