68wm6 PH2 Exam 4
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| Coronary Artery Disease (CAD) | conditions that obstruct blood flow in the coronary arteries
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| Stable Angina Pectoris | Narrowed coronary arteries cause predictable chest pain or discomfort with exertion. The blockages prevent the heart from receiving the extra oxygen needed for strenuous activity. Symptoms typically get better with rest.
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| Unstable Angina Pectoris | Chest pain or discomfort that is new, worsening, or occurs at rest. This is an emergency situation as it can precede a heart attack, serious abnormal heart rhythm, or cardiac arrest
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| Hyperlipidemia | elevated concentraions of any or all lipids in the plasma
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| Arrhythmia (dysrhythmia) | An abnormal heart rhythm due to changes in the conduction of electrical impulses through the heart. Some arrhythmias are benign, but others are life-threatening.
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| Congestive heart failure(CHF) | The heart is either too weak or too stiff to effectively pump blood through the body. Shortness of breath and leg swelling are common symptoms.
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| Cardiomyopathy | A disease of heart muscle in which the heart is abnormally enlarged, thickened, and/or stiffened. As a result, the heart's ability to pump blood is weakened
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| Pericarditis | Inflammation of the lining of the heart (pericardium). Viral infections, kidney failure, and autoimmune conditions are common causes
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| Pericardial effusion | Fluid between the lining of the heart (pericardium) and the heart itself. Often, this is due to pericarditis
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| Atrial fibrillation | Abnormal electrical impulses in the atria cause an irregular heartbeat. Atrial fibrillation is one of the most common arrhythmias
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| Heart valve disease | There are four heart valves, and each can develop problems. If severe, valve disease can cause congestive heart failure.
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| Heart murmur | An abnormal sound heard when listening to the heart with a stethoscope. Some heart murmurs are benign; others suggest heart disease.
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| Endocarditis | Inflammation of the inner lining or heart valves of the heart. Usually, endocarditis is due to a serious infection of the heart valves
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| Mitral valve prolapse | The mitral valve is forced backward slightly after blood has passed through the valve
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| Sudden cardiac death | Death caused by a sudden loss of heart function (cardiac arrest).
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| Cardiac arrest | Sudden loss of heart function
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| Electrocardiogram (ECG or EKG) | A tracing of the heart’s electrical activity. Electrocardiograms can help diagnose many heart conditions
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| Echocardiogram | An ultrasound of the heart. An echocardiogram provides direct viewing of any problems with the heart muscle’s pumping ability and heart valves
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| Exercise stress test | By using a treadmill or medicines, the heart is stimulated to pump to near-maximum capacity. This may identify people with coronary artery disease
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| Cardiac catheterization | A catheter is inserted into the femoral artery in the groin and threaded into the coronary arteries. A doctor can then view X-ray images of the coronary arteries or any blockages and perform stenting or other procedures
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| Holter monitor | If a doctor suspects an arrhythmia, a portable heart monitor can be worn. Called a Holter monitor, it records the heart's rhythm continuously for a 24 hour period
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| Event monitor | If a doctor suspects an infrequent arrhythmia, a portable heart monitor called an event monitor can be worn. When you develop symptoms, you can push a button to record the heart's electrical rhythm
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| Exercise | Regular exercise is important for heart health and most heart conditions. Talk to your doctor before starting an exercise program if you have heart problems
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| Angioplasty | During cardiac catheterization, a doctor inflates a balloon inside a narrowed or blocked coronary artery to widen the artery. A stent is often then placed to keep the artery open
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| Percutaneous coronary intervention (PCI) | Angioplasty is sometimes called a PCI or PTCA (percutaneous transluminal coronary angioplasty) by doctors.
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| Coronary artery stenting | During cardiac catheterization, a doctor expands a wire metal stent inside a narrowed or blocked coronary artery to open up the area. This lets blood flow better and can abort a heart attack or relieve angina (chest pain)
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| Thrombolysis | “Clot-busting” drugs injected into the veins can dissolve a blood clot causing a heart attack. Thrombolysis is generally only done if stenting is not possible
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| Lipid-lowering agents | Statins and other cholesterol (lipid) lowering drugs reduce the risk for heart attack in high-risk people
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| Diuretics | Commonly called water pills, diuretics increase urination and fluid loss. This reduces blood volume, improving symptoms of heart failure
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| Beta-blockers | These medicines reduce strain on the heart and lower heart rate. Beta-blockers are prescribed for many heart conditions, including heart failure and arrhythmias.
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| ICD (Implantable cardioverter defibrillator) | If a doctor suspects you are at risk for a life-threatening arrhythmia, an implantable cardioverter defibrillator may be surgically implanted to monitor your heart rhythm and send an electrical shock to the heart if necessary
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| Pacemaker | To maintain a stable heart rate, a pacemaker can be implanted. A pacemaker sends electrical signals to the heart when necessary to help it beat properly.
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| Aneurysm | a localized dilation of the wall of a blood vessel
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| Arteriosclerosis | aterial disorder characterized by loss of elasticity, thickening, and calcification of the arterial walls, resulting in a decreased blood supply
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| Atherosclerosis | arterial disorder characterized by yellowish plaques of cholesterol, lipids, and cellular debris in the inner layers of the walls of large and medium size arteries.
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| Defibrillation | converting ventricular fibrillation by delivering a direct electrical countershock to the precordium
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| Dysrhythmia | any cardiac rhythm that is not normal sinus rhythm. Also called arrhythmia
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| Embolus | a foreign object, piece of tissue or tumor, air or gas, or a thrombus that travels in the circulatory system until it becomes lodged in a vessel
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| Heart Failure | syndrome of circulatory congestion due to the hearts inability to act as an effective pump
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| Endarterectomy | surgical removal of the intimal lining of an artery
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| Cardioversion | restoration of the hearts normal sinus rhytm by delivery of a synchronized electric shock through two paddles placed on the patients chest
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| Hypoxemia | an abnormal deficiency of oxygen in the arterial blood
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| Intermittent Claudication | a weakness of the legs accompanied by cramp like pain in the calves caused by decreased arterial blood circulation to the leg muscles
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| Ischemia | Decreased blood supply to a body organ or part, often marked by pain and organ dysfunction
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| Myocardial Infarction(MI) | necrosis of a portion of the cardiac muscle caused by an occlusion of a major artery or one of its branches
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| Occlusion | an obstruction or closing off in a canal, vessel, or passage of the body
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| Orthopnea | patient must sit up or stand to breath deeply and comfortably
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| Peripheral | pertaining to the outside, surface or surrounding area
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| Pleural Effusion | an accumulation of fluid in the thoracic cavity between the visceral and parietal layers
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| Polycythemia | an abnormal increase in the number of red blood cells in the blood
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| Pulmonary Edema | Accumulation of extravascular fluid in lung tissues and alveoli, most commonly caused by left sided heart failure
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| Tachycardia | a heart rate of greater than 100 beats per minute
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| Bradycardia | a heart rate of less than 60 beats per minute
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| Three layers of the heart | Pericardium, Myocardium, Endocardium
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| The right ventricle pumps blood to the lungs through what valve? | Pulmonic Valve
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| Blood Vessels | Ateries, Capillaries, Veins
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| Circulates blood from the left ventricle to all parts of the body and back to the righ atrium, carries oxygen and nutrients to all body tissues and removes products of metabolism | Systemic Circulation
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| Circulates blood from the right ventricle to the lungs and back to the left atrium of the hearts, also carries deoxygenated blood to the lungs to be re-oxygenated and removes the metabolic waste product, carbon dioxide | Pulmonary Ciculation
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| The right and left coronary ateries branch off what blood vessel | The Aorta
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| Diastole | Phase of relaxation
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| The Sa Node is located where? | The superior portion of the right atrium
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| Classifications of heart failure | I. Minimal II.Mild III.Moderate IV. Severe
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| Describe the Pitting edema Scale | (+1 Trace, 2mm, Rapid); (+2 Mild,4mm, 10-15 seconds); (+3 Moderate, 6mm, 1-2 Minutes); (4+ Severe, 8mm, 2-5 Minutes)
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| Signs and Symptoms of Heart Failure (decreased cardiac output) | Fatigue, Anginal pain, Anxiety, Oliguria, Decreased gastrointestinal motility, pale cool skin, weight gain, restlessness
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| Signs and Symptoms of Heart Failure(Left Ventricular Failure) | Dyspnea, Paroxysmal nocturnal dyspnea, cough, Frothy blood-tinged sputum, orthopnea, Pulmonary crackles, radiographic evidence of pulmonary vascular congestion with pleural effusion
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| Signs and symptoms of Heart Failure(Right Ventricular Failure) | Distended jugular veins, Anoreixa, nausea, abdominal distention, liver enlargement with RU quadrant pain, (Edema in feet, ankles, sacrum; may progress up the legs into thighs, external genitalia and lower trunk)
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| Actions of Cardiac Glycosides | strengthen cardia force and efficience, slow heart rate, increase ciculation-effectin diuresis
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| Actions of Diuretics | Increase renal secretion of sodium, block sodium and water reabsorbtion in kidney tubles, (Are safe for long-term use)
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| Actions of Potassium supplements | Restores electrolyte loss
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| Actions of Sedatives and Analgesics | Promotes rest and comfort, relieves chest and abdominal pain,reduces anxiety, decreases myocardial oxygen demands, lessens dyspnea
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| Actions of Nitrates | Dilates arteries, improves blood flow, reduces blood pressure
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| Actions of Ace Inhibitors | Act as antihypertensives, reduce peripheral arterial resistance andand improve cardiac output
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| Actions of Beta-Adrenergic Blockers | Directly blocks the sympathetic nervous systems negative effects on the failing heart
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| Actions of Inotropics Agents | In low dose they dilate renal blood vessels, stimulate renal blood flow and glomerular filtration rate, which in turn promote sodium excretion
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| Actions of Human B-Type Natriuretic Peptides | Causes arterial and venous dilation, thereby decreasing systemic vascular resitance and pulmonary arterial pressures; decreases blood blood pressure, promotes better left ventricle ejection, increases cardica output, may also promote diuresis
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| Rheumatic heart disease | is the result of rheumatic fever and the clinical manisfestation of carditis resulting from an inadequately treated childhood pharyngeal or upper respiratory tract infectoin
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| What are Inotropic drugs | Drugs that influence the force or energy of muscular contractions, particularly contraction of the heart muscle
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| Refractory Period | The period during which a pulse generator is unresponsive to an electrical input signal of specified amplitude and during which it is impossible for the myocardium to respond. cannot depoloarize again
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| Common ACE Inhibitors | Benazepril, Captopril, Enalapril, Fosinopril, Quinapril, Univasc, Vamipril, Lisinopril
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| Common Angiotensin II Receptor Antagonists | Iosartan, Irbersartan, Valsartan,
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| Common Beta Blockers | Acebutolol HCI, Atenolol, Carvedilol, esmolol HCI, Metoprolol, Mexiletine HCI, Nadolol, Propafenone HCI,Propranolol, Soltalol HCI, Tocainide HCI
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| Signs and symptoms of Rheumatic Heart Disease | Increased pulse, Epistaxis, Anemia, Joint involvment, Nodules found on joints & SQ tissues
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| Signs and symptoms of Pericarditis | Pericardial Friction and often mimics the pain of an MI
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| Signs and symptoms of Cardiac Tamponade | Anxiety, Malaise, Dyspnea, Muscle Aches, Excruciating precordial pain
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| Signs and symptoms of Infective Endocarditis | Insidous onset, Recurrent fever, Flu-like symptoms, HA, Undue Fatigue, Joint pain, Chills, Chest pain, weight loss
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| Signs and symptoms of Myocarditis | Cardiac enlargement, murmur, gallup, tachycardia, dysrhythmias
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| Common Calcium Channel Blocker | Amlodipine, Diltiazem HCI, Nifedipine, Verapamil
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| Common Diurectics | Potassium Sparing, Loop-butmetanide fourosemide
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| Three nursing interventions related to Inflammatory disorders of the heart | Decreased cardiac output, Pain r/t inflammatory process, fluid volume excess r/t ineffective pumping actoin
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| Degenerative changes in the vascular system | (Tunica Interna- The inner walls of the blood vessels become thick and less compliant)(Tunica Media- The middle walls of the blood vessels become less elastic)
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| Diagnostic test for Peripheral Vascular Disorders | (Non-invasive- treadmill test, plethysmography, digital subtraction angiography, doppler ultrasound)(Invasive- Venography, angiography, D-dimer, duplex scanning)
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| What does the acromyn PATCHES stand for? | (P: pulses A: appearance T: temperature C: capillary refill H: hardness E: edema S: sensation) "Used for assessment and documentation of peripheral vascular disease"
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| The first symptom of an arterial disorder due to arterial insfficiency and ischemia | Pain
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| Arterial Embolism | Blood clots or other foreign substances in the arterial blood stream, dangerous when embolus becomes lodged and impairs blood flow
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| Signs of ruptured Arterial Aneurysm | Paleness, weakness, tachycardia, hypotension, abd pain, back pain, groin pain
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| What is Buergers disease? | is an occlusive vascular condition in which the small and medium-sized arteries become inflamed and thrombotic. Most commonly affected are men between the ages of 25-40 who smoke. Women however make up as much as 40 percent of patients with this disease.
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| What are the antagonist of the following drugs: 1. Warfarin 2.Heparin | 1.Protanine sulfate, 2.Vitamin k
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| What is Raynaud's disease? | Is caused by intermittent arterial spasms, and as disease progresses the intimal wall thickens and the medial wall hypertrophies. Primary Raynauds disease usually occurs before 30 years of age whereas secondary raynauds disease occurs after age 30.
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| Signs of Buerger's disease | pain, skin in infected area may be cold and pale, ulcers and gangrene may be present. An early sign may be superficial thrombophlebitis.
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| Signs of Raynaud's disease | Chronically cold hands and feet, during arterial spasms pallor, coldness, numbness, cutaneous cyanosis, and burning throbbing pain occur
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| Disorders of the Veins | Thrombophlebitis, varicose veins, venous stasis ulcers,
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| What is thrombophlebitis? | Thrombophlebitis is inflammation of a vein in conjuction with the formation of a thrombus. Occurs more frequently in women and incidences increase with age. Usually occurs more frequently in extremities
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| What are Varicose veins? | A Varicose vein is a tortuous, dilated vein with incompetent valves. Usually occurs in women between the ages of 40 t0 60.
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| What are Venous stasis ulcers? | Ulcers or leg ulcers that occur from chronic deep vein insufficiency and stasis of blood in the the venous system of the legs. Cause include severe varicose veins, burns, trauma, sickle cell anemia, diabetes, neurogenic disorders and hereditary factors.
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| Two characteristics that affect the functions of the heart | Automaticity and Irritability
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| The heart beat is initiated in with this node and is located in the upper part of the right atrium just beneath the opening of the superior vena cava. It is also known as the pacemaker | SA Node
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| The hearts electrical impulses fires in this order? | Sa Node, AV node, Bundle of his, right and left bundle branches of AV bundle, and Purkinje fibers
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| What is depolarization of the heart? | When the heart contracts. The P wave represents the depolarization of the atria. The QRS complex represents the depolarization of the ventricles.
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| What is repolarization of the heart? | Relaxtion phase of the heart. The T wave represents the repolarization of the ventricles.
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| Four methods for rate determination on an ECG? | Cardiac Ruler Method, Six Second Tracing Method, 300 Method, and 1500 Method(most exact)
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| Componets of the normal ECG complex | P,Q,R,S, and T waves.
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| Define Normal Sinus Rhythm | Rate of 60-100 BPM, Regular rythm, P wave present of each QRS complex, normal configuration, and each P wave is identical.
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| Prehypertension Parameters | S: 120-139 D:80-89
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| Stage 1 Hypertension Parameters | S:140-159 D: 90-99
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| Stage 2 Hypertensino Parameters | S: >160 D: >100
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| Hypertension occurs when a sustained level is above what parametters? | S: >140 D: >90
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| How is Hypertension diagnosed? | Hypertension is diagnosed based on the average of two seperate readings on two seperate occasions.
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| This type of hypertension constitues 90-95% of all cases and has no known cause | Primary(Essential) Hypertension
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| This type of Hypertension will most likely subside when the underlying condition causing it is corrected | Secondary Hypertension
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| Define Malignant Hypertension | Svere rapidly progressing elevation in blood pressure: Diastolic >120. Damages small aterioles in major organs, most distingushing is damage to eyes arteioles. More common in black males under 40. Fatal without medical intervention
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| Symptoms of advanced hypertension? | Awakening with a headach, blurred vision, Spontaneous epistaxis
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| Blood pressure is measured in this order for assessment of hypertension? | Supine and then sitting
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| Why doe hypertension often go untreated? | Because it is frequently asymptomatic until target organ damage begins
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| What classes of medication are used to treat hypertension? | Antihypertensives which include, ACE inhibitors, calcium channel blockers, diuretics,beta-blockers, and alpha-agonist
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| Adrenergics Side Effects? | Drowsiness, Depression, Dizziness, Nervousness, nightmares, bradycardia, hypotension, paplitations, dry mouth, constipation, nausea, vomiting, erectile dysfunction, rash, sweating, sodium retention, weight gain, withdrawal phenomenon
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| Describe Adrenergics(Antihypertensive) use and action | Management of mild to moderate hypertension. They are a vasodilator, improve myocardial contraction and they reduce pulmonary congestion.
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| Side effects of ACE Inhibitors | Dizziness, fatigue, headache, vertigo, weakness, cough, hypotension,chest pain, abd pain, N/V/D, proteinuria, impaired renal function, rashes, hyperkalemia, angioedema
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| Side effects of Beta-Blockers | Orthostatic hypotension, bradycardia, CHF, blood dyscrasias, bronchospasm, N/V/D
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| Side effects of Calcium Channel Blockers | Headache, dizziness, fatigue, dysrhytmia, peripheral edema, angina, bradycardia, hypotension, palpitations, flushing
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| How to use the Cardiac Ruler Method when determining a heart rate on an ECG? | Find an R wave that falls on a thick black line, Then find the next R wave, The Solid black lines between R waves are the following rates: 300,150,100,75,60,50,43,37,33,30
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| How to use the 1500 Method when determining a heart rate on an ECG? | Count the number of small boxes between two R waves, then Divide this number into 1500 to obtain the HR/Min.
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| Describe what the P wave represents on an ECG? | It is the first positive deflection representing depolarization of the atria
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| Describe what the QRS complex represents on an ECG? | Represents ventricular depolarization
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| Describe what the PR interval represents? | Represents the time it takes an impulse to travel from the SA node across the atria to the AV node fibers, Measured from the begining of the P wave to the begining of the QRS complex.
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| Describe what the T wave represents on an ECG? | Represents repolarization of the ventricle.
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| Describe what the ST segment represents on an ECG? | Early depolarization of the ventricle muscle
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| List the three steps for interpreting an ECG? | Sysematic analysis, determine heart rate, and determine rhythm.
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| Major indications for cardiac transplant? | Sever weakness of cardiac muscle(Cardiomyopathy) and end stage inoperable CAD(Coronary Artery Disease)
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| Desc | complaints of feeling cold, flushed, warm skin,pallid cold skin, shivering, increased repiratory rate and depth, increased heart rate
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| What is PTCA? | Percutaneous Transluminal Coronary Angioplasty; a balloon-tipped catheter is passed into a blocked artery, then inflated pressing the plaque against the coronary wall. Performed under conscious sedation.
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| What are the four valvular heart disease's? | Mitral Stenosis, Aortic Stenosis, Tricuspid, Pulmonary stenosis
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| Signs of Valvular disorders? | Heart murmur and extra heart sounds, crackles and wheezing in the lungs, presence of edema pitting and non pitting
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| Anticoagulants contraindications? | Hypersensitivity, underlying coagulation disorders, ulcer disease, malignancy, recent surgery, active MAJOR BLEEDING
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| Anticoagulants side effects? | Fever, diarrhea, rash, hemorrhage, agranulocytosis, leukopenia, eosinophilia, thrombocytopenia
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| What is the dose of Protamine Sulfate in a patient with heparin toxicity? | 1MG for each MG administered by slow IV injection.
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