NCLEX Review Cardio Flashcards

cardiogenic shock
Terms Definitions
Universal donor
O –
ACE inhibitor
Ends in "pril"
Beta Blocker
Ends in "lol"
PVC
Ventricle contracts prematurely manifesting in palpitations and abnormal QRS
QRS
Complex showing ventricular depolarization
Neutrophils less than 1000
Leukopenia
Complication of Rheumatic Fever
Endocarditis
myocardial infarction
Diaphoresis, nausea, vomiting, anxiety, and fear can be symptoms of this condition, along with chest pain
septic
________ shock is systemic vasodilation due to infection
Common Antiplatelets
Abciximab (ReoPro), Anagrelide (Agrylin), Cilostazol (Pletal), Clopidogrel bisulfate (Plavix), Dipyridamole and aspirin (Aggrenox), Eptifibatide (Ticlid), Tirofiban (Aggrastate), Treprostinil (Remodulin), Deltaparin (Fragmin), Danaparoid (Orgaran), Enoxaparin (Lovenox), Tinzaparin (Innohep), Anisindione (Miradon)
What is Raynauds phenomenon
unilateral involvement
Raynauds disease is bilateral
extremity involvment
Blood pressure consistently greater than 140/90 Systolic and diastolic BP
Hypertension
What could compromise the intra-abdominal graft after a femoral poplieteal bypass graft surgery
Hypertension
What is VLDL
triglyceride and protein
Beta Blockers
Acebutolol (Sectral), Atenolol (Tenormin), Bisprolol (Zebeta), Metoprolol (Lopressor, Toprol), Carvedilol (Coreg), Nadolol (Corgard), Pindolol (Visken), Propranolol (Inderal)
Additional Antidysrhythmics
Disopyramide (Norpace), Flecainide (Tambocar), Mexiletine HCL (Mexitil), Moricizine (Ethmozine), Procainamide (Pronestyl, Procan), Propafenone HCI (Rythmol), Tocainide (Tonocard), Acebutolol (Sectral, Monitan), Esmolol (Brevibloc), Metoprolol (Lopressor), Propranolol (Inderal), Sotalol (Betapace), Amiodarone (Cordarone), Dofetilide (Tikosyn), Diltiazem (Cardizem), Verapamil (Calan, Isoptin, Verelan)
venous
____________ ulcers are reddened and bluish, edema usually present
arterial
___________ ulcers appear punched out and no edema is present
Fluid accumulation in the alveoli
Pulmonary edema
Coagulation Modifiers action
Antiplatelet and anticoagulants interfere with the formation of blood clots to prevent heart attacks, strokes, and DVT. Thrombolytics dissolve blood clots
How do I treat V Fib
Defibrillate
CPR ratio
30:2 of compressions to respirations
cardiogenic
__________ shock is failure of the heart to pump adequately
neurogenic
__________ shock is loss of vascular tone resulting in hypotension
0.12-0.20
Normal time in seconds of PR interval
15
Monitor apical pulse, BP, and perform neurovascular assessments ever ____ minutes for 2-4 hours
Signs of Pericardial Tamponade
Tachycardia, Hyptension, Paradoxial Pulse, Distant or muffled heart tones, Jugular vein distention
What is done on ALL AMI clients
Echocardiogram
CPR Cycles
15 with 100/min compressions then switch with another person for a break, when changing people begin with compressions
Side Effects of Antidysrhythmics
Hypotension, Dizziness, Other dysrhythmias, Confusion especially in the elderly
What do unstable angina clients have
cardiac insufficiency
100
During CPR, keep a compression rate of ___ per min for all ages
Expected chest tube drainage in 24 hours of placement
500 ml
What type of schock occurs with damage to the spinal cord
Neurogenic
Inflammation of all parts of the hear, especially the mitral valve
carditis
What form can Colony Stimulating Factors be given
SQ and IV
Common Colony Stimulating Factors
Erythropoietin (Epogen, Procrit) makes Erythrocytes (RBCs), Filgrastin (Neupogen) and pegfilgrastim (Neulasta) makes Neutrophils (WBC)
1
Do not use AED on children under ___ year(s)
morphine, oxygen, nitrate, aspirin
MONA - treatment for heart attack
What blood level elevation is the earliest indicator of AMI
Troponin and CPK-MB
What type of pacemaker Fires as needed when the heart rate slows down
Synchronous (demand)
Common Calcium Channel Blockers
VERY = Verapamil (Calan, Isoptin, Verelan), NICE= Nifedipine (Adalat, Procardia), DRUGS= Diltiazem (Cardizem, Dilacore, Tiazac) others are Amlodipine (Norvasc), Bepridil (Vascor), Nicardipine (Cardene) (tend to end ind ipine)
What will relieve pain in arterial insufficiency
putting legs down
Action of Antidysrhythmics
treat abnormal heart rhythms which can begin in the atria or the ventricles
What stage of shock will I see client dying
irreversible
Pale, shiny skin with decreased pulses, pale when elevated, red when dependent. Need to tell client to check pulses periodically
signs of arterial insufficiency
What is the treatement for Anaphylactic shock
Give fluid, antihistamines, bronchodilators, and steroids, Epinephrine 1:1000, 0.2-0.5 ml SQ for mild reaction 1:10,000, 0.5 ml for severe reaction “ remember give the $10,000 drug for a severe reaction”
What type of shock occurs due to an infectious process
Septic
Right sided HF clinical manifestations
Fatigue, Distended Jugular veins, swelling in hands and fingers, dependent edema, enlarged liver and spleen from increased pulmonary pressure due to long term repiratory acidioses, ascites, anorexia and complaints of GI distress
If a question is about heart blocks where is the problem?
AV node
What is ic called when the left ventricular pressure is increased and enlarged and Systolic murmur
Aortic Stenosis
What do you see with Ventricular Tachycardia
Wide, bizarre QRSs
Describe Premature Ventricular Contractions (PVCs)
Periodice wide, bizarre QRS, premature beats followed by a compensatory pause
Common HMG CoA reductase inhibitor (Statin Drugs)
Atrovastatin (Lipitor), Fluvastatin (Lescol), Lovastatin (Mevacor), Pravastatin (Pravachol), Rosuvastatin (Crestor), Simvastatin (Zocor)
What is S2?
the closure of the AORTIC and PULMONIC valves and heard loudest in those areas
If the PR interval is greater then 0.20 the client has a?
first degree block
What is most predicative of CAD
Elevated LDL and cholesterol levels
What is the study called when wires are put into the right side (veneous) heart to stimulate abnormal rhythms
Electrophysiology EP study
Steps to cardioversion and defibrillation
call “all clear” before discharge of energy in defribrillation, lubrication on chest for discharge, TURN OFF O2 if possible before defibrillation due to combustion, need to remove nitroglycerine patch if present due to it has metal in it.
What stage of shock will I see Metabolic acidosis, widespread cellular injury, third spacing, multisystem organ dysfunction
Decompensated or progressive
What is treatment of Neurogenic shock
Give fluids and vasopressors early
Clinical manifestations of late shock
BP less than 90 systolic (hypotension), Weak increased heart rate, pale, cold and clammy, coma, incrased shallow respirations, NO urine output
How is Digoxin excreted
by the kidneys dosage must be DECREASED in renal dysfunciton
What is Coronary artery disease
Plague buildup resulting in a reduction of blood flow to the myocardium. Affected by blood cholesterol levels
Calcium Channel Blockers Action
Relax the blood vessels reducing blood pressure and improving blood flow. They also slow down the electrical conduction in the heart and can be used to control rapid dysrhythmias.
Device used to pace or defibrillate a client our of a dangerous dysrhythmia
Implantable cardioverter defibrillator
What is a disorder of blood vessels resulting in vasoconstriciton and decreased blood flow
Raynauds disease and phenomena
What do you call damage to the myocardium resulting from an interruption of blood flow
Acute myocardial infarction (AMI)
Red cell destruction by antibodies
Erythroblastosis this is a type of hemolytic disease, will see low Hgb and Hct and high bilirubin due to the breakdown of the blood cells
Side Effect with Quinidine gluconate (Quinaglute)
Diarrhea, N&V, Loss of appetite, Dizziness
Lab effects of Polycythenia vera
increased Hgb, Hct, if COPD on increased Hct
What is treatment of Cardiogenic shock
Give fluids, vasopressors (such as Levophed or Dopamine), vasodilators, and insert an intra-aortic balloon pump. Monitor for the development of pulmonary edema.
Side Effects of Calcium Channel Blockers inclued the 5 H’s
Hypotension, HA, Hot Flashes, Heart Block, Hard Bowel Movements
What is the bump seen after the QRS complex and signifies return to resting for the heart?
The T wave
Target Levels of LDL
less than 100 LDL for those with risk factors, less than 160 LDL for all others
Target levels of VLDL
less than 100 LDL for those with risk factors, less than 160 LDL for all others
What does ST segment elevation signify?
ischemia over the area of the infarction
What shock occurs due to histamine release
Anaphylactic shock, will see broncial constriciton and decreased periperal resistance, leads to hyptension and flushed appearance
A client is bleeding from everywhere what do they have
DIC, give blood, paletlets, FFP and heparin to prevent further depletion of clotting factors
What is the most common cause of death immediately after an acute MI
V Fib, or V tachcardia
What type of shock occurs with damage to the heart muscle
Cardiogenic shock, pulmonary edema may result
A non invasive EP study is a
holter monitor diary should be kept with the following info, medication times and does, chest pain episodes, and description, valsalva, sexual activity, exercise
Bile acid Sequestrants use
they are a powder that I mix in water, may bind to other medications so give alone, Take 1 hours before or 4-6 hours after other meds
The ST segment is the point where the end of the ______ and the _____ wave join.
QRS and the T wave join.
Will PVCs cause palpitations in the client
yes, feel for a pulse deficit when the beats occur
How many seconds is each small block on a rhythm strip?
0.04 seconds, this may be used to determine intervals such as the PR interval or the duration of the QRS complex. If the complex is really small, adjust the gain or amplitude on the monitor
What do I begin joules at for Defibrillation
200 joules up to 360, clinet is uncouscious, EKG monitor, no cardiac output, Must be in Ventricular Fibrillation or Tachycardia, it is an emergent procedure to safe a life.
What EKG changes will I see with an area of infaction
irreversible damage, causes a Q wave to dip down on the EKG
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