Term
| S 4 (comes just before S1) is associated with what problem |
|
Definition
| heart failure (r/t Hypertensive heart disease) |
|
|
Term
| S 3 heart sound or a ventricular gallop. An S 3 heart sound is often an indication of _____ _____ in an adult |
|
Definition
heart failure
(but may be a normal sound in younger people) |
|
|
Term
Which is used to describe the ability of the heart to initiate an electrical impulse?
a) Conductivity b) Excitability
c) Contractility d) Automaticity |
|
Definition
|
|
Term
| _______: ability of the specialized electrical cells of the cardiac conduction system to contract in response to an electrical impulse |
|
Definition
|
|
Term
| _____: ability of the specialized electrical cells of the cardiac conduction system to transmit an electrical impulse from one cell to another |
|
Definition
|
|
Term
| The ______ is the primary pacemaker of the heart. |
|
Definition
|
|
Term
|
Definition
| coordinates the incoming electrical impulses from the atria and, after a slight delay, relays the impulse to the ventricles |
|
|
Term
__________ is the electrical activation of a cell caused by the influx of sodium & eflux of potassium.
_____ is the return of the cell to the resting state, caused by reentry of potassium into the cell while sodium exits the cell |
|
Definition
| depolariztion, repolarization |
|
|
Term
|
Definition
| any kind of pain brought on by coronary ischemia |
|
|
Term
| what natural herb : Powerful anti-inflammatory agents, can lower cholesterol levels & inhibit platelet aggregation (↓ clotting time) |
|
Definition
|
|
Term
| Decongestants – cold medicines (fedrine, sudafed), nasal sprays- what is the effect on blood pressure? |
|
Definition
|
|
Term
| why is Rheumatic and scarlet fevershistory pertinent to perfusion assessment |
|
Definition
|
|
Term
| MAP, the average pressure in vessels, is calculated how? |
|
Definition
systolic + (2diastolic)
3 |
|
|
Term
| what is minimum MAP value for adequate tissue perfusion |
|
Definition
|
|
Term
| Drop in systolic pressure of >10 on inspiration |
|
Definition
|
|
Term
| what does pulsus paradoxus indicate |
|
Definition
| fluid in the pericardial sac |
|
|
Term
| increased pulse pressure indicates ___ or ___, decreased PP indicates __ |
|
Definition
| exercise or atherosclerosis, hypovolemia |
|
|
Term
| what is a positive finding when assessing for orthostatic hypotension |
|
Definition
| systolic decrease of >10-20 points and/or HR increases > 15-20 OR if symptoms occur |
|
|
Term
where do you listen for
a) S1
b) S2 |
|
Definition
a) mid-clavicular line/5th inercostal
b) second intercostal, R or L sternum |
|
|
Term
| S1 is from the closing of the __ valves, S2 is from the closing of the __ valves |
|
Definition
| tricuspid/mitral, pulmonic/aortic |
|
|
Term
sound that occurs when blood enters the non-compliant ventricles during early
diastole – Normal finding in children and adults up to 35 to 40 years of age
o Abnormal early diastolic sound during period of rapid ventricular filling |
|
Definition
|
|
Term
| abnormal heart sound that occurs when blood enters non-compliant ventricles at the start of diastole |
|
Definition
|
|
Term
| abnormal sound that occurs when atrial blood tries to enter non-compliant ventricle at the end of diastole |
|
Definition
|
|
Term
| what is a summation gallop |
|
Definition
| s3 plus s4, indicates severe heart failure |
|
|
Term
1. gentle blowing, swooshing sounds
that reflect turbulent blood flow through the valves
2.what might cause it? |
|
Definition
1. murmur
2. valve defects |
|
|
Term
term for pulse that is Strong beat then weak beat, strong, weak...
o This can indication heart failure or hypertension |
|
Definition
|
|
Term
|
Definition
Faster apical pulse than radial pulse, the heart is not contracting forcefully enough to get every
beat to the extremities- (Due to left ventricular contraction failure) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Amount of blood that returns to the right atrium |
|
Definition
|
|
Term
| Amount of resistance the blood meets as it is ejected from the ventricle |
|
Definition
|
|
Term
| How forcefully the heart cells contract |
|
Definition
|
|
Term
| ___ is secreted by the ventricles in response to increase preload |
|
Definition
|
|
Term
| synthetic BNP (name of drug) |
|
Definition
|
|
Term
1.) PTT baseline value
2.) Therapeutic aPTT (heparin) |
|
Definition
1.) 21-35 seconds
2.) 1.5-2.5x baseline |
|
|
Term
1. Fibrinogen normal value: ___-___mg/dL (adult)
Fibrinogen levels go up with MI or tissue death
2. Fibrinogen levels go down with severe liver disease or ________ |
|
Definition
200-400
DIC ( disseminated intravascular coagulation) |
|
|
Term
| FDP stands for __ and the normal value is ___ |
|
Definition
| fibrin degradation product, <10mg/dl |
|
|
Term
| MI, post cardiac surgery, pulmonary embolism, with thrombolytics can cause increase in ___ |
|
Definition
|
|
Term
LDL should be <
Triglycerides should be < |
|
Definition
|
|
Term
1. C-reactive protein normal value
2. homeocyteine normal value |
|
Definition
1. 1-3 mg/L
2. 8-20 umol/L |
|
|
Term
| when should people start having their lipids checked |
|
Definition
| Everyone @ the age of 20 should have levels checked, then, if normal every 5 years. |
|
|
Term
| A protein that the liver produces if there is acute inflammation in the body and is checked to assess risk for atherosclerosis |
|
Definition
|
|
Term
| Amino Acid that damages the lining of blood vessels causing clots to form. Correlates with risk for athersclerosis. |
|
Definition
|
|
Term
| procedure where dye is injected for visualization of vessel |
|
Definition
|
|
Term
| right sided cardiac cath will be threaded through what vessel |
|
Definition
|
|
Term
| left sided cardiac cath will be threaded through what vessel |
|
Definition
| artery (probably femoral) |
|
|
Term
|
Definition
blood loss
Hypoproliferative
Hemolytic |
|
|
Term
| what type of anemia is NOT iron-deficiency |
|
Definition
| hemolytic (rbcs are made but get destroyed) |
|
|
Term
sore tongue, brittle nails, ulcer at corner of mouth, pale, tired.
S&S of what? |
|
Definition
|
|
Term
| what lab value goes up with anemia |
|
Definition
|
|
Term
| t or f - take antacids with iron supplements to increase absorption |
|
Definition
| FALSE it decreases absorption |
|
|
Term
| how long does it take for iron to be restored in body tissues after supplements are started |
|
Definition
| 3-6 (symptoms disappear quickly) |
|
|
Term
| inflammation of inner lining of heart |
|
Definition
|
|
Term
|
Definition
|
|
Term
| what are endocaditis growths called |
|
Definition
|
|
Term
| what is usually the cause of acute/sudden onset endocarditis |
|
Definition
|
|
Term
| what is usually the cause of subacute (slow progressing) endocarditis |
|
Definition
|
|
Term
| fever, and heart murmur are often the first S&S of _____ (because of Sepsis & destruction of heart valves) |
|
Definition
|
|
Term
fever, flu-like, petichiae, roth spots, Janeway lesions, osler nodes are
S&S of what |
|
Definition
|
|
Term
| endocarditis: tender, red lesions with white centers – on fingers and toes- are called |
|
Definition
|
|
Term
| white spots seen on retina that are round or oval |
|
Definition
| roth spots (seen in endocarditis) |
|
|
Term
| 2 endocarditis risk factors that are related to medical procedures/interventions |
|
Definition
| prosthetic valves & indwelling catheter (PiCC, Central, tunneled cath) |
|
|
Term
| t or f: history of endocarditis is a major risk for reoccurance |
|
Definition
|
|
Term
| AHA guidelines for pts at high risk for ______ : should receive prophylactic antibiotics before invasive procedures such as invasive dental |
|
Definition
|
|
Term
| what is the pharm treatment for endocarditis |
|
Definition
| iv antibiotics 4-6 weeks- usually picc line |
|
|
Term
A balloon-tipped catheter is inserted through a peripheral vessel into the heart. The
balloon is inflated in the valve to increase value diameter & then removed (endocarditis) |
|
Definition
|
|
Term
A sternotomy incision is made to remove stenotic tissue at the valve, or a ring is placed at
valve leaflets to prevent regurgitation for stabilization |
|
Definition
|
|
Term
| A surgical repair is made to the shape chordate tendinease to prevent regurgitation. (endocarditis) |
|
Definition
|
|
Term
1. P wave - coincides with __
2. QRS complex - coincides with __
3. T wave - coincides with ___ |
|
Definition
1. the spread of electrical activity over the atria & start of atrial contraction.
2. the spread of electrical activity over the ventricles and the start of its contraction.
3. the recovery phase of the ventricles. |
|
|
Term
| non cardiac causes of chest pain (5) |
|
Definition
| Esophageal spasms, gall bladder, hiatal hernia, GERD, heartburn |
|
|
Term
| t or f- excessively thin blood (low viscosity) can result in a heart murmur |
|
Definition
|
|
Term
1. overweight BMI range
2. underweight BMI |
|
Definition
1. Overweight 25 to 29
2. Underweight below 18.5 |
|
|
Term
| how is stroke volume determined |
|
Definition
| SV can be estimated by echocardiogram or measured by a cath during cardiac cath. |
|
|
Term
| 4 non-modifiable athersclerotic risk factors |
|
Definition
| Age, family history, gender(m), and race (a.a,) |
|
|
Term
| t or f: Diabetes Mellitus, Hypertension, and Metabolic Syndrome are risk factors for atherosclerosis that are considered modifiable through management |
|
Definition
| true- other modifiable RFs: stress, smoking, weight, cholesterol, sedentary lifestyle |
|
|
Term
| which perfusion diagnostic test uses contrast dye and x-rays to provide cross-sectional images |
|
Definition
|
|
Term
| 2 non-invasive dx tests for visualization of perfusion problems |
|
Definition
|
|
Term
| t or f- transthoracic and transesopageal echocardiograms are considered invasive proceures |
|
Definition
| F: only transesophageal (TEE) is considered invasive |
|
|
Term
| t or f- MUGA, ERNA, and V/Q scans are nuclear scans that use dye/radiactive isotopes for visualization of perfusion stuff. |
|
Definition
|
|
Term
| V/Q less than 0.8 is a problem with __ |
|
Definition
|
|
Term
| V/Q greater than 80% is a _____ Problem |
|
Definition
|
|
Term
| what 2 tests are performed together to see the electrical and mechanical cardiac/coronary functioning at the same time |
|
Definition
12 lead-ekg (electrical) &
Transthoracic echocardiogram (mechanical) |
|
|
Term
| V/Q results of greater than 0.8 suggests high probability of what? |
|
Definition
|
|
Term
portable ECG monitor worn by patient for few hrs. to a few days to asses heart & pulse activity as person goes thru daily activities
- used to assess a patient who experiences chest pain & unusual heart activity during exercise & normal activities |
|
Definition
| holter monitor (you can phone in results) |
|
|
Term
| ____ failure is the inability of the heart to pump effectively due to impaired ventricular contraction (pump probs) |
|
Definition
|
|
Term
___failure is the inability of the heart to pump effectively due to impaired ventricular relaxation
and filling. (fill probs) |
|
Definition
|
|
Term
hypertension is usually a ___ issue in heart failure
a. filling
b. pumping |
|
Definition
|
|
Term
| T or F: iron overload, anemia, dysrhythmias, acidos, infections and electrolyte imbalances can all cause/contribute to heart failure |
|
Definition
|
|
Term
| t or f: heart failure reduces stroke volume and cardiac output |
|
Definition
|
|
Term
| condition with diseased cells of myocardium |
|
Definition
|
|
Term
1. describe Stage 1 heart failure
2. describe Stage 4 heart failure |
|
Definition
1. S&S of HF on significant exertion
2. S&S of HF at rest |
|
|
Term
| t or f: hypo or hyper Thyroid disorders, Radiation treatment to the chest area, Chemotherapy medications and alcohol abuse are HF risks |
|
Definition
|
|
Term
|
Definition
| heart attack simulator for stress test if pt can do exercise test (crushing angina for 3 minutes) |
|
|
Term
|
Definition
| compression of heart due to blood collection in pericardial sac (heart has leaked/bled) |
|
|
Term
| where do arterial barroreceptors monitor pressure (2 places) |
|
Definition
| aortic arch and wall of left ventricle |
|
|
Term
| if barroreceptors detect an increase in arterial pressure they respond by triggering these 2 things to happen |
|
Definition
slowing of HR &
dilation of vessels |
|
|
Term
| most common cause of secondary HTN in women |
|
Definition
| estrogen replacement therapy |
|
|
Term
| adrenal tumor causes release of catecholmines, leads to HBP |
|
Definition
|
|
Term
|
Definition
erythropoetin
steroids
cyclosporine |
|
|
Term
| Systole ˃ 200, Diastole ˃ 150 with fast onset vascular changes |
|
Definition
|
|
Term
| T or F: HTN that is resolved with 4 BP meds is considered Resistant hypertension |
|
Definition
|
|
Term
| why does malignant HTN need rapid intervention |
|
Definition
| prevent HF, renal failure, stroke, MI |
|
|
Term
| Injects dye and looks at the circulation to the kidneys can show narrowing to the kidneys (HTN damage test) |
|
Definition
| Intravenous Pyelogram (IVP) |
|
|
Term
| HTN pts should be encouraged to lose weight if BMI is _____ |
|
Definition
|
|
Term
| what exercise should be avoided by HTN pts |
|
Definition
| muscle building exercise (weight lifting, wrestling, rowing- causes increase in thoracic pressure) |
|
|
Term
| Defined as a BP greater than 180/120, accompanied by evidence of actual or impending organ damage |
|
Definition
|
|
Term
| initial treatment goal for hypertensive crisis is to decrease MAP by __% per hour |
|
Definition
| 25 (any quicker could cause dangerous hypotensive ischemia) |
|
|
Term
| Defined as a BP > 160/100 but without evidence of target-organ damage. Goal is to steadily decrease BP |
|
Definition
|
|
Term
|
Definition
* swelling/shiny
* pain
* redness
* warmth |
|
|
Term
| where are DVTs most commonly found |
|
Definition
|
|
Term
| clot that forms inside vessel that partially or completely occludes it |
|
Definition
|
|
Term
| a thrombus that moves through the bloodstream until it lodges in a vessel |
|
Definition
|
|
Term
| clot in vessel associated with vessel inflammation |
|
Definition
|
|
Term
| where are most superficial vein thrombosis found |
|
Definition
|
|
Term
| what are the 3 parts of Virchow's Triad (3 things that are often responsible for venous thrombus) |
|
Definition
stasis
vascular injury
hypercoagulability |
|
|
Term
| t or f: birth control pills, dehydration, and blood loss can lead to viscous blood |
|
Definition
|
|
Term
| most accurate DVT dx test |
|
Definition
| venogram (invasive- has dye) |
|
|
Term
|
Definition
|
|
Term
| t or f: discontinuation of anticoagulants need to done by tapering |
|
Definition
| True- abrupt discontinuation raises DVT risk |
|
|
Term
| T or F: positive Homan's sign (pain on dorsiflexion) indicates DVT |
|
Definition
| True, but EBP says it is not safe |
|
|
Term
| rationale for using moist heat as treatment for DVT |
|
Definition
| relieves pain and dilates collateral circulation pathways |
|
|
Term
| rationale for elevating extremity with DVT |
|
Definition
| gravity drains fluid away from site, decreases discomfort |
|
|
Term
| what kind of pt might be a candidate for a transvenous filter? |
|
Definition
| pts with Frequent DVT recurrance |
|
|
Term
| T or F: sudden onset SOB, stabbing chest pain are frequent S&S of PE |
|
Definition
|
|
Term
| what happens to d-dimer value in case of Pulm. Embolism |
|
Definition
|
|
Term
| spiral CT scan with contrast is good for DX of what problem |
|
Definition
|
|
Term
| most common dx test for Pulmonary Embolis |
|
Definition
| V/Q scan (greater than 0.8 indicates likely PE) |
|
|
Term
| most conclusive dx test for PE, why isn't it used often |
|
Definition
| pulmonary angiography, requires rt. side cardiac cath |
|
|
Term
| what is a Greenfield filter |
|
Definition
| IVC filter that traps little clots- like a little umbrella |
|
|
Term
| arrest from massive PE, what are the first 3 priorites |
|
Definition
| oxygen, establish IV, EKG monitoring |
|
|
Term
| What is embolectomy and what is its main risk |
|
Definition
| go into pulmonary arteries and suctioning out emboli- high risk of death |
|
|
Term
Indications for cryoprecipitate
transfusion |
|
Definition
| Bleeding with hypofibrogenemia |
|
|
Term
| what does cryoprecipitate contain |
|
Definition
| factor 8 and fibrinogen and some plasma |
|
|
Term
| what does fresh frozen plasma contain? |
|
Definition
| all clotting factors plus plasma |
|
|
Term
| what is mostly removed from packed red cells |
|
Definition
|
|
Term
| why is a skin assessment important before a blood transfusion |
|
Definition
| rash is common reaction- need to know if it was present before transfusion |
|
|
Term
| when watching for reaction from blood transfusion- what should you tell the pt to alert you about? |
|
Definition
| if you feel any different (be non-specific) |
|
|
Term
| what gauge IV must you use for blood products? why? |
|
Definition
| 20 or larger, anything smaller destroys RBCs |
|
|
Term
| if you suspect any type of reaction to blood products transfusing what should you do? |
|
Definition
|
|
Term
| what is the likely reaction of receiving the wrong blood type |
|
Definition
| acute hemolytic reaction (host blood attacks donor blood- emergency- call a code) |
|
|
Term
| pts cells react to donor's WBC- flu lik-symptoms. What is that called |
|
Definition
| febrile non-hemolytic reaction |
|
|
Term
| usually course of action for febrile non-hemolytic reaction |
|
Definition
| benadryl and resume transfusion, filter blood products in future |
|
|
Term
| why is it so important to start transfusion w/in 30 minutes |
|
Definition
| if blood warms risk for bacterial contamination increases- (would cause sepsis) |
|
|
Term
| transfusion related lung injury |
|
Definition
| fluid leaks to lungs, causes ARDS- poor prognosis |
|
|
Term
| what solution is used for flush in blood transfusion |
|
Definition
|
|
Term
| what should you hang before getting blood from bank? |
|
Definition
| NS (setup up, make sure it is patent, running with special blood tubing) |
|
|
Term
| Once you get the blood from bank you must spike within ___ and complete infusion within ___ |
|
Definition
|
|
Term
| T or F: never have clamp from blood bag open at same time as saline bag |
|
Definition
|
|
Term
| If there is a blood transfusion reaction how do you stop infusion (specific) |
|
Definition
close blood clamp
open saline clamp |
|
|
