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Cardiac Impairments
| Question | Answer |
|---|---|
| What is a TEE? | Transesophageal Endoscope- Procedure used to view outside of heart (Blood vessels, etc.) |
| What is the heart's natural pacemaker? | SA Node |
| What happens if the SA node stops functioning? | The AV node compensates temporarily until problem is resolved. |
| What happens if a left or right bundle branch is blocked? | The other side (L or R) compensates temporarily. |
| What happens to the conduction in the heart is O2 is low? | Can't function correctly and MI can occur |
| What is the term for contraction of the myocardium? | Systole |
| What is the term for relaxation of the heart (filling of the ventricles with blood)? | Diastole |
| What is the term for the amount of blood ejected from the ventricles with each heartbeat? | Stroke volume |
| What is the term for the amount of blood pumped by each ventricle in one minute? | Cardiac output |
| What is the term for the percentage of the total volume of blood ejected with each heartbeat (Measures what was ejected compared to what is left in percentages)? | Ejection fraction |
| How is the ejection fraction measured? | Echocardiogram |
| In blood pressure, which is always present, systole or diastole? | Systole |
| What system is the HR regulated by? | Autonomic nervous system |
| What 3 factors affect stroke volume? | Preload, afterload and contractility |
| What is the degree of stretch of cardiac muscle at the end of diastole (filling), PRIOR to contraction? | Preload |
| If blood volume is increased, what happens to preload? | Increases |
| What is the resistance the ventricles must overcome to eject blood into systemic circulation? | Afterload |
| If blood pressure (resistance) increases, what happens to afterload? | Increases |
| What body system affects afterload and how? | Sympathetic nervous system (fight or flight)- HR increases |
| What is the force of contractions generated by myocardial muscle? | Contractility |
| What are two factors that can decrease contractility? | Arrhythmias and fibrillation |
| What med is given to increase contractility which allows the heart to not work as hard? | Digoxin |
| What must you check before administering Digoxin and why? | HR- Digoxin decreases HR |
| What is defined as the number of complete cardiac cycles per minute? | Heart rate |
| What do chemoreceptors do for the heart? | Measure amount of 02 |
| What do baroreceptors do in the heart? | Measure blood pressure |
| What two places in the heart are baroreceptors located? | Aortic arch and carotid sinuses |
| If baroreceptors sense blood pressure is not in an ideal range, what do they do? | Signal the medulla to either increase or decrease HR |
| What enzyme stimulates release of angiotension? | Renin |
| What hormone constricts blood vessels thereby increasing blood pressure? | Angiotension |
| As we age, collagen increases while elastin decreases. T or F? | True |
| What series of cardiac events can lead to SOB? | Preload increases ad forces heart to work harder to pump blood, causing SOB |
| What is a common cause (not severe) of chest pain in women? | Indigestion |
| If a pt presents with chest pain, what are the first two things you do? | EKG then call MD |
| What is the only narcotic that can truly relieve chest pain? | Morphine |
| Because ACE inhibitors are less effective in African Americans, what is a common alternative? | Thiazides |
| What drug typically requires African Americans to get a higher dose while Asian Americans get a lower dose? | Beta blockers |
| What is the term for the enzymes released into the bloodstream from damaged myocardial cells? | Cardiac markers |
| What cardiac marker is present in all muscles and brain tissue and can give a false positive if a pt was exercising before the test? | CK- Creatinine kinase |
| What test is 95% specific to cardiac tissue, rises 4-6 hrs after onset of chest pain and peaks after 18-24H? | CK-MB |
| What test is 100% specific to cardiac tissue and begins rising at onset of damage, even if pt is symptomatic? | Troponin |
| What is a normal Troponin level? | <0.1% |
| What level of LDL is recommended for pt's with CAD compared to a pt with no CAD? | CAD: <70 No CAD: <160 |
| What test is used for measuring cholesterol? | Non-fasting blood draw |
| What level is recommended for total cholesterol (HDL and LDL combined)? | <200 |
| What do elevated triglycerides as well as elevated cholesterol place pt at risk for? | CAD |
| What is the term that describes how much fat is in the blood? | Triglycerides |
| What test do we use to measure triglycerides? | Fasting blood draw (min. 12H and no ETOH for 24H) |
| What is the recommended level for triglycerides in a diabetic pt compared to that of a non-diabetic pt? | Diabetic: <150 Not diabetic: 100-200 |
| What lab values are included in serum chemistry? | NA, K, Ca, Mg, BUN, Cr, Glucose |
| What are the normal values for Na and what symptoms appear if Na in not WNL (within normal limits)? | 135-145 Neurologic (confusion) |
| What are the normal values for K and what can occur if levels are not WNL? | 3.5-5.0 Arrhythmmias and renal impairment |
| What are the normal values for glucose? | 70-110 |
| What are normal BUN values and what is indicated if BUN is low? | 10-20, Fluid overload |
| What are normal Cr levels and what is indicated if levels are high? | 0.6-1.2, Kidney failure |
| What is indicated with an elevated BUN and a normal Cr? | Dehydration |
| What are normal levels for PTT? | 25-38, Pt on Heparin: multiply baseline by 1.5-2.0 |
| What are normal levels for PT? | 12-18, Pt on Coumadin: multiply baseline by 1.0-1.5 |
| What are normal levels for INR? | 2.3 if on COumadin for DVT or pulmonary embolism 2.5-3.5 for pt with Afib or prosthetic valve |
| How do we measure efficacy of Lovenox? | We can't. We can only measure platelets. |
| What tests do we use to measure efficacy of Coumadin? | PT/INR |
| What tests do we use to measure efficacy of Heparin? | PTT |
| What is the typical dose for Lovenox considering its half life? | Lovenox has a half life of 12H so it is usually given 2x/day |
| What cell carries Hgb? | RBCs |
| What cells are elevated in the event of infection? | WBCs |
| What are our clotting factors? | Platelets |
| What are 2 meds that prevent platelet aggregation (sticking)? | Lovenox and Plavix |
| What protein in our blood carries oxygen? | Hgb |
| What measures the amount of RBCs in the plasma? | Hct |
| What is the condition where there are too many RBCs creating thickened blood? | Polycythemmia |
| Why is ASA given to a pt with chest pain? | If the problem is an occlusion, ASA will prevent platelets from sticking and causing a full blockage. |
| How does low Hgb manifest in the respiratory system? | SOB |
| What is the marker of choice for distinguishing cardiac vs. respiratory cause of dyspnea? | BNP or B-type Natriuretic Peptide |
| What is BNP specific to? | CHF |
| What level of BNP indicates HF? | >100 |
| What is a marker of inflammation that can predict cardiac events such as CHF, angina, etc.? | CRP or C-reactive protein |
| What test predicts MI? | None |
| What amino acid indicates risk for CV disease when elevated? | Hcy or Homocysteine |
| What is a diagram of the electrical activity of the heart? | Electrocardiogram or EKG |
| What are 6 events an EKG can show? | Dysrhythmias, conduction abnormalities, **lack of O2 to heart muscle**, Afib, misfires and blockages |
| What test evaluates CV response physical exercise or med. induced (nuclear) stress? | Cardiac stress test |
| If a pt fails a stress test (body responds in an unhealthy way), is the test considered positive or negative? | Positive |
| What must pt refrain from before a stress test? | Stimulants, NPO per provider, and some meds (beta blockers) |
| What systolic and diastolic levels are considered normal in an adult BP reading? | Systolic: <120 Diastolic: <80 |
| What systolic or diastolic levels indicate prehypertension? | Sys: 120-139 Dias: 80-89 |
| What sys. and dias. levels indicate stage 1 HTN? | Sys: 140-159 Dias: 90-99 |
| What sys. and dias. levels indicate stage 2 HTN? | Sys: >160 Dias: >100 |
| What is the formula for BP? | CO x SVR= BP |
| Vasodilation decreases BP while vasoconstriction increases BP. T or F? | True |
| Where are Alpha and Beta receptors located and what do they affect? | In the Sympathetic Nervous System. Affect preload, afterload and contractility |
| What part of the body controls sodium excretion, ECF volume and controls the RAAS, contributing to BP regulation? | Kidneys |
| What is stimulated by A-II to release aldosterone? | Adrenal cortex |
| What gland releases ADH? | Posterior pituitary |
| Does water retention and edema increase or decrease BP? | Increase |
| What type of HTN is due to loss of elasticity in vessels and is measured by sys >140 and dias <90? | Isolated systolic HTN |
| What type of HTN includes 90-95% of all pt.s with HTN? | Primary HTN |
| What type of HTN is caused by another disease or medication? | Secondary HTN |
| Name four risk factors for developing HTN? | Obesity, family history, sedentary lifestyle and smoking |
| What are 5 common S&S of blood pressure abnormailties? | Nosebleeds, dizziness, HA, blurred vision, ear ringing |
| A pt with HTN is at high risk for developing failure of what body system? | Renal |
| What is the name of the diet specifically used to try to prevent or stop hypertension? | DASH diet |
| What are 2 common diuretics? | Lasix and thiazide |
| What should be monitored for with pt.s on diuretics? | Hypokalemia |
| What class of meds blocks angiotension (vasoconstrictor) thereby reducing BP? What does the drug name typically end with? | ACE inhibitors- "pril" |
| What class of meds block receptors causing decreased CO and HR? What does the drug name typically end with? | Beta blockers- "lol" |
| What class of meds interferes with flux ions from entering smooth muscle causing vasodilation, decreasing BP and HR? | Calcium channel blockers |
| WHat are 2 examples of calcium channel blockers? | Verapamil, Calan and Norvasc |
Created by:
mm318
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