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NU402 Exam 3
Whole lotta Stuff
| Question | Answer |
|---|---|
| systole | ventricular contraction |
| diastole | ventricular relaxation/filling |
| CO | SV x HR Normal is 5 L/min |
| Common Symptoms of Decreased CO | Syncope, vertigo, mental status changess, CP, hypotension, decreased urine, cool/pale/mottled skin, fatigue |
| stroke volume | 60-70 mL |
| preload | pressure in ventricles after diastolic filling (how much ventricle stretches) |
| afterload | resistance required by ventricles to pump blood during contraction (increase BP--> increase afterload) |
| ejection fraction | % blood ejected from ventricle w/ each contraction, 60-75% normally |
| Frank-Starling Law | more heart stretches during filling, more forcefully it contracts |
| depolarization | electrical activation of muscle cells |
| dsyrhythmia | abnormal heart rhythm (used interchangeably w/ arrhythmia, which actually means NO heart rhythm) |
| ACE Inhibitors | Vasodilates arteries (opposes angiotensin) and a diuretic bc decreases aldosterone production (aldosterone makes kidneys hold onto water and Na) HTN, MI, HF |
| ARBs | Blocks angiotensin II, stopping vasoconstriction and aldosterone release HTN- not first line |
| Alpha 1 Receptor Agonists | block alpha receptors in arteries causing vasodilation. Also relaxes smooth muscle in bladder (treats BPH) HTN |
| Alpha 2 Receptor Agonist | antiadrenergic, slows heart rate and decreases peripheral resistance HTN |
| normal | S <120, D<80 |
| pre-HTN | S 120-139, D 80-89 life style changes |
| Stage 1 HTN | S 140-159, D 90-99 thiazide diuretic, consider beta blocker, ACE, ARB, CCB, combo |
| Stage 2 HTN | S > 160, D > 100 Two drug combo- thiazide + other |
| hypertensive crisis | S > 180, D >120 To the ER |
| LDL vs HDL | Low density lipoproteins are bad, eat healthier. Want LDL <100, HDL >60 |
| DASH diet | Dietary approaches to stop HTN, rich in K and Ca, fruits, veggies, etc. |
| CVD and HTN | For each 20mmHg increase of SBP or 10 mmHg DBP, risk of CVD doubles |
| Cardiac markers: CPK (and isoenzymes) | Elevated during heart attack |
| troponin | elevated during heart attack. Your test results are usually considered normal if •Troponin I : less than 10 µg/L •Troponin T : 0–0.1 µg/L Elevated during heart attack |
| LDH | Elevated in tissue damage (Such as MI) typical range is 105 - 333 IU/L (international units per liter). |
| cardiac catheterization | long thin tube (catheter) threaded through distant artery (femoral) to heart to help dr. diagnose heart problems. performs tests |
| SGOT (AST) | AST (aspartate aminotransferase) is an enzyme found in high amounts in heart muscle and liver and muscle cells. It is also found in lesser amounts in other tissues. normal range is 10 to 34 IU/L. |
| SGPT (ALT) | Alanine transaminase (ALT) is an enzyme found in the highest amounts in the liver. Injury to the liver results in release of the substance into the blood |
| PTT | PTT (Partial thromboplastin time) normal is 25-35, therapeutic anticoagulation range would be 45-75 seconds)(Heparin!) |
| INR | Normal INR is 1, therapeutic is 2-4 Coumadin |
| PT | 9-11 seconds Coumadin |
| serum cholesterol | total LDL, HDL, and other parts <200 desirable, >240 is high -->HTN |
| triglycerides | <150 normal, >200 is high -->HTN |
| LDL | <100, BORDERLINE 100-159, high >160 |
| HDL | >60, low levels increase risk of CV disease (40 men, <50 women) |
| venogram digoxin levels | x-ray used to gauge the flow of blood through the veins more effectively, digoxin can be toxic (treats HF) |
| angiogram | visualize the inside of blood vessels and organs of the body, raditionally done by injecting a radio-opaque contrast agent into the blood vessel and imaging using X-ray based techniques such as fluoroscopy |
| ECHO | cardiac ultrasound, it uses standard ultrasound techniques to image two-dimensional slices of the heart. The latest ultrasound systems now employ 3D real-time imaging. can show flow of blood |
| diabetic ketoacidosis (DKA) | excessive accumulation of ketone bodies (acids) that cause abd pain, vomiting, hyperventilation, fruity breath, altered LOC. tx w/ insulin, fluid, electrolytes |
| gestational diabetes | glucose intolerance d/t hormonal changes causing insulin resistance. causes increased risk for HTN |
| 3 p's | polyuria, polydipsea, polyphagia 3 signs of diabetes + unexplained weight loss |
| short-acting insulin | works for 4-6 hours. marked R for regular. Humalog R. Administered 20-30 min before meal. Clear |
| intermediate-acting insulin | NPH (neutral protamine hagedorn) or Lente or works for 16-20 hours. Humulin N. Appear white or cloudy. Taken w/ or after food |
| rapid acting insulin | humalog, eat w/in 5-15 min of injection |
| very long-acting insulin | Glargine (Lantus). basal, or peakless, absorbed over 24 hours. give at any time of day but on a regular schedule. cannot be givine w/ others. |
| mixing insulin | short (regular) with intermediate. Draw up regular insulin first (clear). Don't inject cloudy insulin into clear. |
| hypoglycemia | glucose less than 50-60 mg/dL. SNS stimulated, so sweating, tremor, tachycardia, hunger. Moderate leads to more CNS changes, severe can be passing out |
| serum glucose | 64.8 and 104.4 mg/dL |
| urine glucose | Glucose is not usually found in urine. If it is, further testing is needed. |
| serum acetone and ketones | A normal test result would be negative, meaning there are no ketone bodies in the blood. Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results. |
| glycohemoglobin A1c | American Diabetes Association recommends an A1c less than 7.0%, American Association of Clinical Endocrinologists recommend less than 6.5%. Gives data on blood sugar levels over 3 months. Checks percent of hemoglobin in the blood w/ sugar bound to it |
| glucose tolerance test | give glucose and see how long it takes for it to be cleared from blood. most common is the oral glucose tolerance test (OGTT). •Fasting: 60 -100 mg/dL •1 hour: less than 200 mg/dL •2 hours: less than 140 mg/dL. Between 140 - 200 mg/dLpredbts >200-diab |
| ketone urine test | A negative test result is normal. When ketones are present in the urine, the results are usually listed as small, moderate, or large with these corresponding values: Small: < 20 mg/dL Moderate: 30 - 40 mg/dL Large: > 80 mg/dL |
| Diagnosing diabetes | Fasting plasma glucose test is best. Diabetes is its 126 mg/dL or above and confirmed on a different day |
| exercise + diabetes | increase glucagon (increases glucose levels)and decreased insulin but enough produced to get sugar into muscles |
| basal-bolus principle | half given as basal dose, other half around meal times. |
| witholding insulin | even if pt is NPO, will usually give long-acting but perhaps not short and rapid |
| sliding scale | rapid/short acting insulin given according to pt's blood glucose level |
| IV insulin | only short-acting(Regular) given IV w/ BG levels checked every 2 hours. Give SQ insulin before discontinuing IV so it can take effect |
| oral antihyperglycemic meds | for type 2 DM |
| sulfonylurea | stimulates pancreas to secrete insulin. 1st line tx |
| p wave | atrial depolarization |
| PR interval | delay of conduction at the AV node. Normally 0.12-0.2 seconds (less than 5 small boxes on EKG) |
| QRS complex | ventricular depolarization. Normally <0.12 seconds |
| T wave | repolarization (resting) of ventricles. Ischemia inverts it |
| ST segment | should be isoelectric (parallel w/ baseline) time between ventricular depolarization and ventricular repolarization |
| QT | total time for ventricles to depolarize and then repolarize. Lengthened by certain drugs. 0.35-0.44 seconds |
| treating a pt w/ an abnormal rhythm | treat pt, not rhythm careful w/ using antiarrhythmic drugs. they can make the pt unstable. treat w/ just 1 |
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kinipelap
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