Myocardial Infarction, Nurs 3, Unit 5+kahoots
The PR interval is normally ______ to _______ seconds.
.12, .2
Acute Coronary Syndrome lasts _______ minutes or longer and is defined by radiating ___________ pain.
10-20, upper body
After CABG, drainage greater then ______ml/Hr should be reported.
150
HTN for people over 60 is _________.
150/90
Which of the following can increase your chance of developing an AAA?
1st order relative to the condition having Ehlers-Danlos syndrome
Patients experiencing heart failure, by definition, gain _____lbs in one day or ______lbs in two days.
2, 5
ACE inhibitors and ARBs are prescribed within ______ hrs of ACS if ejection fraction is less then 40% to prevent _________ and heart failure.
48, remodeling
A patient with ACS can resume their sex life _____ days after an MI and when _________.
7-10, they can climb two flights of stairs
MRI of an AAA isn't a common imaging modality because?
A. too time consuming and poor spatial resolution of AAA ( Ultra sound, Ct scan, angiography is preferred )
Radiating pain in the lower back is a sign of ________
AAA
_______________ prevent remodeling and reduce H20 and Na retention
Ace Inhbitors
Vtach is treated with __________ and _________ if the patient is unresponsive.
Amioradone, defibrulated
What is the number one Risk Factor for MI?
Arteriosclerosis !
A vagal blocker that increases HR and CO in heart blocks and severe bradycardia; also dries secretions by blocking vagus. Used to treat bradycardia, bradydysrhythmis, and AV heart block
Atropine Sulfate
Cardioselective ___________ may improve morbidity and mortality in heart failure.
Beta blockers
Serum Chemistry Indicators of MI are?
CPK, Myoglobin, Troponin
The standard tool for assessing the size and location of an abdominal or thoracic aneurysm is ______________
CT scan
For patient with a newly diagnosed AAA on ultrasound the next imaging test would be...
CT-angiography
When a patient has CAD, Afib and a pulse of 160 bpm the priority med to give them is ________.
Cardizem
After aneurism repair, patient receive continuous ______ monitoring.
EKG
Which type of AAA repair reduces post-op complications and is common for a patient with an overall poor health state..?
Endovascular repair
Men with a history of ________, under the age of _____ are the people most likely to have a AAA
HTN, 60
For treatment of MI: complete the following acronym; MONA
M-morphine ( to ease anxiety and decrease O2 demand) O-xygen (increase O2 flow to the heart) N-itroglycerin (for vasodilation) A-sprin (to break up and aggregate)
An elevated 'ST' segment can be a sign of ________
MI
_________________ is a potentially lethal connective-tissue disease, that results in abnormal fibrillin, a structural protein found in the human aorta
Marfan syndrome
A coronary vasodilator and antianginal that dilates arterial and venous beds systemically; can be administered sublingual, IV, and transdermal
Nitroglycerin
Do patients with large abdominal aortic aneurysms usually have early warning symptoms..?
No ... are usually asymptomatic
Ichemia is a lack of _____ in the heart. Infarction is ________ following a lack of blood supply.
O2, necrosis
Ventricular depolarization is represented on an EKG as ________.
QRS
Why are asymptomatic small (<5.5cm) AAA not treated ?
Risk of surgery outweighs risk of AAA rupture
After a MI a ______ gallop indicates heart failure. It can be heard using the bell of the stethoscope over the ______ of the heart.
S3, apex
On an EKG, ACS is diagnosed by _____ depression and ______ inversion.
ST, T
On an EKG, Stable Angina Pectoris reveals _____ depression, which indicates _________.
ST, ischemia
____________ is usually associated with plaque rupture leading to complete occlusion
STEMI
Anestesia can cause ____________
Sinus bradycardia
For the development of an AAA, important risk factors are:
Smoking, gender, age, heredity
___________ heart failure is often caused by inflammation. Signs include _________.
Systolic, fatigue
After an MI, a patient's EKG may show ____ wave inversion and ______ depression or elevation.
T, ST
It may take hours for an EKG to evolve after MI True or False
TRUE !
What is the purpose of a CT scan in AAA?
To confirm size, location, and guide tx options
The enzyme elevates 2-4 hours after heart injury.. it is also the most specific marker for MI
Troponin
Pain from MI is due to decreased O2 reaching the heart muscle.. True orFalse
True
Small AAA's can rupture unexpectedly ... true or false
True !
The most common site for an MI is the anterior wall of the Left Ventricle True or False
True :) (** also most Heart failure's occur in the Left Ventricle as well !! )
A side effect of the medication Retevase is...?
a. bleeding is common with Retevase; for the first hour assess pt for bleeding q15min HIGH RISK for internal bleeding and for hemorrhaging at any incision site.
Which side of the heart does the most pumping ?
a. left side does the most pumping
Unstable Angina is marked by occuring ________. Patients should be given a _______ within 10 minutes and maintain an O2 sat > 95.
at rest, EKG
After CABG patients are at risk for _________. TCDB and ___________ are essential post-op.
atelectasis, ambulation
_________________ is the most common cause of Abdominal, Thoracic or Dissecting aneurysm and Myocardial Infarction_.
atheroscolorsis
1st degree Heart Block is caused by slow conduction through the ______, creating a PR interval > ____ seconds.
atria, .2
The 'P' wave represents ___________ and is normal when generated by the ________
atrial depolarization, SA node
The left circumflex (circling or surrounding) supplies the left _________ and _________.
atrium and ventricle
Crackles are ausculated at the _______ of the lung.
base
Sternal wound infections are characterized by fever, ________ of the sternum, issues with the surgical site and increasing ________.
bogginess, WBC
Post-op of an AAA repair a nurse would administer what to decrease the risk of infection ...
broad spectrum antibiotic
A patient with a history of HTN comes to the hospital complaining of abdominal pain. A sign of an AAA would be the detection of a _________.
bruit
Place these MI cardiac markers in order from when they would appear (earliest to latest).. a. CK-MB b. EKG c. Troponin d. physical notable damage on imaging
c. Troponin (2-4 hrs) a. CK-MB (4-6 hrs) b/d. EKG and physical damage noted after (6-8 hrs)
When giving nitroglycerin in relief of chronic stable angina in the community, if the patient does not improve after taking nitroglycerin then _________, if they do show improvement then ___________.
call EMS, give nitro up to three times every 5 minutes
During CABG, blood can accumulate around the heart causing ___________.
cardiac tamponade
The U wave occurs after the T wave, it occurs due to _______ and _________.
cardiomyopathy, hypokalemia
the most frequent non-invasive diagnostic study for AAA is...
chest x-ray
What is the most common symptom for a pt presenting with MI ...
crushing chest pain that often radiates to the left arm
Patients experiencing Vfib should be ___________
defibrilated immediately
A patient with advanced heart failure that develops asystole should be treated with ________.
defibrilation
Premature ventricular contractions and bradycardia are both symptoms of _________ toxicity.
digoxin
Ripping and radiating pain are signs of a _________ aneurism
dissecting
Left sided heart failure is treated with ________. A side effect of this treatment can be _________.
diuretics, noctoria
During a stress test ___________ can be identified and the effectiveness of ___________ can be tested.
dysrhythmias, antidysrthymic drugs
Ventricular Asystole is the absence of ___________ and should be treated with __________ and cpr.
electrical impulses, epiniphrene
In stable angina pain occurs after __________ and is relieved by _________
exercise, nitro
Male and Females often present with the same signs and symptoms for a MI... true or false
false ! females often present with atypical symptoms such as stomach pain, nausea, jaw pain.
The most common sign of heart failure is _________
fatigue
Indications of a graft repair leak would include which of the following ...
groin and back pain
_____________ causes an inversion of the 'T' wave.
hypokalemia
A patient with Acute Coronary Syndrome suffering from an MI may report _____________, these symptoms are not relieved by __________.
immobilizing chest pain, nitrates or rest
_____________ is a temporary deprivation of blood supply; occurs within 10 seconds of occlusion
ischemia
Paroxysomal nocturia can be caused by _____ sided heart failure.
left
Post MI crackles and wheezes are signs of ________ heart failure.
left sided
In left sided heart failure, fluid accumulates in the _______, in right sided heart failure fluid accumulates in the _______.
lungs, feet
24-36 hrs after an MI, these congregate at the site during inflammation ...
neutrophils gather at the site due to injury
BetaBlockers are used to reduce ______ demand on the heart and decrease ______
o2, HR
The nurse is admitting a patient who has chest pain. What assessment data suggest that the pain is caused by an acute myocardial infarction (AMI)?
pain lasting longer then 30 minutes
A IABP is inserted to improve _________ during a _________. It reduces preload and afterload and facilitates left ventricular ejection.
perfusion, acute MI
A patient being managed for Chronic Stable Angina should be _________ and _________.
placed in an upright position, have their heart and lung sounds assessed
All of the 6 P's...
poikilothermia, pallor, paresthesia, paralysis, pain, pulselessness
Dobutamine and Milrinone are __________, they promote __________.
positive inotropes, cardiac output
The Swan Ganz catheter is used to measure pressure in the heart and _________, it is zeroed at the __________.
pulmonary artery, plebostatic point
Vfib is a _______ rhythm, patients should be ________ immediately
pulseless, defibrulated
Aflutter is characterized by by the 2/1 or 4/1 _________ formation between ______ complexes
sawtooth, QRS
Silent Ischemia can be detected on a _______, it most often affects people with __________
stress test, heart disease
A patient with a history of HTN comes into the hospital with SOB and backpain. In order to assess for a Thoracic Aneurism, the nurse would _________.
take a BP on both arms
Bleeding and reprofusion are complications of _____________
thrombolytics
Prinzmetal Angina has _______ ST elevation. It is treated with ________ and nitrates.
transient, CA channel blockers
Calcium channel blockers promote __________ and perfusion and are used for __________, and for those that continue to have angina despite beta blocker therapy.
vasodilation, hypertension
The left anterior descending artery supplies the left and right _________ and the _________.
ventricles, septum
The QRS complex represents __________ and is normally _____ to .12 seconds.
ventricular depolarization, .04