Term
|
Definition
systolic above 140
diastolic above 90 |
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|
Term
|
Definition
systolic above 160
diastolic above 100 |
|
|
Term
|
Definition
systolic 120-139
diastolic 80-89 |
|
|
Term
| Sign of hypovolemic shock due to hemorrhage following femoral-to-popliteal bypass graft |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Differences between cardioversion and defib |
|
Definition
Cardioversion typically elective, defib emergent
Cardioversion uses sedation, defib doesnt
cardioversion synchronized to protect "T" wave, defib there is no T wave to protect
If elective, informed consent is needed for cardioversion, not possible for defib |
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|
Term
Effect of hydrochlorathiazide on potassium
Take with or without food?
What time of day"
Common side effects? |
|
Definition
Potassium wasting
Take with food
Morning
Hypokalemia, hyperglycemia, blurred vision, dry mouth, hypotension |
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|
Term
| antagonist of heparin. needs to be available at all times when giving heparin. |
|
Definition
|
|
Term
| what lab test should be monitored for a patient on warfarin (coumadin) therapy? What are therapeutic levels? |
|
Definition
Prothombin time.
Therapeutic level 1.5 times control |
|
|
Term
What lab test should be monitored for a patient on heparin therapy?
What are therapeutic levels? |
|
Definition
partial thromboplastin time
Therapeutic level is 1.5-2.5 times the control |
|
|
Term
| sudden cessation of mediastinal chest tube drainage after CABG is indicative of what complication? |
|
Definition
|
|
Term
| Proper nursing actions for a patient with changes in level of consciousness, disorientation, and confusion post CABG |
|
Definition
| frequent reorientation using calm clear voice w/ explinations. Planning rest periods, preventing lines/tubes from being pulled out. Common complication, may be called delirium, should be temporary. |
|
|
Term
| signs and symptoms of digitalis toxicity |
|
Definition
| anorexia, nausea, blurred vision |
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|
Term
| CAB of CPR stands for what? |
|
Definition
| Compressions, airway, breathing |
|
|
Term
Side effect of propranolol (inderal)
drug class
Uses |
|
Definition
Bronchospasm.
beta-blocker
treats hypertension, cardiac dysrhthmeas, angina, post MI |
|
|
Term
| Purpose of digoxin & mode of action |
|
Definition
| increases strength of heart contractions by slowing heart rate and conduction through the AV node |
|
|
Term
| technique to prevent thrombophlemitis for a patient on bedrest |
|
Definition
| instruct patient to flex and point toes every two hours |
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|
Term
| a patient complaining of pain similar to the pain experienced prior to an aortofemoral bypass may be experiencing what complication? |
|
Definition
|
|
Term
| what position will a patient be for up to 24 hours after aortofemoral bypass? |
|
Definition
|
|
Term
| Mode of action & side effects of aldomet (methyldopa) |
|
Definition
reduces peripheral vascular resistance.
Drowsiness, sedation, orthostatic hypotension, bradycardia, loss of libido. discontinuing quickly can cause hypertensive crisis. |
|
|
Term
| how is dopamine administered? |
|
Definition
| micrograms per kilogram per hour via pump titrated to a certain dosage. |
|
|
Term
| Patient complains of severe leg pain not releived by rest or medication. What will the leg most likely look like? |
|
Definition
| Cold, mottled, dusky, pale |
|
|
Term
What needs to happen first for a patient experiencing MI?
Analgesia or anticoagulants? |
|
Definition
|
|
Term
| What does an IV lidocane drip do for a patient experiencing acute MI? |
|
Definition
| decrease myocardial irratibility |
|
|
Term
| how often does the nurse need to check popliteal pulses after femoropopliteal bypass graft procedure? |
|
Definition
|
|
Term
| Normal right atrial pressure |
|
Definition
|
|
Term
| Mean arterial pressure required to maintain tissue perfusion |
|
Definition
|
|
Term
| Normal pulmonary artery wedge pressure (PAWP) |
|
Definition
|
|
Term
| Normal Po2 from an arterial line |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What do positive inotropic agents do? |
|
Definition
| Increase force of contraction, thus increasing CO |
|
|
Term
| essential pre-op question when preparing patients for TEE (transesophageal echocardiogram) procedure? |
|
Definition
| Owing to risk for aspiration, patient must be NPO before procedure |
|
|
Term
| Is modest bleeding at the catheter insertion site for PAP monitoring a cause for concern? |
|
Definition
|
|
Term
| where will a chest x ray show the tip of a catheter placed for PAP monitoring? |
|
Definition
|
|
Term
| alternative to arteriography with contrast |
|
Definition
| intravascular ultrasonography |
|
|
Term
are BP meds taken on the day of a cardiac cath procedure?
are oral hypoglycemics taken on the day of a cardiac cath procedure? |
|
Definition
BP meds - yes
hypoglycemics - no |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
Normal C-reactive protein level.
What do elevated results indicate? |
|
Definition
less than 1mg/DL
Risk for CAD. Does not indicate ACS |
|
|
Term
|
Definition
|
|
Term
Normal lipoprotein-a (Lp[a])
what does this indicate? |
|
Definition
| Normal 18mg/dL, risk for CAD. Does not indicate ACS |
|
|
Term
| Where is aortic valve auscultated? |
|
Definition
| second intercostal space at right sternal border |
|
|
Term
| Where is apical pulse palpated? |
|
Definition
| fifth intercostal space in midclavicular line |
|
|
Term
Normal homocystein level.
What does elevation indicate? |
|
Definition
Normal lower than 12mmol/dL.
Elevation indicates risk for MI, not myocardial damage |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
What is cardiac nuclear scanning?
Is it invasive? |
|
Definition
| nuclear material injected and imaging done. Non-invasive |
|
|
Term
| Important notes for cardiac nuclear scanning. |
|
Definition
No pain beyond venipuncture.
Short NPO period before procedure.
May have to wait 15min-4hrs after radionuclitides injected to do scans.
Only tiny amount of nuclear material used
Encourage patient to drink after to help excrete substance |
|
|
Term
| Patient teaching for prior to cholesterol blood test |
|
Definition
| no alcohol for 24 hours prior. no food for 12-14 hours prior. dietary intake for 2 weeks pre-test will affect results |
|
|
Term
When do CKMB levels begin to rise after MI?
When do they peak (if no further damage)?
When do they return to normal levels? |
|
Definition
Begin to rise 3-6hrs after MI
Peak at 12-24hrs after MI
Return to normal 12-48hrs after MI |
|
|
Term
What impact would a high CK-MB result have on a decision to give thrombolytic therapy?
What is important to note on lab strips? |
|
Definition
significant damage has already occured, thrombolytic therapy may not be useful
Important to note exact time of blood draw. |
|
|
Term
|
Definition
|
|
Term
| Important patient teaching for before a cardiac stress test |
|
Definition
four hours before:
No Smoking
No Caffeine
No betablockers, calcium channel blockers, digoxin, and nitro |
|
|
Term
| Does cardiac stress test (treadmill test) require informed consent? |
|
Definition
|
|
Term
| Normal triglyceride level |
|
Definition
Male 40-100
Female 35-135
Critical value >400 |
|
|
Term
| Important pre-test teaching for triglyceride blood test |
|
Definition
| Fast for 12-14 hrs pre-test. No alcohol 24 hours before. 2 weeks of dietary choices will influence results. |
|
|
Term
Normal troponin T Test
Normal troponin I test
When do they elevate?
How long do they remain elevated? |
|
Definition
< 0.1 ng/mL
< 0.03 ng/mL
Elevate 2-3 hrs after MI
Trop T remains elevated for up to 14 days
Trop I remains elevated for 7-10days |
|
|
Term
| Does increased Trop T levels ALWAYS indicate MI? |
|
Definition
| No. Can also be contusion, ablasion, pacing, CHF, Hypertension, hypotension, and arrhythmias, PE, Renal falure, myocardits |
|
|
Term
NPO status for trop draws?
What is important to put on the label? |
|
Definition
No NPO status
mark TIME accurately |
|
|
Term
Normal myoglobin levels
Is myoglobin specific to cardiac muscle?
How long after MI do levels increase?
What can myoglobin damage? |
|
Definition
< 90mcg/L
Not specific to cardiac muscle
increase in about 3hrs after MI
More sensitive than CK-MB
nephrotoxic. Urin dipstick for hemoglobin will also react to myoglobin |
|
|
Term
|
Definition
greater than 45 mg/dL (> 0.75mmol/L) Men
greater than 55 mg/dL (> 0.91 mmol/L) Women |
|
|
Term
|
Definition
|
|
Term
What does C reactive protein level indicate?
What are the normal lab values?
NPO? |
|
Definition
Non-specific, acute phase reactant used to diagnose bacterial infectious disease and inflammatory disorders. Rises with CK-MB, but peaks 1-3 days later. Continued high levels may indicate continued cardiac damage.
Low <1mg/dL
Average 1.0-3.0 mg/dL
High >3.0mg/dL
Probably don't need to be NPO |
|
|
Term
What do homocystinne levels indicate?
What are normal lab values?
What would cause an elevated level?
Dos the patient need to fast? |
|
Definition
Promote the progression of atherosclerosis. Higher risk for cardiovascular disease
Normal 4-14 mmol/L (levels increase w/ age)
B vitamin deficiency, renal impairment, smoking,drugs cause elevated levels(among other things)
Fasting required 10-12 hours |
|
|
Term
BNP
What does it identify?
What are normal levels? |
|
Definition
Identifies **CHF**, MI, systemetic hypertension, Cor pulmonale, heart transplant rejection
Normal BNP < 100 |
|
|
Term
|
Definition
| right sided heart failure |
|
|
Term
Amiodarone (Cordarone)
What monitoring by the nurse is necessary? |
|
Definition
QT interval - prolongs QT interval which can precipitate dysrhythmias
Monitor HR & Rhythm
Monitor electrolytes (pot & mag) which may predispose to further dysrhythmia |
|
|
Term
| What is the therapeutic range for digoxin? |
|
Definition
|
|
Term
| What impact do NSAIDS have on heart failure? |
|
Definition
| Long term use of NSAIDS cause fluid and sodium retention, possibly leading to heart failure |
|
|
Term
| What organ may have altered function with ACE inhibitors? |
|
Definition
|
|
Term
| What is important to consider when starting a patient on lisinopril (or any ACE inhibitor) |
|
Definition
| Risk for orthostatic hypotension, particularly for those over 75 |
|
|
Term
| Is there chest pain with CHF? |
|
Definition
| Yes. Decreased tissue perfusion may cause chest pain or discomfort |
|
|
Term
| Symptoms of digoxin toxicity |
|
Definition
bradycardia
fatigue
anorexia |
|
|
Term
| What medication when given in heart failure may imporove morbidity and mortality? |
|
Definition
Carvedilol (Coreg)
beta blockers reverse consequences of sympathetic stimulation and catecholamine release that worsen heart failure. They improve morbidity, mortality, and quality of life. |
|
|
Term
| What are splinter hemorrhages a sign of? |
|
Definition
|
|
Term
| What is paradoxical pulse? What might it indicate? |
|
Definition
abnormally large decrease in systolic blood pressure & pulse wave amplitude during INSPIRATION. Normal is less than 10.
Might be cardiac tamponade or pericarditis |
|
|
Term
| What would an S3 heart sound indicate? |
|
Definition
|
|
Term
| What would an S4 heart sound indicate? |
|
Definition
| MI, CAD, hypertension, aortic stenosis |
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|
