12 lead

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12 lead
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2011-01-31 03:49:04
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12 lead
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  1. spectrum of coronary artery disease proceses from myocardial ischemia and myocardial injury to myocardial infarction and includes the clinical entities of stable and unstable angina and acute myocardial infarction.
    ACS (acute coronary syndrome
  2. chest pain that results when the heart's o2 requirements exceed o2 supply available from blood.
    angina pectoris
  3. physiologic Q waves measure:

    pathologic Q waves measure:
    • phy - less than .04 sec (40 mms)
    • pas - greater than or equal to .04 sec
  4. restoring blood flow to ischemic tissue
    reperfusion
  5. death and subsequent necrosis o fthe heeart muscle caused by inadequate blood supply; also (AMI) acute myocardial infarction
    MI (myocardial infarction)
  6. myocardial infarction that affects the full thickness of the myocardium and almost always results in a pathological Q wave in the affected leads.
    transmural infarction
  7. more then ________ americans have some form of CVD
    60 million
  8. the single largest killer of Americans is ____ in which _____people die
    • CHD
    • 446,000
  9. communication between 2 or more vessels.
    anastomosis
  10. protective mechanism that provides an alternative path for blood flow in case of a blockage somewhere in the system.
    collateral circulation
  11. Poiseulles law
  12. law stating that blood flow through a vessel is directly proportional the the radius of teh vessel to the fourth power.
  13. cardiac cycle
    period of time from the end of one cardiac contraction to the end of the next
  14. diastole
    period of time when the myocardium is relaxed and the cardiac filling and coronary perfusion occur
  15. systole
    the period of the cardiac cycle when the myocardium is contracting
  16. ratio of blood pumped from the ventricle to the amount remaining at the end of diastole
    ejection fraction
  17. stroke volume
    amount of blood pumped out by heart in one cardiac contraction
  18. Starling's law
    the more the myocardium is stretched up to a certain point, the more forceful the subsequent contraction will be
  19. afterload
    resistance against which the heart must pump
  20. preload
    the pressure within the ventricles at the end of diastole; commonly called the end-diastolic volume
  21. cardiac output
    the amount of blood pumped by the heart in 1 minute
  22. formula for blood pressure
    blood pressure = cardiac output x systemic vascular resistance
  23. formula for cardiac output
    cardiac output = stroke volume x heart rate
  24. chronotropy
    pertaining to heart rate
  25. intropy
    pertaining to cardiac contractility force
  26. dromotropy
    pertaining to the speed of impulse transmissions
  27. alpha receptors located in _______ responsible for __________
    • blood vessels
    • vasoconstriction
  28. beta1 located in ____ increase __ and __
    beta2 located in _____
    • - heart increase heart rate and contractility
    • - lungs cause bronchodilation and peripheral vasodilation
  29. specialiazed bands of tissue inserted between myocardial cells that increase the rate in which the action potential is spread from cell to cell.
    intercalated discs
  30. cardiac depolarization
    a reversal of charges at a cell membrane so that the inside of the cell becomes positive in relation to the outside.; the opposite of the cell's resting state in which the insideof the cell is negative in relation to the outside
  31. resting potential
    the normal electrical state of cardiac cells.
  32. The heart receives blood from the ___, which originate in the ______
    coronary arteries, aorta
  33. blood is supplies to the left ventricle, interventricular septum, part of the right ventricle, and conduction system by
    left coronary artery
  34. the 2 major branches of the left coronary artery
    anterior decending artery and the circumflex artery
  35. blood is supplied to part of the right ventricle and right atrium, and part of the conduction system by
    right coronary artery
  36. the 2 major branches of the right coronary artery
    posterior descending artery and marginal artery
  37. coronary vessels receive blood during ___
    diastole
  38. communication between two or more vessels
    anastomosis
  39. layers of artery and vein walls
    • innermost - tunica intima
    • middle - tunica media
    • outermost - tunica adventitia
  40. purpose of AV junction
    slow impulse down to allow ventricles to fill
  41. cardiac cells have these 4 characteristics
    • excitability
    • conductivity
    • automaticity
    • contractility
  42. where the esophapus meets the the stomach
    hiatus
  43. 3 groups that may show untypical signs and symptoms of chest pain
    elderly, females, diabetic
  44. most common cause of fatalities from a heart attack
    dysryhytmias
  45. leading cause of death ACS
    dysrhythmias
  46. this results in increased back pressure into the pulmonary circulation
    Left ventricular failure
  47. this results in increased back pressure into systemic venous circlation
    Right ventricular failure
  48. pitting edema result of
    systemic backup
  49. pathophysiology of CHF
    reduction in stroke volume causes fluid overload throughout the body's other tissues
  50. how is hydrostatic pressure affected in CHF
    increased
  51. drugs to treat CHF
    1st line_____
    2nd_____
    use cautiously___
    • nirto
    • morphine
    • albuterol
  52. in CHF mental status changes indicate
    impending respiratory failure
  53. primary cause for HTN emergency
    noncompliance with prescribed antihypertension medications
  54. signs/symptoms including headache, nausea vomiting, blurred vision, SOB, epistaxis, vertigo, tinnitis point to
    hypertensive emergency
  55. ballooning of an arterial wall, usually the aorta, that results from a weakness or defect in the wall
    aneurysm
  56. aneurysm inferior to vena cava often the result of atherosclerosis
    AAA - abdominal aortic aneurysm
  57. blockage of a pulmonary artery by a blood clot or other particle.
    acute pulmonary embolism
  58. sudden occlusion of arteriol blood flow due to trauma, thrombosis, tumor, embolus, or idiopathic means
    acute arteriol occlusion
  59. inflammation of the blood vessels commonly stems from rheumatic diseases and syndromes
    vasculites
  60. dialated superficial veins common with pregnancy and obesity
    varicose veins
  61. blood clot in vein that typically occurs in larger veins of thigh and calf - swelling, pain and tenderness, with warm red skin.
    deep venous thrombosis
  62. can be chronic often associated wth diabetes. estremities exhibit pain, coldness, numbness, and pallor
    peripheral arterial atherosclerotic disease
  63. 5 P's for assesing assessment and management of vascular disorders
    • pallor
    • pain
    • pulselessness
    • paralysis
    • parethesia
  64. reeentry may cause _______ that occurs when ___. can result in rhytms such as ____
    • isolated premature beats
    • ischemia or another disease process alters 2 branches of a conduction pathway conducted retrograde back to branch's origin
    • - PSVT and A-fib
  65. electrolytes most commonly associated with ecg disturbances are
    potassium and calcium
  66. hypokalemia
    condition where potassium level in blood is low
  67. hypokalemia effect on ecg
    cause prominent u wave and flatten T wave
  68. hyperkalemia
    potassium level in blood is elevated
  69. hyperkalemia effect on eck
    tall pointed T waves
  70. - hypocalcemia can be caused by
    - effects on ecg
    • - diuretics and certain endocrine conditions
    • - prolongs repolarization and causes prolonged ST segment and prolonged QT interval
  71. -hypercalcemia can be caused by?
    - effect on ecg
    • - adrenal insufficiency, hyperparathyroidism, kidney failure, or malignancies.
    • - shortens the repolarization phase thus ST segment to shorten
  72. effects of digitalis on ecg
    sagging or scooping of ST segment and can prolong pr interval
  73. effects of hypothermia on ecg
    osborn (J) wave
  74. the ratio of blood pumped from the ventricle compared with the amount contained at the end of diastole
    ejection fraction
  75. series of events between the end of a cardiac contraction to the end of the next
    cardiac cycle
  76. the resistance against which the heart must pump
    afterload
  77. . the phase of the cardiac cycle during which the heart contracts
    systole
  78. the amount of blood pumped by the ventricle during one cardiac contraction
    stroke volume
  79. the amount of blood pumped by the ventricle during one minute
    cardiac output
  80. the phase of the cardiac cycle during which the heart muscle is relaxed
    diastole
  81. the end-diastolic volume in the ventricle
    preload
  82. The parasympatholytic agent used to treat symptomatic bradycardias is
    atropine
  83. the most common presenting symptoms in cases of cardiac disease.
    chest pain
  84. A blood clot in one of the pulmonary arteries is called
    pulmonary embolism
  85. progressive degenerative disease of the medium-sized and large arteries.
    Artherosclerosis
  86. Conduction of the electrical impulse through the heart’s conductive system in an abnormal fashion
    aberrant conduction
  87. A delay in conduction at the level of the AV node is called
    first degree AV block
  88. The five Ps of acute arterial occlusion are
    pain, pallor, paresthesia, pulselessness, and paralysis
  89. law states that the flow rate of a fluid through a tubular vessel was linked to the radius of the tube. The flow rate or pressure of blood flow through a blood vessel therefore is related to the radius or size of the vessel.
    Poiseuille’s Law
  90. Chest pain that results when the heart’s oxygen demands exceed the blood’s supply is called
    angina pectoris
  91. variant of angina pectoris caused by vasospasm of the coronary arteries is called
    Prinzmetal’s __________ angina
  92. and subsequent necrosis of the heart muscle caused by inadequate blood supply
    myocardial infarction
  93. A cerebral disorder of hypertension indicated by severe headache, nausea, vomiting, and altered mental status is called
    hypertensive encephalopathy
  94. The thickening, loss of elasticity, and hardening of the walls of the arteries from calcium deposits is known as
    artherosclerosis
  95. are standardized such that the paper moves across the stylus at the rate of
    25 mm/sec
  96. When properly calibrated, a deflection of ______ large box(es) is equivalent to 1 mV.
    2
  97. One small horizontal box on an ECG is equivalent to ___ _________, and one large box is equivalent to _____seconds________________.
    0.04 and 0.20
  98. The time-interval markings placed at the top of ECG paper are located at intervals of
    3 seconds
  99. Prominent U waves and a widened QRS complex are both ECG evidence of this electrolyte imbalance
    hypokalemia_________________.
  100. inflammation and clots within a vein
    thrombophlebitis
  101. relief of dyspnea on sitting upright
    orthopnea
  102. alternation of weak and strong pulse over time
  103. pulsus alternans
  104. episodes of being awakened at night by shortness of breath
    paroxysmal nocturnal dyspnea
  105. drop of more than 10 mmHg in systolic BP with inspiration
    pulsus paradoxus
  106. T wave inversion indicative of what on ecg
    infarcted tissue or extensive transient ischemia
  107. pathological Q wave on ecg idicative of
    infarcted tissue that has formed a scar
  108. S-T segment elevation on indicative of
  109. myocardial injury
  110. S-T segment depression
    myocardial ischemia
  111. infarction affects the full thickness of myocardium and almost always results in pathological Q waves in the leads associated with the region of tissue death.
    transmural myocardial infarction
  112. The most common and one of the most life-threatening complications of an acute MI
    dysrhythmias
  113. The typical window for thrombolytic therapy in the setting of acute MI is initiation of therapy within _________ of onset of symptoms
    3
  114. An MI is usually associated with complaints of radiating chest pain that lasts longer than 30 minutes
    acute MI
  115. is the heart's reduced stroke volume causing an overload of fluid in the body's other tissues.
    CHF
  116. sudden episode of difficult breathing that occurs after lying down
    paroxysmal nocturnal dyspnea
  117. The accumulation of excess fluid inside the pericardium is called
    cardiac tamponade
  118. The inability of the heart to meet the metabolic needs of the body, resulting in inadequate tissue perfusion
    cardiogenic shock
  119. The absence of any ventricular contraction is called
    cardiac arrest
  120. death within one hour after the onset of symptoms.
    sudden death
  121. duration from the beginning of the cardiac arrest until effective CPR is established.
    downtime
  122. Left ventricular failure causes back pressure of fluid into the pulmonary veins and into the lungs, resulting in
    pulmonary backup
  123. is the most common symptom of congestive heart failure (CHF).
    Labored breathing
  124. problems are the most common cause of cardiac arrest in infants and children.
    respiratory and shock
  125. is a late and often sudden sign of cardiovascular decompensation in pediatric patients.
    hypotension
  126. The initial dosage of fluid in a pediatric patient suffering from hypovolemia should be
    20ml/kg_________ of an isotonic fluid
  127. What is the suggested initial setting for defibrillation of pediatric patients?
    - What energy is used on subsequent shocks?
    • 2 j/kg
    • 4 j/kg
  128. What is the initial IV dose of epinephrine in pediatric cardiac arrest
    0.01 mg/kg
  129. passage of electrical current through the heart during a specific part of the cardiac cycle to terminate certain dysrhythmias
    . synchronized cardioversion
  130. passage of electrical current through a fibrillating heart to depolarize a critical mass of myocardium, resulting in conversion to an organized rhythm
    defibrillation
  131. Dyspnea, tachycardia, noisy, labored breathing, gallop heart rhythm
  132. left ventricular failure
  133. Syndrome in which the heart’s pumping ability does not meet body needs
    heart failure
  134. Unresponsiveness with apnea and pulselessness
    cardiac arrest
  135. Jugular venous distention, engorged liver, edema, tachycardia
  136. right ventricular failure
  137. possible diagnosis to Pulsus paradoxus and pulsus alternans
    cardiac tamponade
  138. Dyspnea, orthopnea, decreased systolic BP with narrowing pulse pressures
    pulmonary edema
  139. Severe headache, visual disturbance, seizures, stupor, diagnostic vital signs
    . hypertensive encephalopathy
  140. adenosine for ped dose SVT
    0,1 mg/kg may double dose once for the second dose
  141. left sided heart failure can present with
    pulmonary edema
  142. atropine for bradycardia adult dose
    0.5 mg IV may repeat up to 3mg
  143. atropine bradycardia peds does
    0.02 mg/kg IV may repeat up to 1mg
  144. side effects atropine
    Blurred vision, dilated pupils, dry mouth, tachycardia, drowsiness, confusion
  145. Amiodarone for VF peds dose
    5mg/kg IV max dose is 15 mg/kg
  146. amio side effects
    Hypotension, bradycardia, prolonged PR interval
  147. adenosine peds dose
  148. 0.1 mg/kg, may repeat once in 1-2 min. at 0.2mg/kg., max dose is 12 mg
  149. adenosine side eff
  150. Facial flushing, headache, SOB, dizziness, nausea
  151. . Epinephrine for cardiac arrest adult dose
    • 1mg 1:10000 IV
    • Every 3 – 5 minutes until circulation retstored
  152. . Epinephrine for cardiac arrest peds dose
    0.01 mg/kg 1:10000 IV every 3 to 5 minutes
  153. epi side effects
    Nausea, vomiting, palpitations, dizziness,anxiety
  154. dopamine dose adult and peds
    2-5 mcg/kg/min up to 20mcg/kg/min titrated to ef
  155. dopamine sides
    tachy, nausea, vomiting, headache, dilated pupils
  156. fentanyl adult dose
    25 to 100 mcg
  157. Fentanyl ped dose
    2.0 mcg/kg IV

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