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Med Surg test 2 cardiac part 1
Terms in this set (74)
why are women past childbearing age at greater risk for heart attacks than they were before menopause?
What does PQRST mean when assessing patient for chest pain?
P-precipating factors (activity), Q- quality(pressure, squeezing,burning) R-radiation S-S&S (diaphoresis, pallor, weak) T- timing (sudden, constant)
What are some respiratory signs associated with chest pain?
DOE, PND, Orthopnea
What does a person's skin look like when they might be having chest pain or an MI?
What are some things you would inspect for when assessing the heart patient?
clubbing, cap refill, peripheral edema, JVD
Where would you listen anatomically for the mitral area?
2nd ICS along the left sternal border
2nd ICS along the right sternal border
5th ICS at left lower sternal border
3rd ICS left sternal border
What is the point of maximum impulse?
5th ICS left midclavicular line
if the point of maximum impulse moves laterally, what does this indicate?
left ventricular hypertrophy
if you hear an S3 (ventricular gallop) what might this mean?
early sign of HF
if you hear an S4 (atrial gallop) what might this mean?
if older than 50, a systolic BP greater than 140 is important to what dieases risk factors?
CVA, and CV
What is the procedure called when you measure the BP of brachial artery 2x with doppler, then measure BP above malleolus at dorsalis pedis & posterior tibial 2x. Divide the ankle by brachial.
An ankle brachial index of <1.0 indicates ???
an ankle brachial index of <0.8 indicates???
an ankle brachial index of <0.5 indicates???
a lab test (diagnostic test) for troponin is specific to what?
cardiac muscle only. any rise in Troponin is diagnostic and is used in early dx.
CK-MB is a diagnostic test specific to what?
cardiac or myocardial damage.
in CK-MB test, you can see the peak level within how long of injury?
24 hours after onset of pain
what is Myoglobin used for?
used to rule out MI in early stages
Lipid profile measures?? (4 things)
cholesterol. triglycerides. HDL, LDL.
Total cholesterol desirable levels?
Triglycerides desirable level?
HDL desired level?
LDL desired level?
<100 and <70 with CV disease
smoking, alcohol, coffee, sugar, obesity all raise ___ levels.
Measures the amount of time it takes for the blood to clot. Used to monitor therpeutic effects of heparin.
.PTT (partial thromboplastin time)-
What is the normal range for PTT?
60 to 70 seconds.
What is the therapeutic range for PTT?
90 to 140 seconds (1 to 2 x the normal)
What is APTT?
aptt is the modified ptt. it adds the clotting factors to activate the blood sample before timing the clot. Removes the time variable. How long does it take for this persons blood to form a clot?
What is the normal APTT?
30 to 40 seconds
A measure of an activity of prothrombin, fibrinogen, clotting factors, and the time it takes for a firm fibrin clot to form.
PT (prothrombin time)
What is PT used for?
Used to elevate the therapeutic effects of anticoagulants like Coumadin (warfarin)
What is the normal PT?
PT is similar to what other diagnostic test?
INR normal range is ??
0.7 to 1.8
BUN elevation is seen with??
After a stress test, the patient should take a hot shower T or F?
False. causes vasodilation.
What is purpose of stress test?
the cardiacs response to increased workload
Which test measures ventricular wall motion & ejection fraction as the patients ECG is synchronized with pictures taken of the blood passing through the heart.
What is the most invasive test?
What might you explain to a pt who is about to receive a cardiac cath?
may experience palpitations, warm sensation when dye in injected, desire to cough when dye injected
Post op cardiac cath?
bed rest, remain still, dont flex extremities
which disease is a narrowing of the coronary arteries from either plaque, stricture, or clot that prevents adequate blood flow to myocardium causing ischemia and/or infarction?
Coronary Artery Disease (CAD)
lack of oxygen
dying heart muscle
disorders or complications of CAD?
angina, HF, MI, HTN
what is the leading cause of death in the US with one death occuring every 40 seconds?
Cardiovascular disease (CVD)
To have metabolic syndrome, you must have 3 of 5 possible conditions...what are they?
HTN, DM, decreased HDL, increased triglycerides, large waist circumfrence
chest pain that has a predictable pattern, feels the same each time it occurs, lasts the same amt of time, always relieved by NTG or rest.
which type of angina is assoc.w/ fixed artherosclerotic plaque?
chest pain that is unpredictable. occurs while at rest or at night. last longer than 15 mintues. not relieved with NTG or rest.
chest pain that occurs at rest with ST elevation on the EKG due to artery spasm
Variant chest pain
patient has never had chest pain symptoms before. this is their first time.
chest pain that occurs days or weeks before MI
Women are more likely to have S&S of atypical angina, what are some atypical S&S?
pain between shoulders, aching jaw, choking sensation, feeling of indigestion
what does Morphine do for person having MI?
relieves pain, decreases O2 demand
what does NTG do for person having MI?
dilates arteries, decreases venous return
what does aspirin do for a person having MI?
prevents clot formation
what do ACE inhibitors do?
prevents ventricular remodeling
patients that are on drugs for ED also do what to the BP which could be a risk for someone taking new heart medications?
Ed drugs lower BP bc they are vasodilators. Patients should not take these drugs together.
the physiologic state in which heart is unable to pump enough blood to meet the metabolic needs of body at rest or exercise.
pt can move back and forth between classifications
New York Heart classifications
progressive in nature. based on symptoms that are additive.
AHA/American college of cardiology
what is the best indicator for fluid overload?
most important in assessment of HF?
assessing LV ejection fraction with Echocardiogram. should be 50 to 70%
ACE inhibitors most common side effect?
what type of medication teaching would you give for a person taking digoxin?
teach them how to take their pulse before they take it to make sure its not already low bc dig can lower BP
what is the normal range for digoxin levelS?
DO NOT take digoxin with what two things?
antacids and/or laxatives
what are some signs of dig toxicity?
loss of appetite, N/V, diarrhea, palpitations, visual changes (halo)
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