Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardio Jean > Unit 4 > Flashcards

Unit 4 Flashcards

1
Q

If ventricular contractions don’t have a pattern on a EKG, what do you need in order to discern

A

more strip, at least 15 sec worth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the normal pathway of conduction through the heart

A

(atrial) SA to AV to BOH to Purkinjie (ventricle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which electrolyte sets the resting membrane potential in the heart

A

K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

On a clock, list where lead 1, 2, 3 would be

A

1 is 9-3
2 is 11-5
3 is 1-7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does the term augmented lead mean

A

these leads fill in the gaps not picked up by leads 1, 2, 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Mantra for determining HR

A

300, 150, 100, 75, 60, 50, 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

An anterior MI effects which artery

A

LAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

An inferior MI effects which artery

A

RCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When looking at an EKG, what segment might indicate possible electrolyte imbalance

A

ST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

WHat does hypokalemia look like on an EKG

A

short descending T wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what does hyperkalemia look like on an EKG

A

tall, ascending ST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Both hypo and hyperkalemia create a _____ ST segment

A

depolarizing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What part of the heart is the first thing to depolarize (in regards to ventricular)

A

the septum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Depolarization is due to

A

Na

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

REpolarization is due to

A

Ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Depolarization is

A

contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Repolarization is

A

relaxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Contraction or depolarization traveling towards a pos electrode looks like what

A

above the baseline (pos)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Contraction or depolorization traveling AWAY from a pos electrode looks like

A

below the baseline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Lead 1 electrode is located where (what limbs)

A

right arm towards pos left arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Lead 2 electrode is located where (what limbs)

A

right arm towards positive Left Leg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

lead 3 electrode is located where (what limbs)

A

Left arm to pos Left Leg (rule of L’s)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

list the 3 augmented leads

A

AVR, AV1, AVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

AVR is located where

A

right arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

AV1 is located where

A

left arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

AVF is located where

A

left leg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what are the precordial chest leads

A

V1-V6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

the precordial chest leads are looking at what part of the EKG

A

R segment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is normal EKG speed for 1 small box

A

.04 sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is normal height of 1 box of an EKG reading

A

.1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is it called when a section of an EKG is on the baseline (not above or not below)

A

isoelectric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

P wave represents what

A

atrial DEpolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Ventricular Depolarization is what part of the EKG

A

QRS complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the normal length of a QT segment

A

there is no normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

If a QT segment is prolonged, this is ____

A

really bad, there is a risk of arrythmia that could potentially lead to sudden death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

True ventricular repolarization is what part of the EKG

A

T wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

the ST segment is usually (above baseline, below baseline or isoelectric)

A

isoelectric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is J point

A

the point where ST segment begins (the pointy peak)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the rule about P/T waves

A

they should be going in the same direction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

WHat is a U wave

A

not everyone has a U wave, this is the final phase of ventricular repolarization, U should be going in same direction as T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Normal HR Is

A

60-100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

To calculate EXACT HR use what formula

A

1500/ number of small boxes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

the atrial rate goes from ____ to ____

A

P wave to P wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

ventricular rate goes from ____ to ____

A

R to R

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

with brady cardia and tachycardia, how to determine whether or not you will tx them with PT

A

Brady, if under 50 don’t tx and call physician, if they are asymptomatic and above 50 you should be ok
Tachy- are they symptomatic and have DOE

quick HR can cause decreased CO- so watch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

with brady cardia and tachycardia, how to determine whether or not you will tx them with PT

A

Brady, if under 50 don’t tx and call physician, if they are asymptomatic and above 50 you should be ok
Tachy- are they symptomatic and have DOE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Explain what PAC looks like on an EKG

A

a short RR then long RR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Explain the impulse or conduction with PAC

A

the impulse starts in the SA note, except for the one premature beat (this one starts from ectopic atrial focus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

When would you notify Dr. about PACs and not treat

A

when there are more than 9 in 1 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Are PAC’s an immediate threat

A

no, they are fairly common (From stress, caffiene)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

When would you notify Dr. about PACs

A

when there are more than 9 in 1 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Is atrial flutter an immediate threat

A

no, we can treat if their sx are under control (just assess pt)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

P waves are F waves explains

A

atrial flutter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

How many foci does atrial flutter have

A

1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Is atrial flutter an immediate threat

A

no, we can treat if their sx are under control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Explain conduction of Afib

A

it does not start in SA node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

how many foci with Afib

A

multi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What do you look at with Afib (which part of EKG)

A

you can’t count atrial rate, so you look at ventricular rate, if it’s over 100 CO may be compromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

You have a P for every QRS, but you don’t have a QRS for every P explains

A

PVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

3 main types of PVC

A

bigeminy, trigeminy, couplet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

“wide mountain base” looks like a

A

PVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Where does the conduction originate with a PVC

A

ventricals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is one common cause of PVC

A

electrolyte imbalance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

If there are more than ___ PVCs per min you should notify Dr.

A

6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What are other significant parameters to call Dr for PVCs

A

more than 6 per min, coupleting, bigiminy, multifocal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

How might a pulse feel with a PVC

A

skip beat then strong beat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

3 PVCs in a row is considered

A

VTAC (emergency)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

sx of VTAC

A

hypotension, loc, weak pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

VFIB is a

A

medical emergency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

conditions we would not treat

A

bigeminy, trigeminy, vtac, vfib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

pattern of a bigeminy

A

normal, bad, normal, bad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

WHat are the 7 rules to determine whether an EKG is normal

A
  1. Is HR 60-100
  2. Do P waves all look alike
  3. Is there a P wave for every QRS
  4. Look at the PR interval, are there 3-5 little boxes
  5. Does the QRS take less than 2 ½ little boxes
  6. Is there a QRS for every P wave
  7. Is T wave the same direction as the P wave
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

P segment represents

A

atrial contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

WHat are the 5 rules to determine whether an EKG is normal

A

1) check HR (60-100)
2) is the PR interval less than 5 little boxes
3) are the P and T in the same direction
4) Is there a P for every QRS
5) Is there a QRS for every P

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

pattern of a trigeminy

A

normal, normal, bad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

a bunch of little bumps followed by a normal QRS would be

A

atrial flutter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

atrial flutter has how many foci

A

1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

afib has how many foci

A

multi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

with first degree AV block, the PR interval is

A

more than 5 boxes (its greater than .20 sec)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

non invasive dx test that involves a transducer emitting a high freq

A

echo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

which type of echo is best for obese pts, chest deformity or lung diseases

A

4TEE (transesophageal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

4 common issues echos are good to detect

A

thrombus, akenesis, valve fnct, EF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What is MUGA

A

a non invasive multi aquasition image that calculates the left vent EF by way of a stain to the RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

invasive dx procedure used with angiography and dye in the femoral or radial arteries

A

cardiac cath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

cardiac caths are often used when what doesnt work (to determine what is going on)

A

after all efforts with nitroglycerine are used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What is PTCA

A

percutaneous transluminal coronary angioplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Types of coronary vessel surgical procedures (types of percu interventions)

A

PTCA
STENT
LASER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Which type of coronary vessel surgery involves a balloon and angioplasty

A

PTCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Which type of coronary vessel surgery involves a wire left in place to keep vessel open

A

stent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

which coronary vessel surgery clears out plaque

A

laser

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

CABG usually uses what vessels to repair

A

saph vein, left mammary or radial artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

3 ways CABG is performed

A

sternal, minimally invasive, off pump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

pacemakers are implanted where

A

right vent or right atria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

4 main uses for pacemakers

A

SA node malformity (SSS)
complete HB
transplant (cutting of the nerves)
CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

4 main uses for pacemakers

A

SA node malformity (SSS)
complete HB
transplant (cutting of the nerves)
CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Will heat pad effect pace maker

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What intensity scale/monitoring sx to use for pts with pace makers

A

RPE or something other than HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

acutely, what to prevent after pacemaker implant

A

90 degrees shoulder flexion for a week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What is the device called that is an implanted emergency defibrilator in a pt

A

ICD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

**RESP FAILURE pH level

A

pH less than 7.25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

***What is resp failure PO2 level

A

PO2 less than 60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

***What is resp failure for PCO2

A

PCO2 greater than 50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Iron lung is what type of vent

A

neg pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

pro of neg pressure vent

A

less risk of issues/pathologies caused by

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Pos pressure vents can sometimes cause compression of the

A

vena cavas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

what 2 main factors effect pos pressure vents

A

compliance and resistance in lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

What is FiO2

A

the fraction of inspired O2 the pt gets from the ventilator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

the higher the FiO2, the ____ the pt

A

sicker (the more they need the vent to do the work)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

the higher the FiO2, the ____ the pt

A

sicker (the more they need the vent to do the work)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What is PEEP

A

pos end expiratory pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

What is the use for PEEP in a vent

A

used to maintain an open airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

The higher the PEEP, the ____ the pt

A

sicker

113
Q

Do we turn off vent alarms

A

no, not off or on

114
Q

What are high pressure alarms on a vent indicative of

A

secretions in tube or coughing fits that restrict bronchials (all of this increases the need for work of the machine)

115
Q

What are high pressure alarms on a vent indicative of

A

when PIP gets really high…usually from secretions in tube or coughing fits that restrict bronchials (all of this increases the need for work of the machine)

116
Q

Low pressure alarm is usually due to

A

tube getting disconnected

117
Q

Which type of alarm is an emergency

A

apnea

118
Q

apnea alarm indicates (this one is loud an peircing)

A

sx failure, no air

119
Q

to indicate good PFT, reserve should not be equal to

A

TV

120
Q

to indicate good PFT, reserve should not be equal to

A

TV

121
Q

CK is what

A

creatine phosphokinase

122
Q

The higher the level of CK, the more ____ has occured

A

damage

123
Q

CK levels rise how soon after MI

A

3 hours (first enzyme marker to elevate)

124
Q

What is important to know about CK levels and the promptness of a person visiting the ER after MI sx

A

it rises quick, but it leaves sx quickly so get to ER quick to check levels

125
Q

What is important to know about CK levels and the promptness of a person visiting the ER after MI sx

A

it rises quick, but it leaves sx quickly so get to ER quick to check levels

126
Q

CK-MB and LDH1 are

A

isoenzymes

127
Q

what are isoenzymes

A

enzymes not specific to the heart (may indicate organ issues)

128
Q

What are the 3 specific types of CK

A

MM-muscle
MB-heart
BB-Brain

129
Q

MB again (type of CK) is what

A

heart

130
Q

CK returns to normal when

A

3 days

131
Q

Is CK MB specific only to an MI

A

no, it can also elevate with atrial fibrillation and tachycardic arrhythmias, cardiac catheterization, during CPR or cardioversion, with cardiac contusion or multiple traumas, and in congestive heart failure or emboli

132
Q

Is CK MB specific only to an MI

A

no, it can also elevate with atrial fibrillation and tachycardic arrhythmias, cardiac catheterization, during CPR or cardioversion, with cardiac contusion or multiple traumas, and in congestive heart failure or emboli

133
Q

This muscle protein binds to tropomyosin

A 
Troponin T (cTNT) 
Troponin T has three different isoforms:  one for slow-twitch fibers, one for fast-twitch fibers, and one for cardiac muscle
134
Q

which cardiac marker should be the highest normally (in non pathology)

A

LDH 2 should always be highest of the isoenzymes present in bld for healthy people

135
Q

If one has an MI, they have a “flipped LDH” what is this

A

If you have had an MI you will have a flipped LDH, this means that LDH1 is higher in value than LDH2.

136
Q

If one has an MI, they have a “flipped LDH” what is this

A

If you have had an MI you will have a flipped LDH, this means that LDH1 is higher in value than LDH2.

137
Q

CK value that is super high (indicates bad MI or trauma)

A

over 2000

138
Q

normal Hgb values

A

14-16 men

12-15 women

139
Q

normal Hgb values

A

14-16 men

12-15 women

140
Q

what hgb level would you not do therapy

A

under 8

141
Q

elevated WBC is usually indicative of

A

BACTERIAL infection

142
Q

elevated WBC is usually indicative of

A

BACTERIAL infection

143
Q

Decreased WBC is indicative of

A

VIRAL inf

144
Q

normal platelet range

A

15,000-45,0000

145
Q

platelets less than 5000

A

dont treat (they are on BR)

146
Q

platelets less than 5000

A

dont treat (they are on BR)

147
Q

What test is done to see how well blood clots

A

Prothrombin time (PT)

148
Q

coumadin is monitored by way of

A

Prothrombin time

149
Q

heparin is monitored by way of

A

PTT partial thromboplastin time

150
Q

the heart contracts from ___ to ___

A

top right to bottom left

151
Q

the heart contracts from ___ to ___

A

top right to bottom left

152
Q

how many boxes should PR interval be

A

3-5 little boxes

153
Q

how many boxes should PR interval be

A

3-5 little boxes

154
Q

again, what are the steps to determine NSR

A
  1. Is HR 60-100
  2. Do P waves all look alike
  3. Is there a P wave for every QRS
  4. Look at the PR interval, are there 3-5 little boxes btwn
  5. Does the QRS take less than 2 ½ little boxes
  6. Is there a QRS for every P wave
  7. Is T wave the same direction as the P wave
155
Q

again, what are the steps to determine NSR

A
  1. Is HR 60-100
  2. Do P waves all look alike
  3. Is there a P wave for every QRS
  4. Look at the PR interval, are there 3-5 little boxes btwn
  5. Does the QRS take less than 2 ½ little boxes
  6. Is there a QRS for every P wave
  7. Is T wave the same direction as the P wave
156
Q

individual PVCs are not what

A

a big concern

157
Q

individual PVCs are not what

A

a big concern

158
Q

if you notice possible afib on a standard strip, what should you do (in addition to checking pt status)

A

get 15 sec strip to read

159
Q

what might trick you to think afib

A

Afib can look like something similar called artifact. Artifact happens near a body part that is moving around so if you are raising R arm up and down you would just see artificant in Lead I and lead II (only see in an electrode over the moving part). With Afib you will see it in every lead

160
Q

what might trick you to think afib

A

Afib can look like something similar called artifact. Artifact happens near a body part that is moving around so if you are raising R arm up and down you would just see artificant in Lead I and lead II (only see in an electrode over the moving part). With Afib you will see it in every lead

161
Q

what type of scenario would you not tx a pt with afib

A

yesterday they were just fine, but today are showing afib on strip

162
Q

what type of scenario would you not tx a pt with afib

A

yesterday they were just fine, but today are showing afib on strip

163
Q

How AFIB can get serious quickly*****

A

atria never strongly contacts, so 30% of blood stays in the atrium, which makes pts much more likely to get a blood clot, which cold go to the ventricle and the to lungs or periphery which would be very bad.

If it becomes a pulmonary emboli- quick on set of SOB, heavy fatigue, chest pain

If it goes to the brain- stroke, look for facial droop, slurred speech, gait pattern changed, unilateral weakness, confusion.

If it goes to L coronary vessel- heart attack
If it goes to the leg- acute arterial claudication- dec pulse, unilateral leg pain, cold to touch

164
Q

with a PVC, there is a qrs for every p, but not a ___ for every ____

A

p for every qrs

165
Q

with a PVC, there is a qrs for every p, but not a ___ for every ____

A

p for every qrs

166
Q

full thickness, damage is the entire section of the tissue is what type of MI

A

transmural

167
Q

partial thickness, the damage is done from the inside out and some tissue is still healthy and ok is what type of MI

A

subendo

168
Q

what constitutes an MI

A

at least 2 of the following:
sx (lasting more than 20 min)
enzyme changes
EKG changes in at least 2 leads

169
Q

What is the best determining factor for patients with MI sx less than 3 hours (to dx MI)

A

ECG the one BEST discriminator in patients with onset of chest pain of 3 hours or less duration.

170
Q

What is the best determining factor to dx pts with MI after 3 hours of sx

A

After 3 hours, creatine kinase MB mass the one BEST discriminator

171
Q

very first sign of transmural MI

A

ST segment elevation

172
Q

EKG change for transmural ischemia is seen where

A

T wave

173
Q

Myocardial ischemia vs injury

A

ischemia heals, injury doesnt (but injury isn’t as bad as full infarct as infarct = dead tissue)

174
Q

EKG change for transmural INJURY is seen where

A

ST segment

175
Q

Myocardial ischemia vs injury

A

ischemia heals, injury doesnt (but injury isn’t as bad as full infarct as infarct = dead tissue = permanent)

176
Q

In a post transmural MI they look for what on an EKG

A

they look for reciprocal changes – this causes ST segment depression
* as there are no leads directly over posterior part of heart, see reciprocal changes in leads opposite. Therefore, show ST depression and tall symmetrical T waves and large R wave progression.

177
Q

anterior infarct clicks are found where

A

V2, V3 (V4 with greater damage)

178
Q

septal infarct, clicks are found where

A

V1, V2

179
Q

lateral infarct, clicks are found where

A

I, aVL, V5, V6

180
Q

inferior infarct, clicks are found where

A

II, III, aVF

181
Q

post infarct, clicks are found where

A

V1, V2, V3

182
Q

post infarct, clicks are found where

A

V1, V2, V3

183
Q

blood supply for ant and septal infarct

A

LAD

184
Q

blood supply for lateral infarct

A

circumflex

185
Q

blood supply for inf infarct

A

RCA

186
Q

blood supply for post infarct

A

post descending

187
Q

in addition to an MI, what could a depressed ST segment also mean

A

electrolyte issue, or digitalis toxicity

188
Q

in addition to an MI, what could a depressed ST segment also mean

A

electrolyte issue, or digitalis toxicity

189
Q

what electrolyte is related to resting membrane potential

A

K

190
Q

Hypokalemia would look like what on an EKG

A

decreased T wave and ST segmentHy

191
Q

Hyper kalemia would look like what on an EKG

A

increased, tall T wave

192
Q

electrolyte involved in threshold potential

A

Ca

193
Q

sx of hypocalcium

A

Parethesias around the mouth and in the digits
+ Chvostek sign
+Trousaue sign

194
Q

What is chvostek sign

A

(tap the facial nerve just below the temple and the nose or lip twitches)

195
Q

What is Trousaue sign

A

hyperflexia

contraction of the hand and fingers with the arterial blood flow in the arm is occluded for 5 minutes).

196
Q

main diff btwn assist control vent (ASV) and SIMV (synchronized intermittent mandatory)

A

ASV has a sensor that reads when the pt makes an effort breathing, and delivers a pre set amt when needed
SIMV has no sensor, just sends a preset amt regardless of effort or not

197
Q

Which mode of vent is best to use when weaning a pt off a vent

A

SIMV

198
Q

which mode of vent has a risk of hyperventilating

A

ASV

199
Q

this “vent” is used for obstructive sleep apnea and it Applies continuous same positive pressure during inspiration and expiration to a spontaneously breathing patient

A

CPAP

200
Q

DIff btwn bipap and cpap

A

cpap is a continuous amt of pressure regardless of inhalation or exhalation, bipap the pressure can change

201
Q

One of the main jobs of a vent

A

to maintain open airway

202
Q

normal pH

A

7.35-7.45

203
Q

Normal PCO2

A

35-45

204
Q

Normal HCO3

A

22-26

205
Q

ratio of HCO3 to CO2 is

A

20:1

206
Q

Buffers aid in acid base balance, they are chemicals present in both ___ and ____

A

plasma and RBCs

207
Q

are buffers fast or slow

A

very fast (less than a sec)

208
Q

is bicarb or non bicarb the primary buffer

A

bicarb

209
Q

our body’s response to not normal CO2 levels in blood

A

we will start to breath fast to blow it off, or hold our breath or breath slow if it’s too low

210
Q

what initiates our homeostasis for buffering (respiratory wise)

A

if the H+ levels (H is acid) are high, the respiratory sx will increase to breath of the CO2 (acid)

211
Q

Which is a faster sx, buffering or respiratory

A

buffering, resp takes 1-3 min

212
Q

3 main ways to maintain acid base balance

A

buffers, resp, kidneys (kidneys take hours to days)

213
Q

PCO2 is only influenced by

A

respiratory changes

214
Q

CO2 is only eliminated in what 2 ways

A

resp and urination

215
Q

Kidneys control what (acid base balance)

A

bicarb levels

216
Q

what is hypoventilation

A

too much CO2 (resp acidosis)

217
Q

severe obstructive lung disease or overdose with sleep meds would lead to (resp acidosis or alk)

A

acidosis

218
Q

explain what causes hyper ventilation

A

think of the ventilation term as exhaling (exhaling too much)

219
Q

pH should be

A

7.4

220
Q

metabolic or non resp parameters, have to do with

A

bicarb

221
Q

think of HCO3 as

A

base

222
Q

main cause of metabolic acidocis

A

diarrhea

223
Q

main cause of metabolic alkalosis

A

vomitting (fluid loss) - when pple are sick and vomitting, they are ridding their body of acids making them more basic

224
Q

compensatory hyperventilation occurs with (met acidosis or alk)

A

hypervent (breathing alot) with metabolic acidosi

225
Q

compensatory hypoventilation occurs with metabolic

A

alk

226
Q

if our CO2 is too high, but breathing off the CO2 isn’t fixing the issue, what happens next in the body

A

Compensation-the body will then increase bicarb to try and balance out

227
Q

explain compensation vs correction for acid base balance

A

correction- the component causing the imbalance is altered

compensation- the indirect component is altered to fix the direct issue

228
Q

In her chart for acid/base probs, corrected numbers would always be

A

7.4
40 (CO2)
24 (HCO3)
and 20:1

229
Q

again, bicarb is regulated

A

in kidney (directly or indirectly)

230
Q

If a person has kidney disease, can an acid base prob be corrected

A

no, just compensated

231
Q

IF it’s a resp problem the compensation will be _____ and if kidneys are problem then the compensation is ____

A

IF it’s a resp problem the compensation is kidney

if kidneys are problem then resp is compensation

232
Q

If pH is normal, and the 2 components are not, then it’s

A

completely comp

233
Q

if pH is abnormal but the starting comp value is normal it is

A

uncompensated

234
Q

if pH is abnormal and the starting comp value is not normal it is

A

partially comp

235
Q

if both acid and base values are high, look at

A

pH as the problem factor

236
Q

IF BASE IS TOO HIGH (INITIAL HCO3) YOU NEED TO DO WHAT TO COMPENSATE

A

SINCE THE COMPENSATING FACTOR WILL BE THE OPP (RESP OR CO2) YOU NEED TO HYPOVENTILATE

237
Q

IF STARTING HCO3 IS TOO LOW, YOU NEED TO DO WHAT TO COMPENSATE

A

HYPERVENT

238
Q

TO INCREASE CO2 YOU ___ VENTILATE

A

HYPO

239
Q

TO DECREASE CO2 YOU —- VENTILATE

A

HYPER

240
Q

so long story short, if it’s a resp prob something will occur where

A

at kidneys

241
Q

long story short, if it’s a metabolic prob, something will occur

A

at lungs (hypo or hypervent)

242
Q

volume of inspired air OR volume of expired air with each breath

A

TV

243
Q

RV almost ___ with age

A

doubles (amt that is left after an expiration)

244
Q

What is it called when normal TV is exceeded (inhale or exhale)

A

inspiratory reserve volume - TV plus more

expiratory reserve volume - TV plus more

245
Q

Does TLC change with aging

A

no

246
Q

IC or inspiratory capacity is made of

A

IRV + TV (inspiratory reserve plus TV)

247
Q

Amount of air remaining in the lungs after a normal full exhalation (exhalation version of IC)

A

functional residual capacity

248
Q

What is VC (or vital capacity)

A

IRV + ERV + TV

249
Q

What makes up TLC

A

RV +IRV +ERV+TV

250
Q

The max that lungs can expand is

A

TLC

251
Q

what happens during ex with lung volume

A

As exercise begins, tidal volume increases initially followed by an increase in breathing frequency.

252
Q

What makes min ventilation

A

TV x freq

253
Q

maximal total amount of air that can be forced out following a maximal inspiration.

A

FVC (forced vital capacity)

254
Q

VC (amt that can be exhaled) and FVC won’t be the same for what pts

A

emphysema

255
Q

amt of air that can forcefully be exhaled in a matter of sec is

A

FEV

256
Q

normal FEV1 is

A

75% (you should be able to blow out 75% of your air in 1 sec)

257
Q

normal FEV3

A

90% (you should be able to blow out 90% of your air in 3 sec)

258
Q

what 2 main things will increase with an obstructive lung disease

A

RV, TLC

259
Q

how to find METS

A

VO2 max/3.5

260
Q

pts should be able to do ___% of VO2 max for an 8 hour work day

A

40% (so take .40 times the predicted and this gives VO2 Max)

261
Q

For FEV, you should be able to do ___ % of your predicted for your age

A

80-100%

262
Q

posterior thoracatomy goes through what muscles

A

traps, rhomboids, lats

263
Q

anterior thoracatomy goes throu

A

(pec major and serratus) not as common

264
Q

most freq used method of approach for cardiac surg

A

sternal

265
Q

what is a carotid endodarectomy

A

incision in to one of the carotids to check pressure to see level of blockage

266
Q

if 4 things are listed regarding ABG, what are they and what order

A

pH/PaCO2/PaO2/HCO3

267
Q

is cyanosis a reliable sign to check for resp distress

A

no, it could be other things

268
Q

increased a-a gradient is what kind of pathology

A

lung

269
Q

how to determine bradycardia or tachycardia

A

look at number of boxes (big box method)

270
Q

is PAC an emergency

A

no, only if there are more than 9 in 1 min do you need to notify doc

271
Q

transmural MI (1st sign)

A

ST elevation

272
Q

subendo MI you see

A

ST depression

273
Q

when else may you see ST depression

A

during ex (ischemia - will return t normal)

274
Q

first degree from second rom 3rd HB

A

1st- every p will have a qrs and there will be a pattern
2nd - p’s will be without qrs’s and no pattern
3rd- p’s and t’s will start to blend into one bumpity bump

275
Q

4 main ways to tackle plaque (surgically)

A

PTCA
Stent
arthroectomy
laser

276
Q

pacemaker vs ICD (uses)

A

pacemaker-SSS, heart transplant, HB, CHF

ICD-emergencies (VTAC, VFIB)

277
Q

In order to qualify for a pressure support vent , the pt must

A

be able to have some efforts to breathe

278
Q

modes of ventlators

A 
ACV-assisted control vent
SIMV- Synchronized interm. mandatory
Pressure support
CPAP
BIPAP

Cardio Jean (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions