PCCN

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Author:
weepay25
ID:
43919
Filename:
PCCN
Updated:
2010-10-21 00:29:57
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Progressive Care
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Description:
Review questions for PCCN exam
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  1. Mechanical obstruction of a coronary artery or branch, caused by a thrombus, plaque rupture, coronary spasm, and/or dissection.
    Acute Myocardial Infarction
  2. Insufficient blood supply to the heart muscle usually resulting from CAD
    Acute Coronary Syndrome
  3. 2 types of acute MI's
    • STEMI
    • Non-STEMI (NSTEMI)
  4. S & S of Acute MI
    • >Crushing chest pain (may or may not radiate)
    • >Back, neck, jaw, and/or epigastric pain
    • >SOB
    • >N&V
    • >Dizziness
    • >ST elevation on EKG
    • >Elevated enzymes
  5. Object S&S of Acute MI
    • > Increased PAWP
    • >Decreased CO
    • >Increased SVR
    • >Dysrhythmias
    • >S4
    • Cardiac Failure
    • >Cardiogenic shock
    • >Diaphoresis, pallor, referred pain
    • Diabetics & women often present with abnormal symptoms
  6. List some complications of Acute MI
    • Dysrhythmias
    • heart failure
    • pericarditis
    • ventricular aneurysms
    • ventricular thrombus
    • VSD
    • mitral regurgitation
    • papillary muscle rupture
    • pericardial effusions
  7. Interventions for an Acute MI
    • O2
    • Bedrest
    • Routine EKG's
    • Routine enzymes (q8 x3)
    • Pain control (NTG, MSO4) MONA (morphine, O2, NTG, ASA)
    • Heparin, Beta-blockers, ace inhibitors
    • PCI, PTCA, IABP, CABG
  8. Treatments for Inferior Wall MI (IWMI)
    • Fluids
    • Inotropics
    • Afterload reducing meds
  9. Treatments for Anterior Wall MI (AWMI)
    • Diuretics
    • Inotropics
    • Afterload reducing meds
  10. Define Aortic Aneurysm
    • A bulge or ballooning of the aorta
    • When the walls of the aneurysm includes all 3 walls of the artery, they are called true aneurysms
    • When the wall of the aneurysm includes only the outer layer, it is called a pseudo-aneurysm

    Can be abdominal or thoracic
  11. List several causes of aortic aneurysms
    • Artherosclerosis
    • Marfan Syndrome
    • HTN
    • Crack cocaine
    • Smoking
    • Trauma
  12. Saccular and fusiform aneurysms
  13. How will a ruptured abdominal aortic aneurysm present?
    • >Extreme abdominal or back pain
    • >Pulsating mass in abdomen
    • >Drastic drop in BP
  14. How will a ruptured thoracic aortic aneurysm present?
    • >Back, shoulder or neck pain
    • >Cough (due to pressure on the trachea)
    • >Hoarsness
    • >Stridor, dyspnea
    • >Difficulty swallowing
    • >Swelling in neck or arms
  15. Define an aortic dissection
    A tearing of the inner layer of the aortic wall, allowing blood to leak into the wall itself and causes the seperation of the inner and outer layers of the wall

    Usually associated with severe chest pain that radiates to the back
  16. List possible complications of aortic aneurysm
    • >Rupture
    • >Peripheral embolization
    • >Infection
    • >Spontaneous occlusion of the aorta
  17. Medical treatment of aortic aneurysms
    Surgical repair once the aneurysm is >4.5cm for Marfan pts, and >5cm in non-Marfan pts

    Mostly controlled by BP control
  18. Define Cardiomyopathy
    Diseases of the heart muscle that cause deterioration of the function of the myocardium
  19. Cardiomyopathy can be Primary/Idiopathic or Seconday
    • Primary/Idiopathic (intrinsic)
    • Heart disease of unknown cause, although viral infection and autoimmunity are suspected causes

    • Secondary (extrinsic)
    • Heart disease as a result of other systemic diseases, such as autoimmune disease, severe HTN, or ETOH abuse

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