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MedSurg 2 > Week 3 > Flashcards

Week 3 Flashcards

1
Q

What is angina a fancy word for?

A

chest pain!

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2
Q

what are symptoms of an MI?

A

Chest pain radiating to the jaw, back and arms.

nausea, pallor
SOB
Diaphoresis
Upper GI discomfort

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3
Q

How often can you give a nitro tablet?

A

1 pill Q5min up to 3 doses

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4
Q

What medication is nitro contraindicated with and why?

A

SILDENAFIL it can bottom out blood pressure

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5
Q

What lab diagnostic indicates there is trauma to the heart?

A

TROPONIN

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6
Q

what is the lab value for troponin that indicates there has been trauma to the heart?

A

Troponin OVER 0.04!!!

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7
Q

When a cell dies, what happens to troponin, explain

A

when a heart cell dies, troponin is released BUT so is potassium which is why you confirm an MI with troponin levels because potassium will ALSO show an ST elevation due to hyperkalemia

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8
Q

What are the ABC’s of MI surgery?

A

Angioplasty
CABG
Endardectomy

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9
Q

What can also be given to a patient that has an MI if surgery isn’t immediately available?

A

thrombolytics

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10
Q

If someone is having an MI right now, what do you do NOW? think MONA

A

Oxygen
Aspirin
Nitro
Morphine

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11
Q

Once you’ve done MONA on a pt with an MI, what do you do next?

A

get them to the CATH LAB ORRRR

give them a clot buster if surgery isn’t immediately available

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12
Q

After the pt has been treated with an MI (after Cath lab/clot buster), What do you do as continued care?

A
  1. PREVENT or stabilize the clot with a heparin drip
  2. HEART REST, meaning give them a nitro drip, beta blockers
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13
Q

what causes an MI?

A

COMPLETE BLOCKAGE in one or more arteries of the heart causing decreased perfusion of the heart muscle and ischemia

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14
Q

explain what happens when arteries become narrowed

A

when arteries become narrowed by atherosclerosis, there is decreased blood flow which means decreased oxygen to the heart muscle WHICH causes that angina pectoris aka chest pain

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15
Q

what happens if the plaque ruptures and causes total artery occlusion?

A

MI

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16
Q

What is stable angina?

A

acute chest pain caused BY stress/sex

STOPS after activity stops aka usually treated with rest

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17
Q

what is usually the tx of stable angina?

A

rest, pill, spray

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18
Q

what is unstable angina?

A

chronic chest pain BUT happens randomly!!!

aka unpredictable chest pain

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19
Q

tx for unstable angina?

A

transdermal nitro patch OR nitro !!

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20
Q

Which population is a silent MI more likely to occur in?

A

diabetics because diabetes affect the nerves and they may not feel those warning signs

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21
Q

WHAT IS THE NUMBER 1 INDICATOR OF A HEART ATTACK?

A

CARDIAC TROPONIN

AKA YOUR ON THE FLOOR IF YOUR TROPONIN IS GREATER THAN 0.04

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22
Q

if someone is experiencing cariogenic shock, what may that look like?

A

low BP
agitation
pale skin
low urine output

23
Q

what is Becks triad for cardiac tamponade?

A

JVD
Hypotension
muffled heart sounds

24
Q

If someone is having Ventricular fibrillation what do you doooo

A

IF SOMEONE HAS THE V GIVE EMMMM THE D

aka if they have vfib or pulseless Vtach then defibrillate

25
Q

What does a STEMI show on an EKG? What does it mean?

A

ST elevation which means there is a complete occlusion

26
Q

What does an NSTEMI show on an EKG? What does it mean?

A

ST depression which means there is a SEVERE occlusion/necrosis

27
Q

explain what after load is, why is it important?

A

pressure that the L ventricle needs to pump AGAINST in order to get blood into the systemic circuit

28
Q

What two comorbidities set the stage for atherosclerosis?

A

HTN and diabetes

29
Q

If someone has an NSTEMI can if progress and to what?

A

can progress to STEMI aka heart attack, GIVE NITRO

30
Q

What is ACS? what is the pathway of ACS that leads to an MI?

A

Acute coronary syndrome

Starts with atherosclerosis, then stable angina to unstable angina which BOOM leads to MI aka heart attack

31
Q

What is an absolute MUST to give for someone having unstable angina?

A

NITRO

32
Q

what are the two different types of stress tests?

A

exercise
AND
Pharmacologic

33
Q

what is the pharmacologic stress test

A

Lexiscan with the med REGADENESON

34
Q

How does Regadenoson work?

A

by vasodilating the coronary arteries and inducing cardiac hyperemia (excess blood supply to a specific organ or part of the body)

35
Q

What may develop as a long term complication following an acute MI?

A

A-fib

36
Q

POST MI COMPLICATIONS

THINK DARTH VADER

A

Death
Arrhythmias
Ruptures
Tamponade
Heart Failure (acute or chronic)

Valvular disease
Aneurysm
Dresslers syndrome
Embolism
Recurrence

37
Q

How can we measure ejection fraction?

A

with an echocardiogram
aka ultrasound of the heart

38
Q

what can general muscle injuries cause an elevation in?

A

troponin

39
Q

What are the ACE inhibitors you would give for someone experiencing some form of ACS?

A

anything PRIL

ex: lisinopril

40
Q

What are the antilipemic medication you would give someone experiencing an ACS?

A

STATINS ex: lovastatin

41
Q

how does a beta blocker work?

A

slows down the heart so the chamber can fill with blood

ex: atenolol

42
Q

What is the main concern after someone has a heart attack?

A

heart failure

43
Q

if you want to give a cardio delectable bblocker which one would you give

A

metoprolol

44
Q

What does propranolol target?

A

heart and lungs

45
Q

what is used to tx dysrythmmias?

A

diltiazam

46
Q

what class of meds is diltiazam?

A

calcium channel blocker

CARDI BRINGS DOWN THE PARTY

47
Q

What is the order of AMI

A

MI
Vtach
Vfib
asystole

48
Q

What are the clinical manifestations of pericarditis?

A
  1. pericardial friction rub
  2. Pulsus paradoxus
  3. Initial ST elevation
  4. Pleuritic chest pain
  5. Dyspnea
  6. Fever
49
Q

What is pulsus paradoxicus?

A

an exaggerated drop in systolic BP on inspiration (> 10 mmHg)

50
Q

What are Roth Spots?

A

areas of retinal hemorrhage with white centers characteristic of endocarditis

51
Q

What are Osler nodes?

A

pathognomonic skin changes for endocarditis that present as raised, localized hematomas on the fingers and toes

52
Q

What are Janeway lesions?

A

pathognomonic skin changes for endocarditis that present as flat, pinpoint, and bruise-like markings on the palms of the hand and soles of the feet

53
Q
A

MedSurg 2 (5 decks)

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