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C Exam 5
Perfusion Pt 2
| Question | Answer |
|---|---|
| What does nicotine do to the vessels? | vasoconstriction |
| What is the recommended amount of exercise? | 150 minutes a week of moderate aerobic activity 75 minutes a week of vigorous aerobic activity |
| What should be caused by exercise? (HR..?) | HR increase by 30-50 BPM Cause sweating |
| What does alcohol do to BP? | Increases it |
| What is the recommendation of drink consumption per day? | 2 per day for men and 1 drink per day for woman |
| What is a compensatory mechanism to maintain cardiac output? | Tachycardia |
| What is the ankle-brachial index? | |
| What is cardiac bruit? | turbulent blood flow in the carotoid artery. Whoosing sound |
| What would be signs of inadequate perfusion in toddlers/children? | Squatting Fatigue Developmental delay |
| What are signs of inadequate perfusion in infants? | Poor feeding Poor weight gain Failure to thrive Dusky color |
| Which 3 electrolytes can cause dysrthymias? | Calcium Magnesium Potassium |
| What is the desired level of HDL? | ≥ 40mg/dL |
| What is the desired level of LDL? | <100 mg/dL |
| What is the desired serum cholesterol level? | <200 mg/dL |
| What is the desired fasting triglyceride level? | <150 mg/dL |
| What are the cardiac enzymes? | CKMB CPK Troponin Myoglobin C reactive protein |
| What cardiac enzyme is the most specific to heart damage? | Troponin |
| What is a normal troponin level? | <0.5 ng/nl Mrs. O says 0 |
| When do troponin levels become elevated after ischemia? | 3-4 hours |
| When are blood samples drawn for cardiac markers? | report of chest pain every 6 hours for the first 24 hours |
| What does the series of blood tests show? | trends so doctors can determine the time of heart damage by looking at peak levels |
| What is D-dimer? | fibrin product produced after a clot has formed and is in the process of being broken down |
| What is D-dimer test used for? | Diagnosis of DVT, PE |
| What does a D-dimer of greater then 500 indicate? | a clotting event |
| What is BNP? vasodilator or vasoconstrictor? | Vasodilator Suppresses sympathetic tone & renin system |
| What is BNP test used for? | Diagnosis of Chronic Heart Failure |
| What do BNP levels below 100 indicate? | no heart failure |
| What do BNP levels of 100-300 indicate? | suggest heart failure is present |
| What do BNP levels of above 300 indicate? | mild heart failure |
| What do BNP levels above 600 indicate? | Moderate heart failure |
| What do BNP levels about 900 indicate? | Severe heart failure |
| What is a normal D-dimer? | less than 250 |
| What is a holter monitor? | patient sent home on remote telemetry monitoring |
| What is telemetry? | continous tracing of the electrical activity of the heart. Looks at the heart from one angle does not always pick up ischemia or infraction |
| What does a 12 lead EKG do? | looks at electrical activity of the heart from different angles |
| What is a 12 lead EKG used for? | Identify specific areas of ischemia and infarction Heart blocks Arrhythmias |
| What does an echocardiogram do? | visualize the heart and calculate the ejection fraction |
| What kind of test is an echocardiogram? | non-invasive |
| What is a TEE (transesophageal echocardiogram)? | Ultrasound probe is swallowed making it easier to see more clearly because you are closer to the heart |
| When would iv contrast be used with a TEE? | if atrial or ventricular septal defect suspected |
| What are the nursing interventions for TEE? | Pt must sign consent Pt NPO for at least 6 hrs prior to TEE IV sedation and throat anesthesia Pt NPO until gag reflex returns |
| What would an MRI show? | detect and localize areas of MI in a three- dimensional view |
| What is a CT Angiography? | noninvasive scan used to quantify calcium deposits in coronary arteries |
| What does a stress test check? | how a patients heart works during exercise |
| What can a stress test help identify? | Heart disease related to chest pain Cardiac arrhythmias Valve disease Heart failure |
| What should you instruct a pt before a stress test? | Wear comfortable clothes Hold beta blockers for 24 hours prior Chest pain should be reported SOB should be reported but is normal during exercise |
| What is a dopamine stress test? | Dopamine is used to elevate heart rate and ECG is monitored. |
| What patients would need a dopamine stress test? | patients who are not able to exercise for any reason |
| What is a left sided catheter used to visualize? | the coronary arteries |
| What is a right sided catheter used to visualize? | movement of blood through the heart and measure pressures in the heart |
| What allergy should you check for before cardiac catheterization? | iodine or shellfish |
| What are the nursing interventions for cardiac catheterization? | Pt must sign consent NPO 6-8 hrs before Sedative to relax pt Warn pt of warm flush feeling when dye injected Assess vital signs, insertion site every 15 mins for 1st hr, then every 30 mins for 4 hours |
| What can a compression device help with during cardiac catheterization? | prevent bleeding at insertion site |
| What are some complications that can occur with cardiac catheterization? | Rupture vessel Bleeding at insertion site Blood clot |
| What would indicate a ruptured vessel during catheterization? | it would be visualized during the procedure, would need open heart surgery to repair the vessel |
| What are some primary prevention strategies to help prevent perfusion disorders? | Smoking cessation Diet Exercise Weight control |
| At what age should blood pressure screening begin? How often should it be done? | Beginning in infancy and recommended yearly at well child visit |
| How often should adults (18+) get a blood pressure screening? | every two years if BP is 120/80 Every year is 120-139/80-90 |
| Who should have lipid screening? | Men without risk is 35 years Women without risk is 45 years |
| If patient is at increased risk of coronary heart disease when should they start getting lipid screenings? | 20 years of age |
| What drugs are used to lower the heart rate? | Cardiac glycosides Beta blockers Calcium channel blockers Think B,C, D for digoxin |
| What do vasopressors do? | cause vasoconstriction to increase BP |
| What drugs are considered vasodilators? | ACE inhibitors Beta blockers Calcium channel blockers Diuretics Think ABCD |
| What do thrombolytics/ fibrinolytic do? | break up clots, clot busters |
| What drug is antiplatelet? | aspirin |
| What can collaborative interventions can be done to help promote local perfusion? | Revascularization Endaterectomy |
| What is revascularization? | stent or angioplasty to help hold the vessel open |
| What is endaterectomy? | surgical removal of plaque build up |
| What is ablation therapy? | used to help promote central perfusion, procedure to scar or destroy tissue in heart allowing incorrect electrical signals(causing abnormal heart rhythm) |
| What is electrical cardioversion? | heart is shocked to convert it from an irregular rhythm back into normal sinus rhythm |
| What is a pacemaker used for? | small electronic device (placed just below collarbone) to help regulate slow electrical problems |
| What can you do in acute stage to minimize the workload of the heart? | bedrest |
| What does extra fluid do to the workload of the heart? | increases it |
Created by:
cberna00
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