cardiogenic shock wk 3 vocab

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deb1316
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288584
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cardiogenic shock wk 3 vocab
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2014-11-08 16:36:43
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cardiogenic shock
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  1. HRT: hormone replacement therapy
    • once standard therapy for treating menopausal symptoms
    • includes estrogen for women without uterus or estrogen and progesterone for women with uterus
  2. Infarct (Myocardial infarction)
    • occurs d/t sustained ischemia, causing irreversible myocardial cell death
    • degree of altered fx depends on area of the heart involved and size of infarction
    • most MIs involve some portion of left ventricle
    • presence of cardiac markers confirms an infarction and is called STEMI
  3. Injury (myocardial injury)
    • reps a worsening stage of ischemia that is potentially reversible but may evolve to infarction of myocardial cells
    • typical ECG change during injury: ST segment elevation
    • if prompt and effective tx: it is possible to restore O2 to myocardium and avoid infarction
    • absence of serum cardiac markers confirms this
  4. Ischemia (myocardial ischemia)
    • typical ECG changes: ST segment depression and/or T wave inversion
    • Once tx (adequate blood flow is restored) the ECG changes will resolve, and the ECG will return to patient's baseline
  5. ST elevation
    • typical ECG change seen during myocardial injury 
    • if presence of serum cardiac markers= confirms infarction and STEMI
  6. Anterior MI
    result from occlusions in left anterior descending artery
  7. inferior MI
    result from occclusions in right coronary artery
  8. SA node
    • pacemaker of the heart
    • where a normal cardiac impulse begins
  9. Atrial fibrillation (A fib)
    • total disorganization of atrial electrical activity d/t multiple ectopic foci resulting in loss of effective atrial contraction
    • the most common, clinically significant dysrhythmia 
    • results in decreased CO d/t ineffective atrial contractions and or a rapid ventricular response
  10. Troponin
    • myocardial muscle protein released into circulation after myocardial injury 
    • highly specific to cardiac tissue
  11. CPK-MB
    • elevation is specific for myocardial tissue injury
    • levels start to rise about 6 hours after symptom onset, peak in about 8 hours, and return to baseline within 24-36 hours after MI
  12. Thrombolytic
    • use of drugs to break up or dissolve blood clots, which are main causes of heart attacks and stroke 
    • ideally, pts should receive meds within first 30 minutes after arriving at hospital for tx
  13. Reperfusion dysrhythmias
    • accelerated idioventricular rhythm
    • less reliable marker of repercussion
    • generally self-limiting and don't require aggressive treatment
  14. Dopamine
    • positive inotrope, beta adrenergic agonist
    • short-term tx ADHF in ICU or intermediate care units with ECG monitoring capability 
    • dopamine dilates renal blood vessels and enhances urine output
  15. Dobutamine
    • selective beta adrenergic agonist
    • preffered short term tx for ADHF
  16. Diuretic
    • used for chronic heart failure 
    • used to mobilize edematous fluid, reduce pulmonary venous pressure, and reduce preload
  17. ACE inhibitors
    • primary drug for blocking RAAS system in HF patients with systolic dysfx
    • monitor potassium level, hypotension
  18. ARBs- angiotensin II receptor blockers
    • pts who are unable to tolerate ACE inhibitors
    • prevents vasoconstriction
  19. Aldosterone antagonists
    • Aldactone and Inspra
    • avoid foods high in potassium
    • monitor potassium levels
    • potassium sparing diuretic- promotes sodium and water excretion while retaining potassium
  20. Beta blockers
    • reduce myocardial contractility
    • care must be taken to start gradually
  21. Digoxin
    • increases force of contractility
    • monitor potassium levels
    • prior to admin, obtain apical pulse
  22. Lidocaine
    • sodium channel blocker
    • accelerates repolarization
    • little to no effect on ECG
  23. Prodysrhythmic
    • given for life-threatening dysrhythmias 
    • examples: digoxin
  24. IABP- intra-aortic balloon pump
    • purpose: decrease work of heart to improve cardiac output
    • decreases after load, decreases pressure in aorta during systole
    • improves renal perfusion, (renal arteries during diastole)
  25. IABP management
    • monitor anticoagulation
    • prevent infection
    • check for proper fx of IABP- wave form, BP, pain, dysrhythmias
    • monitor for complications: occlusion of femoral artery, migration of balloon
  26. Tachydysrhythmias
    cardiac rhythm higher than 100 beats per minute
  27. Electrical cardioversion
    • when doc restores regular rhythms by sending an electrical shock to the heart
    • treats arrhythmias
    • treats a flutter, a tachy, and v tach
  28. Conscious sedation
    • combo of meds to help pt relax (sedative) and to block pain during medical or dental procedure
    • protect airway
    • o2 delivery
    • prevent pressure to area
  29. Adenosine
    • decreases conduction via AV node
    • Effects on ECG: prolonged PR interval, AV block
    • give over 5 seconds IV push
    • monitor rhythm after tx (medical cardioversion)
  30. Pacemaker temporary
    • used after open heart surgery or MI
    • lead into right ventricle via superior vena cava
    • generator is external to patient
  31. Natural disaster
    caused by natural or environmental forces
  32. Man-made disaster
    • complex
    • technologic
    • not natural but occurs in human settlements
  33. Clostridium botulinum
    • food-born- primarily in adults
    • Spores- if found in infants
    • occurs 18-36 hours after ingestion
  34. Clostridium botulinum manis
    • double vision
    • blurred vision
    • ptosis
    • slurred speech
    • xerostomia
    • muscle weakness- common in infants
  35. C. Botulinum tx
    • antitoxin
    • early diag required
    • mechanical ventilation
    • may require weeks
    • debridement for wound botulism
    • education for prevention

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