Rhythms
Cardioversion or Defibulation ? VT with a pulse, AF, SVT
Controlled electrical discharge of energy at the peak of the R wave......sync! to avoid R on T!
How many layers does the heart muscle have?
Name them!
Epicardium: outer layer
Myocardium: thick middle layer, the muscle layer that is responsible for contractile function
Endocardium: interior lining of the heart and valves
Mediastinum: between thoracic cavity and lungs where the heart sits
Pericardium: Sac around the heart that consists of 2 layers
Name the risk factors of arteriosclerosis
calcium deposits in arterial walls. thickening, build up.
elevated LDL, triglycerides, cholesterol, HTN, dm smoking, obesity
Chest Pain that occurs at rest. What is the treatment?
Unstable Angina. Nitroglycerin.
What is Carotid Artery Disease and what are the risk factors
vessel wall thickening, plaque formation, progressive narrowing
smoking htn, dm, sedentary lifestyle, obesity, family hx, hx CAD
stroke, TIA, headache, vision changes, droop, loss of coordination, dizziness
Treatment: lifestyle changes, symptomatic may require revascularization, CEA (carotid endarterectomy to remove plaque, or carotid stewing, carotid angio with stent placement
Digoxin, Bela blockers, and calcium channel blockers control me, but I might need an ablation or cardioversion
Afib!
Risk of Clots and Stroke
The pulmonary Artery carries oxygenated blood to the lungs
True or False
the pulmonary artery carries deoxygenated blood from the right side of the heart to the lungs
what is primary and secondary hypertension?
Essential (primary): most common, no medical cause, hereditary, lifestyle
Secondary: kidney disfunction, ETOH, obesity, NSAIDS, steroids, cocaine, licorice
Essential Teaching Points for patient son Warfarin
1. take med at the same time each day
2. never skip a dose
3. report blood in fluids
4. INR checked regularly
5. ensure labs are WNL
6. limit green leafy veggies that contain K
7. Consult with care provider taking ASA or Plavix
8. limit contact sports
9. electric razor
10. use soft toothbrush
localized dilation of the artier, widening, tension on the wall increases, diameter changes, spontaneous, chest, back, flank pain describes what???
Aortic Artery Disease
True or False
SHOCK Asystole
False
What is Cardiac Output?
What what influences HR?
What is Stroke Volume?
C.O. 4-8L/min blood ejected from the left sd each min
HR: Sympathetic nervous system stimulation, parasympathetic decreased HR
Stroke Volume: about of blood ejected with each ventricular contraction influenced by preload, after load, and contractility
what mechanisms result in hypertension?
what is MONA
morphine, oxygen, nitro, asa
blood flows or leaks backward in the valve
DVT regurgitation or insufficiency
Stenosis: stiffening and thickening
Prolapse: valve leaflets bulge backwards an do not close causing regurgitation
Atrial depolarization
P wave
PR interval: beginning of the P wave to beginning of QRS
QRS: ventricular depolarization
T: ventricular repolarization
QT: ventricular depolarization and repolarization
Name modifiable risk factors for cardiovascular disease
ETOH, smoking, exercise, excessive fats, sodium, weight gain
name s/s of htn
headaches, chest pain, vision changes, SOB, renal dysfunction, dizziness, fatigue, nose bleeds
Osler's nodes, Janeway lesions, HF, arrhythmias, weight loss, night sweats, Staph and Strep are most common with this diagnosis
Infective Endocarditis
JVD, Ascities, and weight gain are all examples of what kind of HF?
Right
define
action potenial
depolarization
repolariziation
absolute refractory period
action potential: electrical impulse that travels through the heart
depolarization: movement of ions = contraction
depolarization: ion resting state
refractory period: cell unresponsive to any stimulus
When does Troponin elevate, how long can it be elevated?
Pain experienced at rest, often awakens patient at night, described as numbness and burning, usually occurs distal of the extremity, relived by putting the extremity in dependent position is what stage for peripheral artery disease?
Stage 3:Rest pain
Stage 1: Asymptomatic, bruit may be heart, pedal pulses decreased
Stage 2: Claudication: muscle pain, burning, cramping experienced with exercise relieved by rest
Stage 4: Necrosis or Gangrene: ulcers and blackened tissue occur on the toes, the forefoot, heel or foot
signs an symptoms: pleuritic chest pain relieved by sitting up and leaning forward, friction rub with heartbeats
Pericarditis
what nerves are important to assess post CEA
facial (7): symmetry smiling showing teeth,
10 Vagus: swallowing, gag, say "ah",
11 spinal: shrug shoulders rotate head
12 hypoglossal: tongue control