It's Electric!
A P-wave on an ECG electrically represents this (also known as the pacemaker of the heart)
SA node
Creatine kinase (CK) indicates this
Creatine kinase is a general marker of cellular injury. It is released from cells in the brain, skeletal muscle, and cardiac tissue after muscle damage has occurred.
The 5 points of listening to the heart?
Aortic
Pulmonic
Erbs point
Tricuspid
Mitral
The number of doses and frequency of SL Nitroglycerin for a patient with chest pain (and what to check prior to administering
Every five minutes x three doses (check B/P prior to each dose)
Interventions for NSR
nothing
A normal PR Interval takes this amount of time
0.12 - 0.20 seconds
The two electrolytes that usually require PRN replacement orders in the morning are
Potassium and Magnesium
What is Point of Maximal Impulse? Where do you listen to PMI? What sound do you hear?
PMI is point of maximal impulse. This is found at the tip of the heart known as the apex, aka apical pulse. You listen to this at the mitral point: 5th intercostal at MCL.
Sound: S1 "lub"
Use of stool softeners in cardiac patients will help prevent constipation and also this problem
Valsalva manuver
Interventions for symptomatic bradycardia and what type of procedure would you anticipate your patient having
Place transcutaneous pads on patient
Give Atropine
Anticipate patient getting a pacemaker
ST elevation normally represents this
myocardial ischemia
These two lab values are drawn to measure cholesterol one is considerate "good," and one is considered, "bad."
HDL (good cholesterol)
LDL (bad cholesterol)
S3 sounds like this and could indicate this
S3 is a low-pitched sound when blood rushes rapidly from the heart's atrium into the ventricle. It could indicate CHF
When you have a patient on a cardiac gtt in the hospital setting you should check these 3 things. What are they and how often?
1. Heart Rate
2. Blood Pressure
3. Heart Rhythm
Give two nonpharmacologic measures for SVT
carotid massage and valsalva maneuver
A QRS complex on an ECG electrically represents this
Ventricular Depolarization
BNP measure this and helps us distinguish this
BNP is protein made by the heart and blood vessels that helps measure Heart Failure. Helps distinguish cardiac from respiratory causes of dyspnea
The Diaphragm of a stethoscope is best for auscultating these type of sounds while the bell is better for these type of sounds
The diaphragm is most effective at transmitting higher frequency sounds (S1 and S2)
The bell is most effective at transmitting lower frequency sounds (S3 and S4)
This medication could be used for a patient in SVT. What is it, how fast do you give it, what should be prepared for (think worst case scenario).
Adenosine
Give rapidly followed with a rapid saline flush
Be prepared for a code (if the hear stays in asystole)
You see what looks like a, "flat line," on a telemetry monitor. What do you do first?
Check the patient!
5 criteria for NSR for an adult (HINT: Rhythm, Rate, P waves, PR interval, QRS interval, ST segment)
Rhythm: regular
Rate: 60-100 BPM
P waves: One P wave for every QRS complex
PR interval: 0.12 - 0.20 seconds
QRS interval: 0.08 and 0.10 seconds
ST: no elevation, on the isometric line
Troponin I and T measures this and these are their normal values
Troponin (I and T) are proteins expressed almost exclusively in the heart and are specific markers of cardiac muscle damage (Myocardial ischemia).
Troponin I: <0.5 ng/mL
-Troponin T: <0.1 ng/mL
At what point can you hear both the S1 and S2 sounds? Where is it located?
Erb's point. The 3rd ICS to the left sternal border.
I have chronic afib. My doctor has prescribed me what type (classification) medication; what is the name of it; I know need to check monitor these labs; look out for signs and symptoms of what; and avoid these types of foods in my diet at home.
Classification: anticoagulant
Name: Warfarin
Labs: PT; INR (goal of 2-3)
S/S: bleeding
Avoid: foods rich in vitamin K (leafy green)
You see ST elevation on the monitor and decide to implement MONA before calling the provider. What does MONA represent?
Morphine
Oxygen
Nitro
Aspirin