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CC Exam 1
Trivette MC 2013
| Question | Answer |
|---|---|
| Virchow's triad | blood stasis, endothelial injury, hypercoagulability |
| + D-dimer | possible clots |
| - D-dimer | no clots |
| HTN emergency | Nitroprusside (Nipride) or Beta blockers |
| Pericardial Fluid amount | 20-25 ml |
| Which Coronary perfuses the most | RCA |
| MAP Calculation | (diastolicx2)+systolic/3 |
| SV | 60-70 ml |
| EF | >50% |
| Preload is effected by | venous return, atrial kick, volume, Starling's law |
| Afterload is effected by | HTN & tense of wall |
| Constriction | increases preload |
| Meds for constriction | dopamine & Levafed |
| dilate | decreases preload |
| meds for dilation | nitro, morphine, opiate |
| Acute chest pain assessment 3 parts | chief complaint, precipitating events, current medications |
| ascites is a sign of | R Heart failure |
| A/V no hair | venous |
| A/V thin shiny dry skin | arterial |
| A/V flaking, mottled, dermatitis,stasis | venous |
| A/V ulcers present at the ankles & moist | venous |
| A/V pressure points dry & pale | arterial |
| A/V pallor or dependent rubor | arterial |
| A/V brown patch rubor, mottled, cyanosis dependent | venous |
| A/V nails thick & brittle | arterial |
| A/V varicose veins | venous |
| A/V cool skin | arterial |
| A/V warm skin | venous |
| A/V >3 secs | arterial |
| A/V foot to calf edema | venous |
| A/V pulses 0-1 rating | arterial |
| S3 causes | fluid increase or in kids |
| S4 causes | hypertrophy, hyperkinetic, regurgitation |
| murmur scale | 1 faint-6 without stethoscope |
| HyperK | wide QRS, tall peaked T |
| HypoK | PVC & U waves |
| HyperCa | bradycardia, blocks, HTN, pot dig. |
| HypoCa | decrease CO, VT, hypotension, asystole |
| HypoMg | U waves, prolonged PRI, T flattened, wide QRS=SVT, VT, torsade |
| Which electrolyte/mineral do you need to correct 1st? | Mg |
| Troponin 1 | elevates 3-12 hrs. Peak 24hrs. base 5-10 days |
| Troponin T | elevates 3-12hrs. Peak 12-48hrs. base 5-14 days. |
| CKMB | elevates 3-12 hrs. Peak 24hrs. base 2-3 days |
| BNP | >400 very probable 100-400 with hx or suspicion probable |
| INR | <1 anticoag 2-3 |
| aPTT | 28-38 sec anticoag 1.5-2.5xnorm |
| PTT | 60-90 sec anticoag 1.5-2xnorm |
| ACT | 0-120 sec <130 without CAD |
| LDL | <100 no risk <750 with risk |
| Triglycerides | <150 |
| HDL | >40 men >50 women |
| after cardiac cath how long extremity immobilized? | 6-12 hr |
| DM | 70-100 normal 100-125 Pre >126 Diabetic |
| R/L HF GI S | right |
| R/L HF pulmonary | left |
| R/L HF weak peripheral perfusion | left |
| R/L HF nocturia | left |
| R/L HF JVD & edema | right |
| R/L HF mental changes | right |
| R/L HF hepatojugular reflex | right |
| complications with HF | pink frothy sputum, cardiac asthma, < 30 EF and increased dysrhythmias & A Fib |
| diuretics | decrease preload |
| vasodilators | decrease afterload & resistance |
| morphine | peripheral dilation & decreases anxiety |
| + inotropes | decrease contractility |
| S&S endocarditis | fever, stroke, septic emboli, HF, cough, & pleuretic chest pain |
| S&S CAD | TIA, Neuro deficits, reversible ischemic neuro, completed stroke |
| CAD Tx | antithrombotic therapy, surgery, stents |
| Variant angina | spasm |
| pritzmetal angina | spasm |
| MONA | Morphine O2 Nitro ASA/Analgesia |
| 3 mechanisms of MI | plaque rupture, thrombosis, coronary artery spasm |
| ischemia | T inverts or depresses |
| injury | ST elevated |
| infarction | patho Q waves |
| transmural MI/Q | all muscle layers |
| NSTEMI | no Q wave subendocardial |
| V dsyrythmia tx only if | >6/min, closely coupled, polymorphic, multifocal, bursts, runs |
| meds for preventing V remodeling | ACE I |
| dys prevention | beta blockers |
| Aneurysm tx outpt for | 4 cm or smaller |
| MAP decrease for HTN | 20-25% over mins-hr |
| HTN urgency meds | diuretics or oral antiHTN |
| fixed | asych |
| demand | synch |
| AV sequential | dual |
| rate control | # of impulses 60-80 |
| output control | milliamp to threshold |
| sensitivity | millivolts |
| undersensing | inability to sense spontaneous depol showing after or unrelated spots |
| oversensing | inappropriate sensing of extraneous electrical signals causing unnecessary trigger/inhibit |
| protect from microshocks by | covering with rubber caps & preventing static electricity |
| cardiac resynch 3 leads | RA, RV, LV via coronary sinus |
| atria arrhythmia suppression | prevents A Fib. & can have non-p wave tracking when rapid is sensed |
| Fibrinolytic therapy criteria | no more than 12 hr. onset, unresponsive to Nitro, ST elevation or new onset of left bundle branch block, no predsiposition for hemorrhage |
| non specific clotting med | SK |
| S&S reprefusion | chest pain stops, ST elevation returns to baseline, dysrhythmia, peaking of creakine kinase or Troponin |
| PCI Complication late | restenosis & thrombosis |
| contract induced renal failure prevention | increase fluids & take Na bicarb |
| PCI most dangerous for complications | 8-12 hrs |
| Physiological of Cardiopulmonary bypass that are most | fluid volume deficit & myocardial deficit |
| cold postop bypass | constriction increasing BP & afterload |
| how to fix cold postop bypass | nitro, nitropresside, IVF, vasopressor |
| S&S of Tamponade | increasing wedge & CVP pressure, decreased CO, JVD, muffled heart sounds, pulseless paradoxys |
| TX Tamponade | emergency sternotomy at bedside |
| how soon should you try to get off a vent postop bypass surgery | 4-8 hrs |
| intraaortic balloon pump inflates when? | diastole & when aortic valve closes |
| balloon its important to watch for | migration or perforation |
| ventricular assist devices used ot | bridge to recovery, bridge to transplant, or a destination therapy |
Created by:
midnight1854
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