Busy. Please wait.
or

show password
Forgot Password?

Don't have an account?  Sign up 
or

Username is available taken
show password

why


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.

Remove Ads
Don't know
Know
remaining cards
Save
0:01
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
Retries:
restart all cards




share
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

CardiacStack Ex#1

infomation for exam #1

QuestionAnswer
This Heart Rhythm has a P wave for every normal QRS complex, is consistent and HR of 60-100. Normal Sinus Rhythm or NSR
This heart rhythm has a P wave for every normal QRS complex, is consistent and a HR <60. Sinus Bradycardia or SB
What is the treatment for SB if patient was Symptomatic? May give Atropine. May need a pacemaker.
This heart rhythm has a P wave for ever normal to narrow QRS complex, is consistent and a HR >100. Sinus Tachycardia or ST
What is the treatment for ST? Treat the cause of tachycardia Valsalva Maneuver May give Beta Blockers
What heart rhythm has 2-3 P waves for every normal QRS complex (saw tooth waves)? Atrial Flutter
What is the treatment for Atrial Flutter Cardioversion May give Diltiazem Digoxin Verapamil Quinidine
What heart rhythm has no normal P waves, no measurable PR interval, normal QRS complex, Atrial HR of 300-600, Ventricular HR of 50-180? Atrial Fibbrillation
What is the Treatment for Atrial Fibrillation? Cardioversion May give Diltiazem Digoxin Verapamil Quinidine
What heart rhythm has an irregular rate, P waves that are rarely seen or lost in the QRS comlex, no measurable PR interval, QRS complex that are wide and "bizarre" that measure more than 0.1 sec? PVC or Premature ventricular contractions
What is the treatment for PVCs on a stable patient? Give Amiodarone,Lidocaine,Magnesium Sulfate or Procainamide
What is the treatment for PVCs on an unstable patient? Cardioversion
What is the treatment for PVCs on a pulseless patients? Defib, ACLS
What heart rhythm has an irregular rate that is not measurable, no visible P waves, no measurable PR interval, no measurable QRS complex? Ventricular Fibrillation or V. Fib.
What is the treatment for a patient who is in V. Fib? Defibrillation STAT. ACLS protocols, Monitor ABGs for O2 levels
What heart rhythm has an impulse delay at the AV node, a regular rhythm, a PR interval that is >0.2 seconds and consistent, a normal QRS complex? First Degree AV block
What heart rhythm has PR intervals that vary & gradually lengthens until a QRS is dropped, then repeats itself? 2nd Degree AV Block Type 1 OR Mobitz I or Wenckeback
What is the treatment for a 2nd degree AV block Type I on a patient who is symptomatic? Atropine and Temporary Pacemaker
What heart rhythm has some P waves that are nonconduction so there is usually 2-3 waves for every 1QRS complex BUT when P waves are conducting , the PR is normal? 2nd degree AV block Type II or Mobitz II
What is the treatment for a 2nd degree Type II heart rhythm? May give Isoproterenol, Atropine, Epinephrine or Dopamine as temporary measures while waiting for a pacemaker to be inserted.
What heart rhythm has an atrial HR of 60-100 and regular, ventricular HR that varies and is regular, normal but not conducting P waves, a PR interval that varies with no relationship between P and QRS, and a QRS Complex that is wither normal or abnormal? 3rd Degree AV block Complete.
What is the treatment for a 3rd degree AV block --complete? Give Isoproterenol, Atropine, Epinephrine or Dopamine. Put in a temporary pacemaker until permenant pacemaker can be implanted.
What heart rhythm has a lack of ventricular contractions? Asystole
What is the treatment for a patient in Asystole? CPR, ACLS protocols, intubation...
What is the name of the lining that surrounds the heart and it's functions? Name: Pericadium or Pericardial Sac Function: anchors heart in place; prevents ventricles from over filling
What is the purpose of the fluid that is between the heart and the pericardium? The fluid acts as a lubricant to reduce friction.
Name the layers of the heart wall and their thickness and location? Endocardium/thin inner layer Myocardium/midde-thick layer Epicardium/ outer thin membrane
What is the function of the myocardium? It is muscle layer of the heart that is responsible for contraction.
List the blood flow through the heart. In from Vena Cava, Right Atrium, Tricuspid Valve, Right Ventricle,Pulmonic Valve, Pulmonic Artery, In from Lungs, Left Atrium, Mitral Valve, Left Ventricle,Aortic Valve, Aorta, out to body
What is the purpose of the chordae tendineae? Prevent backflow into the ventricles. Make sure the valves stay shut.
In a cell at rest or repolarized call which charge is inside the cell and outside the cell? Name the Ions that would be inside or outside? (+) charge inside/ (-) charge outside Na+ & Ca+ inside / K+ and Cl- outside
In a depolarized cell which charge is inside the cell and outside the cell? Name the Ions that would be inside or outside? (-) charge outside/ (+) charge inside K+ & Cl- outside/ Na+ & Ca + outside (caused by Na+ moving across the membrane and into cell).
What is happening in the heart at the P wave on an EKG? the firing of the SA node and the depolarization of the atria causing atrial contraction.
What is happening in the heart at the QRS complex on an EKG? Depolarization of the ventricles resulting in contraction and Atria filling with blood.
What is happening in the heart at the T wave on an EKG? Repolarization of the ventricles; the heart is at rest.
List the pathway for an electrical impulse that is traveling through the heart. Starts at SA node, travels through atria to AV node, delays briefly, Atria contract, travels down through Bundle of His into R & L Bundle branches into purkinje fibers, venticles contrac,then repolarization.
Define Cardiac Output (CO) and the formula for calculating CO? the amount of blood pumped by each ventricle in 1 min. CO = SV X HR
What factors effect CO? HR affected by the Autonomic Nervous System. SVR is affected by Preload, contractility, and afterload.
What is SV and the formula to calculate SV? Stroke volume: the mount of blood ejected by the ventricles with each beat. SV = (CO x 1000)/HR
Define Dromotropic effect? the speed of conduction through the AV node. (+)= increased speed (-)= decreased speed.
Define Chronotropic effect? when the pulse is affected. (+)= increased pulse (-) = decreased pulse
Define Inotropic effect? changes in contractility that affects contractions. (+)= increased contractility (-)= decreased contractility
Define Preload? the stretching of muscle fibers in the ventricles as the ventricles fill with blood.
Define Contractility? the inherent ability of the myocardium to contract normally. It is influenced by preload. The more stretch, the more forceful contraction.
Define Afterload? it is the amount of vascular resistance that must be overcome by the ventricles to pump the blood. SVR = a measure of L afterload (systemic vascular resistance) PVR = a measure of R afterload (Pulmonary vascular resistance)
What is automaticity? the ability of a cell to initiate an impulse without outside stimuli (ex. SA node generating an impulse)
What is excitability? the ability of a cell to respond to a stimulus and initiate an impulse (AV node)
What is Conductivity the ability of cardiac cells to conduct an electrical charge.
What is Contractility? the ability of the cardiac cells to contract when stimulated.
What is Refractoriness? cells are not able to respond to the stimulus until that have recovered (repolarized) from the previous stimulus.
IN the SNS (sympathetic Nervous System) name the common Neurotransmitters (NT) and what CV changes occur when the SNS is stimulated? NTs: Norepinephrine (nor-epi) and Epinephrine (epi). Stimulation causes: increased Pulse (+) chronotropic Increased conduction speed (+) dromotropic Increased force of contraction (+) inotropic.
IN the PNS (parasympathetic Nervous System) name the common Neurotransmitters (NT) and what CV changes occur when the SNS is stimulated? NTs: ACh or Acetylcholine Stimulation causes: Decreased Pulse (-) chronotropic Decreased Conduction (-) dromotropic Decreased force of contraction (-) inotropic.
What subjective data do you need during your CV assessment? history,current and past health problems, current medications, socioeconomic status, risk factors.
What objective data do you need during your Physical Exam for your CV assessment? PE: skin color and temp, BP and VS, Jug. vein pressure, heart sounds.
What diagnostic and labs are looking for your CV assessment? Labs: CBC, e-lytes, ABG, coag. levels, cardiac enzymes (CK-MB, troponin, CPK...), serum lipids, CXR, coronary angiography, Cardiac Cath, EKG, stress test, Echo,EPS (electrophysiography study), Transesophageal Echo (TEE), Nuclear Imaging (Thallium imaging)
What is hemodynamic monitoring? Invasive lines that monitor CV pressures and blood flow.
Define Starling's Law? the more a muscle is stretched, the stronger a contraction will be until after some point, additional stretching only cause a decrease in strength of contractions.
What does the arterial line measure in hemodynamic monitoring? The arterial in measures the L ventricle afterload or SVR.
What does the pulmonary arterial line (i.e. Swan-Ganz line) measure in hemodynamic monitoring? The pulmonary arterial line measures the R ventricular afterload or PVR.
how does decreased peripheral resistance affect afterload, CO, and O2 required by the heart? Afterload: decreased CO: increased O2: decreased
What are some complications of that can occur with Arterial Lines? Hemorrhage if cath is dislodged. Infections thrombus formation distal circulatory occlusion.
Why is it important by monitoring Pulmonary Arterial Pressure Fluid maintenance can be maintained without overload; preload can be regulated; CO can be maintained without going into pulmonary edema.
What does the circulatory asssitive devices do? stabilize & maintain pts with heart failure decrease L vent workload increased myocardial perfusion augments circulation by reducing L vent afterload.
Repolarized cell or cell at rest have ____ charge outside & ____ charge inside? List the charge and the ions. repolarized cells or cells at rest have __+__ charge outside & __-__ charge inside. Na+ and Ca+ outside & K+ and Cl- inside.
Depolarized cells have ____ charge outside & ____ charge inside List the charge and Ions. Depolarized cells have __-__ charge outside & __=__ charge inside. K+ & Cl- ions outside & Na+ & Ca+ ions inside.
What are the common symptoms of Angina? CP: gradual or sudden onset Chest: tightness, squeezing, indigestion CP located mid-substernal & can radiate to neck, back, arms, jaw & fingers Pain lasts 15-30min Pain relieved w/ NTG other S/S: apprehension, dyspnea, sweating,N, need to pee or burp
What are common symptoms of myocardial Infarction or MI? CP: sudden onset Chest: similiar to angina and more severe. CP: similiar to angina but difficult to pin-point Pain last 30m-2hrs Pain not relieved with NTG other s/s: similiar to angina with fatigue and vertigo.
Normal range values for ABGs pH: 7.35-7.45 PaCO2: 35-45 HCO3: 21-28 PaO2: 80-100
Electrolyte normal range values Na+:135-145 K+ :3.5-5.0 Ca+:9.0-10.5 Cl-:98-106 Mg+:1.3-2.1 Phos: 3.0-4.5
Normal Lab values for: Hgb Hct RBC WBC Platelet PT PTT INR Hgb: female: 12-16/male:14-18 Hct: female: 37-47/male:42-52 RBC: female:4.2-5.4/male: 4.7-6.1 WBC: 5000-10000 Platelets: 150000-400000 PT: 11-12.5sec
Normal Lab values for Serum Lipids Total Cholestrol: <200mg/dL Trigylceride: <150mg/dL HDL: >40mg/dL LDH: <100mg/dL for mod. risk; <70mg/dL for high risk HDL:LDL ratio: 3:1
Normal lab value for Troponin + rise, peak, and return times. Troponin T < 0.20 Troponin I <0.03 Rise: 3-6 hr Peak: 10-24 hr Return : 4-7 days.
Cardiac Enzyme normal values + rise, peak and return times Creatine Kinase (CK): female: 30-135 male: 55-170 CK-MB: 0% of total CK Rise within 1-3 hr Peak: 12-24hr Return: 2-3 days.
Normal lab values for LDH1,LDH2,total LDH + rise, peak and return times LDH1:17-27% LDH2:27-37% (both found in heart, RBCs and kidney) Total LDH: 100-190 Rise: 24-48 hr Peak: 48-72hr Return: 7-10days
Normal lab values for CRP (c-reactive protein)? <10.mg/dL
Normal lab value for AST? 0-35 units/L
Antiarrhythmics-Class I:type IA What they do? what they treat? examples NIs Do: slows conduction (-)dromotropic Lowers HR (-)chronotropic Treats: Afib, PVC, Vtach EX: Quinidine, Procainamide, Disopyramide NI: monitor BP, widening QRS complex, prolong QT or PR interval or heart block, watch for S/S SOB, wt. gain.
Antiarrhythmics-Class I:type IB What they do? what they treat? examples NIs Do: Shorten repolarization Depress ventricular automaticity Treat: PVC, VT, VF Ex: lidocaine, tocainide NI: monitor LOC,BP & HR, watch for tremors or seizures, watch for S/S of CHF.
Antiarrhythmics-Class I:type IC What they do? what they treat? examples NIs Do: Slows conduction (-)dromotropic Treat: Afib, life threatening vent. arrhythmias EX: flecanide, Propafenone NI: Monitor BP, S/S of CHF, for increase in dysrhythmias.
Antiarrhythmics-Class II: Beta Blockers What they do? what they treat? examples NIs Do: Slows HR (-)chronotropic Dec. AV conduction (-)dromotropic Dec. Contractility (-)Inotropic Dec. BP TREAT: AF, A-flutter, PVC EX: -olol atenolol, metoprolol, propranolol NI: Monitor HR & BP, Assess for SOB, insomnia,fatigue, dizzy & S/S of CHF
Antiarrhythmics-Class III:K+ channel blockers What they do? what they treat? examples NIs Do: slows HR (-)chronotropic TREAT: AF, A-flutter, life threatening vent. dysrhythmias EX: amiodarone, Ibutilide NI: monitor HR & BP and ECG
Antiarrhythmics-Class IV:Ca+ channel Bockers What they do? what they treat? examples NIs Do:delay conduction (-)dromotropic depress automaticity Dec HR (-)chronotropic Dec Contactility (-)Inotropic Prolong refractory TREAT: Afib, Aflutter EX:Verapramil, Diltiazem NI: Monitor HR & BP, Dig levels, SS of CHF, change positions slowly.
Digoxin (antiarrhythmic) What they do? what they treat? NIs Decreases HR (-) chronotropic Increases conduction (+)dromotropic increase contraction (+)inotropic TREATS:AF, CHF,A-flutter NI: Apical HR x 1 min before admin. check dig levels : 0.8-2ng/dL monitor for CHF, ECG, HR, BP
Atropine What they do? what they treat? NIs DO: increases HR (+)chronotropic TREATS: bradycardia NI: monitor HR, BP, ECG,
Adenosine What they do? what they treat? NIs DO: decreases conduction (-)dromotropic TREATS: PSVT NI: monitor HR, BP, ECG
Magnesium Sulfate What they do? what they treat? NIs DO: decreases myocardial cell activity TREAT: VT, VF, Atrial Paroxsymal tachycardia NI: monitor for seizure, resp, HR, BP, ECG
Defibrillation What does it do? What it treats NI DO: an electrical shock that depolarizes all heart cells with the thought that it will then use SA node to pace. TREATS: V-fib without a pulse NI: apply pads to pt chest start w/ low dose & then increase as higher dose can cause damage to myocardium.
Describe the 4 Different AV Heart blocks? PR interval:constant;1P:1QRS=1stDeg AV block PR interval:constant;P:QRS not 1:1=2nd Deg Type II PR interval:varied;RtoR,constant=3rd Deg AV block PR interval: varied;RtoR,varied=2nd Deg TypeII
Cardioversion What does it do? What does it treat NI Used for unstable Vtach,Afib,Aflutter. Hold Dig for 48hr prior Hold Anticoag for 4-6wks prior Maintain Airway Assess VS, LOC, EKG, for burns Provide emotional support Doc results from procedure.
Cardiac Catheter What is it used for? Used to assess heart dz, ID the best form of TX for heart Prob, measure intracardiac pressures, check O2 levels at various parts of the heart, to determine CO.
name some nursing interventions for Pre, intra, and post-procedure for Cardiac Catheter Pre: need to d/c blood thinners or metformin before procedure. Intra: watch for complications (Cath looping, kinking, breaking, blood loss, CVA, dysrhythmias, embolism,MI death) Post keep minb straight with femStop for 4-6hr. monitor VS, CV circ, SS o
Created by: shelbycanino