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MedSurge Exam 1
| Question | Answer |
|---|---|
| Preload vs Afterload | Preload= stretch on ventricles during diastole Afterload= resistance ventricles pump against to leave heart |
| how does vasodilation vs vasoconstriction impact preload | dilate= decrease preload bc venous pooling constrict= increase preload bc squeezes venous blood to heart |
| what is stroke volume | amount of blood ejected from ventricle with each beat |
| troponin vs ckmb vs myoglobin | troponin- cardiac specific, gold standard ckmb- reinfarction myoglobin - earliest sign of muscle damage |
| normal cardiac output | 4-6L/min |
| normal EF% | 50-70% |
| normal atrial kick percent | 15% |
| TAA vs AAA vs dissection pain | TAA=boring chest and some back pain AAA= back and flank pain Dissection= shredding/ripping pain |
| Best way to diagnose TAA vs AAA | TAA= TEE AAA= CT/abdomen |
| types of aneurysm surgeries (elective v emergency too) | elective (open vs EVAR) = aneurysm no active rupture emergency= active rupture |
| 6 P's | pain, pallor, pulselessness, paresthesia, polar, paralysis |
| urgency vs emergency HTN | urgency= no organ damage emergency= organ damage (neuro, blurry, blood etc) both have 180/120> BP |
| silent MI s/s vs classic MI s/s | silent (women, old, OSA, diabetes)= unexpected fatigue, back pain, GI s/s classic= chest pain |
| how are murmurs graded | grade 1(very faint)- grade 6 (audible withut stethoscope) |
| cardiac stress test instructions | comfy clothes, no eat 2-4 hr before, dont take like beta blockers, informed consent |
| prodromal s/s of acute cardiac event | fatigu, GI upset, syncope |
| primary v secondary htn | primary= no known cause secondaruy= known cause if multidrug therapy isnt working, look for a secondary htn cause |
| beta blockers education | dont stop abruptly, no for asthma, masks hypoglycemia s/s |
| masked htn vs white coat syndrome | masked= normal reading at clinic but high when at home or work |
| htn emergency plan/goals over time? | 0-1 hr= reduce bp no more than 25% to prevent ischemia then 160/120 or so then normalize EXCEPT in aortic dissection, very large blood loss |
| gold standard for diagnosing htn/masked htn | home bp measure or 24 hr bp measure |
| DASH diet | high protein low fat, K+ helps but if you have CKD/renal issues then DONT EAT K+ |
| TAA s/s | brassy cough, boring/dull chest pain |
| aortic dissection gold standard diagnostic | ct angiography |
| s/s of AAA | abdominal/back pain, heartbeat in abdomen/pulsatile mask, mottling of toes |
| post-graft aneurysm occlusion vs rupture s/s | occlusion= pale, cool, pulseless, change in pulses rupture= abdominal distention, sudden pain, tachy and hypo, |
| how to monitor endoleak | CT scans |
| post op aneurysm repair edu | hob less than 45 deg, uo less than 30ml/hr report |
| bronchoscopy preprocedure and post procedure | informed consent, NPO before, sedate, npo until gag reglex back, remove denture |
| to diagnose htn, how many bp readings and how far apart | 2 and at least 2 mins apart |
| thiazide diuretics monitor for what | electrolyte imbalance (K level) monitor heart function hypotension meds ortho hypo dry mouth volume |
| hypertensive emergency diagnostic first? | 180/120 with organ damage (either or 180 or 120 or more is crisis/urgency) CT without contrast first bc kidney damage CT angio if need to (increase fluids, check kidney levels, cardiac markers, electrolytes maybe) |
| want to bring BP rapidly from htn emergncy if they have whta conditions | aortic dissection, eclampsia, hemorrhagic stroke |
| sacular vs fusiform vs dissecting vs mycotic aneurysm | sacular- one form on one side fusiform- entire vessel dissecting- tear in vessel wall (BAD) mycotic- localized due to infection |
| risks for aneurysms | htn, smoking, fam hx, more than 50, MARFAN SYNDROME (ascending TAA), blunt chest trauma, cocaine |
| aneurysm diagnostic | BP both arms CT chest xray angiography US dupley-- AAA usually |
| aneurysm size and how often to check | small- 3-3.9cm = CT/monitor every 3 years med (4.5cm)= annual CT large 5cm or rapidly growing= surgery endo graft= AAA open= TAA |
| aneurysms most often occur in where | aorta |
Created by:
andywattana