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cardio #4 prep

cardio

Common chief complaint that suggest a cardiac problem? chest pain, dyspnea fainting palpitations and fatigue.
What is Eupnea? Normal breathing
What is Dsypnea? Labored, shortness of breath
What is Orthopnea? Positional Dyspnea
What is PND? Acute shortness of breath when you wake up suddenly and can't breath caused by fluid in the lungs.
Syncope causation if cardiac problem Fainting - brief loss of consciousness caused by transiently inadequate blood flown to the brain.
Pertinent Past Medical History (1) In prehospital medicine, the acronym SAMPLE is used. Signs/Symptoms Allergies Medicines (Prescriptions) Past Pertinent History Last bowel movement/oral intake Events leading to the current complaint
Arteriosclerosis A pathologic condition in which the arterial walls become thickened and inelastic.
Atherosclerosis accumulation of fat inside blood vessels resulting in narrowing of the lumen diameter
Peripheral vascular Disorders are conditions where blood does not flow to your limbs as it should because of blocked blood vessels. usually caused by atherosclerosis. This is when material, such as cholesterol, sticks to the inside of your blood vessels and makes them narrow.
Stable Angina Angina pectoris characterized by periodic pain with a predictable pattern
Unstable Angina Angina pectoris characterized by a changing, unpredictable pattern of pain, which may signal an impending AMI.
Acute Coronary Syndrome ACS Term used to described any group of clinical symptoms consistent with acute myocardial ischemic.
12-Lead ST Depression =
12-Lead ST Elevation=
12-Lead Q wave=
Define Angina Pectoris sudden pain from myocardial ischemia, caused by diminished circulation to the heart muscle; pain usually substernal and often radiates to the arms, jaw, or abdomen and usually lasts 3-5min. and disappears w/ rest.
Define Acute myocardial Infraction Heart Attack occurs when a portion of the cardiac muscle is deprived of blood flow long enough that portions of the muscle die
Levine sign Unconsciously clenches the fist when describing the pain
Nitroglycerin Indications Acute angina pectoris, ischemic chest pain, hypertension, CHF, pulmonary edema
Nitro contraindications Hypotension, hypovolemia, intracranial bleeding or head injury, pericardial tamponade, severe bradycardia or tachycardia, previous administration of erectile dysfunction medications in the past 24 hours
Nitro dosage 0.04mg sublingually repeated at 5 minute intervals up to a total of 1.2mg (three doses)
Morphine indications Severe CHF, acute cardiogenic pulmonary edema, chest pain associated with AMI, analgesia for moderate to severe acute or chronic pain
Morphine contraindications Head injury, exacerbated COPD, depressed respiratory drive, hypotension, undiagnosed abdominal pain, decreased level of consciousness, suspected hypovolemia, patients who have taken MAOIs within the past 14 days
Morphine dosage 2-4mg
How do we/hospital open up clogged coronary arteries? Percutaneous intervention (PCI). In this therapy, balloons, stents, or other devices are passed through a 2-mm-diameter catheter via a peripheral artery to recanalize and keep a blocked coronary artery open
Risk of fibrinolysis therapy? Therapy that uses medications that act to dissolve blood clots. The risk is that it will dissolve all blood clots in the body and cause bleeding.
Pericardial tamponade also called Cardiac tamponade A life-threatening situation in which there is such a large amount of fluid inside the pericardial sac around the heart that it interferes with the performance of the heart. The end result, if untreated, is low blood pressure, shock and death.
Cardiogenic shock management Occurs when the heart is so severely damaged that it can not longer pump a volume of blood efficient to obtain tissue perfusion.
Pressor drug cautions increase afterload, increase O2 consumption, decrease organ perfusion
Locations of Aneurysms An aneurysm that occurs in the chest portion of the aorta is called a thoracic aortic aneurysm (TAA). An aneurysm that occurs in the abdominal portion of the aorta is called an abdominal aortic aneurysm (AAA). Most aortic aneurysms are AAAs.
Concerns of Aneurysms Blood clots can form inside the walls of aortic aneurysms. If a part of a clot becomes dislodged, it can travel to other arteries and block blood flow.
Symptoms of Aneurysms Chest pain described as "ripping, tearing, sharp, or like a knife" located in the anterior part of the chest or in the back between the shoulder blades
Hypertensive emergency: complications, best treatment acute elevation of BP w/ evidence of end-organ damage. Goal: decrease MAP (DBP +1/3 [SBP-DBP]) by 20% over an hour -sodium nitroprusside -labetolol -NTG -hydralazine.
Conditions causing alterations in pluses and/or BP white coat syndrome
Symptoms causing alterations in pluses and/or BP medications
JVD sign of right heart failure. access by placing the patient in a semisitting position (45 degree angle) with the head slightly rotated away from the jugular vein you are examining
Typical pain that suggests AMI chest pain
Atypical pain that suggests AMI nausea, vomiting
Oxygen for the cardiac patient It may limit ischemic myocardial injury and reduce the amount of ST-segment elevation
What is Fibrinolytics the enzymatic breakdown of the fibrin in blood clots
What is Percutaneous coronary intervention (PCI) procedure used to treat the stenotic coronary arteries of the heart found in coronary heart disease. These segments are due to the buildup of the cholesterol-laden plaques that form due to atherosclerosis.
Left heart Failure and associated complications A condition in which the left ventricle cannot effectively pump; this leads to a backup of blood behind the left ventricle, and eventually serum is forced out of the pulmonary capillaries and into the alveoli.
Right Heart failure and associated complications A condition in which the right side has to work increasingly harder to pump blood into engorged pulmonary vessels, which eventually leads to an inability to keep up with the increased workload.
DRUGS: done
Calcium Channel Blockers Block the influx of calcium ions into the cardiac muscle. They relieve angina by preventing spasm of coronary parties and by weakening cardiac contraction therefore decreasing myocardial oxygen demand. Hypotension may be a significant side effect.
Antiplatelet Plavix; keeps the platelets found in the blood from sticking together.
Blood Thinners Warfarin; anticoagulant drugs diminish the ability of the blood to form clots.
Heart Rate Control beta-blockers; work by decreasing the rate and strength of cardiac contractions. Atenolol, metoprolol.
Antidysrhythmic are used to control chronic disturbances in cardiac rhythm. Digitalis, beta blockers, and cardiac channel blockers are also used to treat this condition.
Pain Meds morphine, will also cause patient to relax
Diuretics prescribed to patients with chronic fluid overload (CHF) but are also used to treat hypertension. They trick the kidneys into excreting more sodium and water. Lasix, Apresoline.
Pressors will increase blood pressure and/or CO
digitalis used to treat CHF increasing the strength of cardic contractions, digoxin and digitoxin
antianginal agents used to relieve pain, Nitrates, beta blocker and calcium channel blockers are most common
What is each heart sound and their significance? done
opening snap is indicative of a noncompliant valve, such as the mitral valve found in a patient who has a history of rheumatic fever.
ejection kick a high pitched sound occurs just after the S sound; it may indicate a dilated pulmonary artery or septal defect.
pericardial friction rub creates a to and fro sound that can be heard in systole and diastole.
murmur is an ambiguous sound that is associated with turbulent blood flow through the heart valves.
thrill is a vibration that occurs frequently and remains constant.
pericardial knock is a high pitched sound during the diastole phase that indicates a thickened peri-cardium that is limited how far the ventricle can expand during the diastole phase.
S1 Lub Normal closure of mitral and tricuspid values at start of systole
S2 Dub Normal closure of aortic and pulmonic valves at the end of systole
How can you tell, by reading a 12-lead, if a patient is having an AMI? - ST segment elevation of 1mm or more, in (2) or more contiguous leads
MONA morphine, oxygen, nitro, aspirin
dosages of MONA 2.4, 0.04, and 160 to 325mgs
most common cause of death after AMI a ventricular arrthymia or fibrilliation will occur and lead to fatality and is the leading cause of death post MI.
Pertinent Past Medical History (2) In prehospital medicine the acronym CHAMPS is used. Chief Complaint History Allergies Medicines (Prescriptions) Previous activity Signs/Symptoms
Created by: carsrock112