Cardiac- NU201

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Author:
seraphine7
ID:
75775
Filename:
Cardiac- NU201
Updated:
2011-03-28 22:16:54
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Cardiac
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Cardiac
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  1. What is cardiac output affected by?
    • Its affected by preload
    • Heart rate
    • Metabolic needs- increased calcium, decreased potassium
  2. What is preload? What occurs during preload? What factors can affect preload?
    Everything that occurs before the heart contracts

    Ventricular stretch. Ventricle fills with blood and stretches.

    Preload can be met by high resistance due to Cholesterol and High Sodium

    Preload can be affected by: Blood Loss (less blood available to contract and pump) Increases HR. Exercise and slow HR (make more blood available for contraction and pumping)
  3. What is stroke volume? What affects stroke volume?
    Stroke volume is the amt of blood ejected from the ventricles with each heart beat

    SV can be affected by preload

    Afterload or resistance

    Strength of the cardiac muscle

    Contractility
  4. Where is the best place to assess a pulse?
    The best place to assess a pulse is by checking the Apical pulse. Check this against radial. Both for 1 minute
  5. If a cardiac patient is exhibiting edema, what part of the heart is experiencing the failure?
    The patient is experiencing Right Sided Failure
  6. If a cardiac patient has fluid in the lungs, what side of the heart has the failure?
    The patient is experiencing left sided failure
  7. What is the most common cause of chest pain
    Lack of O2
  8. What can cause a lack of Oxygen in arteries?
    Atherosclerosis- build of plaque, narrowing of vessels
  9. What types of medications are given for the treatment of Angina?
    Nitroglycerin and a Calcium Channel Blocker
  10. What is ischemia?
    lack of O2 to tissue, no damage to tissue
  11. What is an infarction?
    Lack of O2 with permanent tissue damage
  12. What are the effects of Nitroglycerin?
    • Vasodilation
    • Venous pooling
    • Reduces the amount of workload
    • Reduces the amount of blood returning to the heart- affects preload and afterload
    • Relieves pain
  13. When Nitroglycerin is given sublingual, how much time does it take to have an effect?
    3-5 minutes
  14. What does an inverted T wave and elevated S wave mean?
    This means that the patient has suffered an MI
  15. What is CK-MB? Where is it found? When does it rise and peak?
    CKMB is an enzyme found in cardiac cells and it is released when cardiac muscles have sustained injury.

    The level of CKMB rises about 4 hrs after injury

    Peaks in 24 hrs.
  16. How often are cardiac enzymes checked?
    Q 8hrs x3
  17. In an ECG what does the P mean?
    QRS?
    T?
    • P- Depolarization of Atria- Contraction
    • Q,R,S- Depolarization of Ventricle- Contraction
    • T- Repolarizatio of Ventricle- Rest
  18. What tests can help differentiate between and MI and Angina?
    Blood work for enzymes and ECG
  19. What has occurred to a patient that has a positive Troponin level and a negative CKMB?
    It means that the patient had an MI weeks ago
  20. What is Troponin? How long does it stay in the blood?
    Troponin is a protein found in cardiac muscle that is released when the muscle has sustained injury. The levels can stay high in the blood for 3 weeks
  21. What is the primary goal for the patient that has suffered an MI?
    The primary goal is to reduce the workload of the heart
  22. What can be done to reduce the workload of the heart in a patient with a recent MI?
    • Stool softeners
    • Bed Rest, slowly progress to activities
    • Help with bathing
    • NO HEAT- so that vasodilation does not take place
  23. What medication regimen is given to a patient with an MI?
    • Initially- Nytroglycerin- sublingual
    • Then- Nitroglycerin drip
    • Morphine to help manage fluid (affects preload and afterload, less fluid going out means more rest for the heart
  24. What effects to Beta Blockers "LOL" MEDS have on the heart? What are the side effects? Which is the most common side effect?
    • Carvedilol- Coreg
    • Metoprolol- Lopressor

    All Beta Blockers have a direct effect on the SA node

    Beta Blockers reduce the amount of Oxygen consumed and lowers the blood pressure

    DO NOT STOP SUDDENLY!

    MUST CHECK PULSE 1 HR BEFORE ADMINISTERING A BETA BLOCKER

    SIDE EFFECTS:

    • Dizziness
    • Hypotension- Most common
    • Bradycardia

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