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Exam II
Dysrhythmias, Cardiomyopathy, Acute and Chronic AKI
| Question | Answer |
|---|---|
| MVS Sign? | dyspnea on exertion |
| MVS secondary to? | Rheymatic fever |
| MVS common dysrhythmia | Afib |
| MVR Sign | cool extremities, pulmonary edema, S3 (lubb, dubb, whoosh) |
| MVP Sign | Click murmur, chest pain without relief with nitroglycerin |
| AVS Sign | SAD - Syncope, Angina, Dyspnea |
| AVS Treatment note | NO NITRO! Chest pain worsens |
| AVR Sign | Water hammer pulse, L HF Sympotms |
| What does stenosis mean? | narrowing... not opening |
| what does regurgitation mean? | no closing |
| failure to capture | heart didn't hear pacemaker |
| failure to sense | pacemaker didn't hear heart |
| asytole | absence of hear rate |
| diastole | atria open aortic and pulmonary valves are closed ventricles are filling dubb 120 |
| systole | ventricles open aortic and pulmonary valves are open atria are filling lubb 80 |
| EKG lead placement | white is right grass under clouds smoke above fire fire under smoke brown in middle, far from fire (right, 4th intercostal space) |
| tachycardia med | adenosine - push hard and fast, flush immediately |
| bradycardia med | atropine |
| PAC on EKG | abnormal P wave short PR interval irregular rhythm |
| PAC leads to | SVT |
| PSVT on EKG | HR 100-300 hidden P wave regular rhythm |
| Atrial flutter on EKG | Regular rhythm Atria >200 bpm Sawtooth P wave |
| Afib on EKG | Disorganized rhythm atria >350 bpm |
| AFib with RVR | Disorganized rhythm P >350 QRS >100 |
| Afib without RVR | Disorganized rhythm P >350 QRS 60-100 |
| AV block - 1st degree | Prolonged PR PR interval > 0.20 |
| AV block - 2nd degree (in general) | More P's than QRS's |
| AV Block - 2nd degree Type I | Progressively longer PR intervals Then dropped QRS |
| AV Block - 2nd degree Type II | P:QRS = 2:1, 3:1, 4:1 regular pattern QRS > 0.12 |
| AV Block - 3rd degree | independent... no communication |
| PVC on EKG | No P waves QRS wide and bizarre T large |
| PVC sign | Apical/radial pulse deficit |
| Vtach on EKG | 3+ PVCs in a row QRS rate is 150-250 QRS is > 0.12 (wide) |
| Vfib on EKG | extremely irregular |
| Antidysrhythmia Classes | 1 - sodium blocker 2 - beta blocker 3 - potassium blocker 4 - calcium blocker |
| sodium blockers used for | VT, SVT, PVC, prevent Vfib (the ventriculars) |
| Examples of sodium blockers | lidocaine, procainamide |
| beta blockers used for | SVT, Afib, Aflutter |
| what do beta blockers do? | lower HR vasodilation lower contractilit |
| examples of beta blockers | atenolol, the -olols |
| what do potassium blockers do? | delay repolarization (increases PR and QT, widens QRS) |
| examples of potassium blockers | amiodarone, sotalol |
| what do calcium blockers do? | lower HR vasodilation decrease contractility |
| Calcum blockers used for? | SVT, Afib, Aflutter |
| Example of calcum blocker | amlodipine |
| What does digoxin do? | decrease HR increase contratility |
| What does adenosine do? | decrease conduction through AV node decrease HR |
| what does atropine do? | anticholinergic increase HR |
| What does magnesium do? | decrease conduction through AV node |
| what does hydralazine do? | vasodilation |
| what does nitro do? | vasodilation |
| Small box on EKG | 0.04 seconds |
| Large box on EKG | 0.20 seconds |
| 5 large boxes on EKG | 1 second |
| 30 large boxes on EKG | 6 seconds (1/10th of a minute) |
| normal P wave | 0.06 - 0.12 seconds |
| normal PR interval | 0.12 - 0.20 seconds |
| normal QRS | 0.04 - 0.12 seconds |
| normal T wave | 0.16 seconds |
| T wave inversion | ischemia |
| ST depression | ischemia |
| ST elevation | injury |
| ST elevation + pathological Q | infarction |
| when do you defibrillate? | Vfib Vtach |
| when do you use cardioversion? | afib aflutter PSVT sinus tachycardia |
| When do you use asynchronous pacemaker? | AV block Afib w/ RVR BBB Vtach |
| Defib joules rate for biphasic? | 120-200 |
| Defib joules rate for monophasic? | 360 |
| ICD candidates | syncope with Vtach/Vfib survived SCD spontaneous sustained Vtach life-threatening dysrhythmias |
| ICD teaching? | No MRI if it fires, call PCP if it fires and you don't feel well, call 911 |
| Pacemaker candidates | AV block AFib with RVR BBB Vtach Cardiomyopathy HF SA node dysfunction |
| Pacemaker teaching? | No MRI if it fires, call PCP if it fires and you don't feel well, call 911 take daily pulse |
| Aortic dissection signs | weak or absent pulses different between bilateral upper extremities |
| Aortic dissection complication | cardiac tamponade (JVD, pulsus paradoxus) |
| Kidney functions | Eliminate toxins regulate acid/base balance erythropoietin release |
| No renal function characteristics | CA down Phos up anemia metabolic acidosis |
| normal urine output | 30 ml/hr |
| kidney function (AFEVER) | A = acid base balance F = fluid/electrolyte balance E = elimination of wastes V = Vitamin D E = erythropoietin release R - renin releaase |
| kidney failure symptoms (AFEVER) | A = acidic F = K up, CA down, Phos up E = retain fluids V = CA down, hypocalcemia E = H&H down, RBC down - anemia R = BP up |
| when is dialysis needed | creatinine 15 or below |
| nitrogenous waste in blood | azotemia |
| condition of nitrogenous waste in blooc | uremia |
| normal creatinine | 0.6 - 12 mg/dl |
| good indicator of AKI | urine output |
| normal BUN | 6-20 mg/dl |
| crush injury | increased myoglobin |
| Does BUN or creatinine fluctuate more | BUN |
| most accurate kidney function test | creatinine clearance |
| what is creatinine | end product of muscle and protein metabolism |
| what is BUN | end product of protein metabolism |
| BUN would do what with fluid retention | BUN would go down |
| What level is oliguria? | < 400 ml/day |
| Hallmark signs of AKI | increased potassium increased phosphorous decreassed calcium decreased Ph (acidic) |
| Mannitol is what? | diuretic |
| symptoms of hyperkalemia | nausea, fatigue, weakness, tingling, bradycardia, AV block |
| what to do with hyperkalemia | insuin/glucose IV sodium bicarb induce diarrhea calcium supplements phosphorous with meals |
| normal GFR | 100-125 ml/min |
| kidney diet | low salt, low potassium, fluid restrictions, low protein, no dairy |
| osmosis moves what | water |
| diffusion moves what | solvent (potassium) |
| ultrafiltration does what | pressure (like wringing out a mop) |
| dialysis complications | hypertension, cramping, disequilibrium syndrome |
| what do you do with hypertension complciation during dialysis | stop, supine, NS bolus, O2 |
| what do you do with cramping complicatino during dialysis | stop, NS bolus, weight |
| what are signs of disequilibrium syndrome during dialysis | BP up, N/V, HA, convulsions |
| what do you do with disequilibrium syndrome? | decrease time, decrease flow rate, call PCP |
| what are the three types of cardiomyopathy? | dilated, hypertrophic restrictive |
| what cardiomyopathy is most common? | dilated |
| what can be the first sign of hypertrophic cardiomyopathy? | SCD |
| what is a sign of restrictive cardiomyopathy | JVD, RHF |
Created by:
Sharonwhite513
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