Cardiology 1

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hanlin
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171178
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Cardiology 1
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2012-09-16 12:03:23
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Cardiology Test
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Cardiology Nursing Test
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  1. Inotropic
    Strength of Conduction
  2. Chronotropic
    Speed of heart beat
  3. Dromotropic
    Conduction of the impulse
  4. Cardiac Glycoside
    Digoxin
  5. Digoxin
    (Inotrope, Chronotrope, Dromotrope)
    + Inotrope, - Chronotrope, - Dromotrope
  6. What does Digoxin do to the heart rate
    Slow and Strengthens
  7. Digoxin increases or decreases Cardiac output?
    Increases
  8. Digoxin is used for
    CHF, Supraventricular tachyarrhythmias, Prevention of A-fib and flutter
  9. Normal level of Digoxin?
    0.5 to 2.0 mg/ml
  10. First sign of Digoxin toxicity
    Anorexia
  11. SE of Dig
    Visual distrubances blurred, yellow green halo, spots, confusion
  12. Decreased potassium level can cause?
    Toxicity
  13. Before giving Dig should check what?
    Apical HR for full min If below 60 hold and call
  14. Pt will have increased or decreased Urinary output when Dig is working correctly?
    Increased
  15. How to prevent Dig toxicity?
    Alternate dosage
  16. Calcium Channel Blockers end in what?
    dipine
  17. 2 Groups of Ca Channel Blockers
    Decrease BP, Decrease HR
  18. Effects of Ca Channel Blocker
    • Block Ca
    • Decrease HR as conduction is slow through SA and AV Nodes (-Dromotrope)
    • Coronary Artery vasodilation
    • Vasodilation of peripheral arteries
    • Negative Inotrope inhibits smooth muscle contraction, decrease HR, Decrease contraction
  19. Uses of Ca Channel Blocker
    • Angina
    • Prevent Tachycardia Dysrhythmia
    • Treat HTN
  20. SE of Ca Channel Blockers
    Decrease BP, May cause headache, dizzy, rash, ankle edema, complaint of dry mouth
  21. Always check what before giving a Ca channel blocker?
    BP if systole is below 90 hold or HR below 50 hold and call
  22. Ca Channel blockers do not work well with what?
    Smokers
  23. Nitrates are
    Vasodilaters
  24. Effects of Nitrates
    • Dilate vascular smooth vessels
    • Decrease peripheral arterial vascular resistance
    • (reduce afterload)
    • Decrease venous blood return to heart
    • (reduce preload)
  25. Uses of Nitrates
    • Anti-anginal
    • Hypertension crisis
  26. SE of Nitrates
    • Postural HTN
    • Flushed face
    • Headache
    • Vertigo with faintness
  27. Considerations before taking Nitrates
    • Check BP and Pulse
    • Do not mix with other drugs
    • Take Nitro patch off at night so don't become tolerant
  28. Beta Blockers will ____ HR and ____contractibility
    Decrease, Decrease
  29. Beta Blockers Effects
    • Decrease sympathetic stimulation (stress response)
    • to heart and major blood vessels
    • Decrease HR (- chronotrope) (-Inotrope) (- dromotrope) Decrease O2 consumption
  30. Uses of Beta-Blockers
    • Decrease HR with Tachy dysrhythmias
    • Anti-anginals
    • Prevention of second MI
    • Treatment of HTP
  31. SE of Betablockers
    • Bradycardia
    • Beta 2 effects can cause bronchospasms (especially asthma pts)
    • Penile dysfunction, relaxes urianry sphinchter
    • Can cause Fatigue and Nightmares
  32. Non Selective Beta 2 Drugs don't give to who?
    Those with respiratory problems
  33. Considerations before giving a beta Blocker
    Assess BP and HR Below 50 or BP Systolic below 90 hold
  34. Beta 1 is
    Beta 2 is
    • Beta 1 selective (Only Heart)
    • Beta 2 Non selective (Heart and Lungs)
  35. Beta 2 Use cautiously in pts with?
    Diabetes
  36. ACE Inhibitors drugs ending in?
    PRIL
  37. Action of ACE Inhibitors
    • Inhibit angiotensing converting enzymes (ACE)
    • Converts Angiotensin 1 to Angiotensin 2
  38. Angiotension 2 is a powerful what?
    Vasoconstrictor
  39. Angiotension 2 effects on the body
    • Vasoconstriction (Increase BP)
    • Causes release of Aldosterone (NA and water retention)
    • Urinary output decreased
  40. Uses of ACE Inhibitors
    • Reduce the workload of the heart
    • antihypertensive
    • Renal protective helps protect the kidney from failure
  41. SE of ACE Inhibitors
    • Dry Cough, Lost of taste, Decrease BP,
    • CHECK renal, Kidney and Liver Function
    • Can cause Neutropenia (decrease WBC) so Risk for infection
    • Kidney Failure
  42. Angiotensin 2 Receptor Antagonist ends in
    Sartans
  43. Angiotensin 2 Receptor Antagonist action
    • Blocks the effect of angiotensin 2
    • Blocks vasconstriction and releases aldosterone
  44. Uses of Angiotensin 2 Receptor Antagonist
    Treat HTN
  45. SE of Angiotensin 2 receptor Antagonists
    Check BP, Check Renal Function
  46. Drugs of Angiotensin 2 receptor antagonist
    Losartan, Valsartan, Candesartan, Irbesartan
  47. Anticholinergics
    (drug)
    Atropine
  48. If someone has a slow HR (bradycardia) they will receive which med?
    Atropine
  49. Effects of Anticholinergics
    Increase rate of SA node (+ chronotropic) Increases conduction through AV Node (+dromotropic)
  50. Uses of Anticholinergics
    • Sinus brady cardia
    • Pre procedure prep for pt
    • -bronchoscope
    • -esophagram
  51. SE of Anticholinergics
    Dry Mouth, Flushing, Dilation of Pupils, Decrease in bronchial secretions, Inability to void especially with prostate enlargement
  52. Atropine is give to ___ the pt's HR
    Increase
  53. Antihypertensive drugs purpose
    Reduce blood pressure to normal or near normal
  54. Alpha blockers (Alpha 1 to treat hypertension and to reduce -____
    Peripheral resistance
  55. Alpha blockers should be taken when? and why?
    Night because it can cause orthostatic hypertension
  56. Antiarrhythmic drug is
    Lidocaine
  57. Lidocaine must have
    EKG monitor
  58. What is lidocaine give for?
    Ventricular dysrhythmias
  59. EKG monitors what?
    Electrical activity of heart ongoing basis (impulses) No pain while doing this test
  60. 12 Lead EKG looks at what?
    • Electrical activity of heart from 12 different views
    • DX of MI, It can tell us if the pt has hyper or hypokalemia Decrease or increase potatisum levels, Ca levels and dysrhythmias
  61. Holter Monitor
    EKG on a outpatient base (telemetry) recorded for 12-24 hrs looking for dysrhythmias or abnormalities , keep diary or log for all activities
  62. Stress test
    No caffeine prior to test for 24 hrs, NPO for 4 hrs before the test, when exercise the cornary arteries dilate 4 x
  63. Chest X-ray
    Measures heart size, location, pulmonary infiltrates
  64. Echocardiography (Sonogram)
    Non invasive, shows wall motion, Contractility, ejection fraction, stroke volume, valve function, can look for size, shape, beating
  65. rapid fast CAT scan
    Good for Coronary arteries disease
  66. Cardiac Cath or angiogram
    • NPO 8-12 hrs before, IV Access, teaching, Draw BUN to check Kidney Function, PT, PTT, INR (evaluate clotting factors), Platelets and electrolytes
    • Continous EKG, IV Heparin
  67. Cardiac Cath Pt should be
    • Flat, bedrest for 2-6 hrs, Neurochecks, look for bleeding at cath site
    • Potential problems Allergy to dye, hematoma, hemorrhage
    • Kidney failure due to dye (increase fluids to flush)
    • Urinary retention
  68. Vasovagal reaction
    The HR and BP drops this can occur just by distended bladder and pain, may need to give IV atropine to increase HR and BP
  69. Cholesterol
    Less than 200
  70. LDL
    Less than 130
  71. Fatty triglycerides
    45-150
  72. HDL
    35-85
  73. When the heart is damaged it releases what?
    Enzymes
  74. Depolarization
    Electrical activation of cell caused by influence of NA going in cell while K exits
  75. Repolarization
    Return of cell to resting state Na goes out and K goes in cell
  76. P Wave
    Conduction of impulse through atrium (atrium in depolarization) SA spreading in atria

    0.11 sec or less
  77. QRS Complex
    Conduction of impulse from (ventricular depolarization) SA Node to AV Node (ventricular depolarization)

    Less tahn 0.12 secs
  78. PR Interval
    O.12 -0.20 secs
  79. ST segment
    Refelects end of ventricle depolarization (QRS) thru end of Ventricle repolarization (T wave)
  80. T wave
    Repolarization of ventricle (resting state)
  81. One small box
    0.04 secs
  82. 1 Big box (5 small)
    0.20 secs
  83. Ventricle Contraction:
    Begin with S1 (systole) depolarization electrical stimulation
  84. Ventricle emptying and relaxing (Dilate) S2
    Repolarization electrical relaxation Dystole
  85. Factors that affect stroke volume
    After load
  86. Ejection fraction
    The perecnt of blood ejected with each beath of the heart should be greater than 50 percent
  87. Factors affecting Cardiac Output
    • Length of Diastole
    • Force of contractility of muscle
    • Venous Return
    • Peripheral vascular Res (BP)
    • Ventricular Compliancy
  88. Diastole=
    Filling, relaxation of the heart
  89. Systolic=
    Pumping the contraction of the heart
  90. Which ventricle pumps the blood to the aorta to go to the rest of the body?
    Left Ventricle
  91. Cardiac preload is
    a stretching of the ventricle of atria while they are filling with the blood (diastole)
  92. Afterload is
    The work required by the heart to move blood into systemic circulation you could be even more specific say the left ventricle
  93. What happens during S1 and S2?
    Preload- The strength of the ventricles to atrium filling of the blood (diastole) relaxation

    Afterload- the work load it takes teh heart to pump (syst) contraction
  94. s1 heard best
    Closer T M , apex (sys) Lub
  95. S2 heard best at
    A P , Base (diast) Dub
  96. Superior and Inferior Vena Cava
    Rt Atrium
    Rt Ventricle
    Pulmonary Artery
    Lungs
    Pulmonary Veins
    Left Atrium
    Left Ventricle
  97. Aortic
    Pulmonic
    Erbs point
    Tricupsid
    Mitral
  98. S1 is the closer of Tricupsid and Mitral, heard best at apex (sys) S1 lub
  99. S2 is the closer of the Aortic and Pulmonic (dys) heard best at the base of the heart
  100. Systole
    Mechanical contraction (blood pushes out of the ventricle)
  101. Diastolic
    Mechanical relaxation
  102. Coronary arteries fill during when?
    Diastole
  103. If you have a pt who has tachycardia, Increase HR, Shorten diastole mycardial perfusion will -----
    Decrease.. Coronary arteries will not perfuse
  104. ICD (automatci) Implantable cardioverter defibillator
    Mechanism that is implanted in the pt to provide a shock directly to the heart for recurring v tach or v fib uncontrolled by medication
  105. ICD what does it do?
    Gives repetitive shocks directly to the heart
  106. Statin are
    • Antiplatelets aggregation
    • Plavix, ASA
  107. MVO2
    Mixed venous oxygen saturation
  108. PTCA (percutaneous transluminal coronary angioplasty)
    Balloon on a wire is inserted into artery feed back uup aorta (against the flow) and into coronary arteries to a lesion. The ballon is inflated the plaque is pressed into the walls of the vessel
  109. PTCA
    • NPO
    • Consent sign
    • IV
    • Pt is awake
    • Will have angina
  110. Post PTCA
    • Stay overnight
    • Receive heparin during procedure
    • Check for bleeding in the groin
    • affected leg should be straight
    • Pt flat
    • Apply pressure if bleed
    • on ASA rest of life
  111. Stent: a wire mesh that holds the wall lumen open
  112. CABG (Coronary artery bypass grafting)
    • Bypasses the blocked area and uses a vessel
    • The heart is not opened
    • The sternum is cut open to have acess to the heart from top to bottom
    • The blood that normally flows through the heart given through a machine
    • The heart is stopped, using strong potassium adn other electrolyte solution
    • Bypass grafts are sewn onto the coronary artery
  113. ACE
    (Inotrope, Chronotrope, Dromotrope)
    • +
    • -
    • -
  114. Angina is usually caused by?
    CAD
  115. CABG can have pain and swelling where?
    Leg
  116. S4 is always abnormal
    S3 is not
  117. Dfib for Vfib
  118. Graham Crackers and Apple Juice
    No Cheese
  119. Blood Clot in Rt Ventricle goes in?
    Pulmonary artery
  120. Coronary artery fills during?
    Diastole
  121. Chest Pain-mowing
    CABG Leg pain normal
  122. Coffee away nothing else
    Drug at night
  123. Stool softner, Decreases HR BP
    Ca Blocker, Decrease HR BP, Angina
  124. PTCA- Normal if having pain
    Check bleeding in groin
  125. Affected leg straight, pt flat
    ACE Inhib reduced afterload
  126. Echo No prep
    Risk for decrease Cardiac Output
  127. Apical= Pulse pressure
    Ejection fraction should be greater than 50
  128. Coronary artery difuses during Diastole
    Sinus Tachycardia is one of the strips
  129. ICD- Bradycardia prepare for surgery
    Telemetry-Damage to heart
  130. Alpha 1- Orthostatic HTN
    Atropine decreases urine output
  131. Nitrates -vasodilator
    Lidocaine for V Tac
  132. 120 HR
    Normal Rhythm
  133. HDL Good want high, helps reduce LDL
    LDL bad want it low
  134. Low fat, Low cholesterol Diet
  135. Beta 2 don't give to pts with
    Asthma
  136. Atrial Kick
    Last part of Diastole and ventricular filling accounts for 25-30 of cardiac output
  137. Stroke Volume
    Amount of blood ejected from ventricle per heart beat (about 70)
  138. Increase strength of contraction cardiac output will
    Increase
  139. Beta Blockers end in
    Olol
  140. isometric
    Has increased tension while maintaing length of muscle fibers
  141. Isotonic
    shortening of muscle fibers while tension remains constant
  142. Pulse Pressure
    Difference between systolic and diastolic pressure
  143. Sympathetic (adrenergic) Epinephrine Norepinerpherine
    Parasymathetic (cholinergic) Mediated by vagus nerve secretes acetycholine
  144. Sympathetic Increases SA node rate
    Increases Conductivity and Contractilility
    • Parasympathetic decreases SA Node rate
    • Decreases Conductivity and Contractility
  145. If ejection fraction is lower than 50 percent pt is not getting oxygenated
  146. If pt is Tachycardia will
    Shorten diastole myocardial perfusion will decrease
  147. Aorta
    Right 2nd ICS close to sternum
  148. Pulmonic
    Left 2nd ICS sternal border
  149. ERBS Pt
    L 3rd ICS sternal border
  150. Tricupsid
    L 5th ICS sternal border
  151. Mitral
    L 5th ICS Mid Clavicular Line
  152. Apical Pulse is taken at
    Left 5th Intercostal Space Mid Clavicular Line
  153. S3 Normal in children young adults, heart failure pts
    S4 Always abnormal , stenosis of aortic valve, heart pt, HTN, CAD
  154. Internal Jugular Vein distention indicates
    High preload
  155. Metabolic Acidosis indicates
    Poor peripheral perfusion
  156. CBC monitor ?
    Blood viscosity and inflammatory process
  157. Bundle of His and Purkinjes fibers conduct
    electrical impulses through the ventricles
  158. K+ Level
    3.5-5.0
  159. Na level
    135-145
  160. Too low K+ causes
    Toxicity
  161. Normal PR Interval
    0.12-to 0.20 sec
  162. Diagnostic ultrasound won't interfere with ICD
  163. Enzyme inhibiting antilipemics end with the suffix?
    Statin
  164. Increase HR causes increased 02 consumption, decreased amount o ftime in diastole
    There is the potential for a decrease in the myocardial oxygenation related to the increase demand, and decreased time during diastole

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