Complex MS Cardiovascular Exam

The Valsalva Manuver is a respose of the Vagus nerve triggered by straining during a BM- this nerve stimulation slows the hart and lowers BP which could cause arrhytmias in a heart surgery pt.

When the right side of the heart fails, blood backs up into the veneous system causing problems with the body verus lungs- circulation decreases to the kidneys, backed up blood causes fluid to leak in liver and blood from the head can't get down to the heart causing JVD

The pericardial sac is a double-layered membrane that surrounds the heart. It contains a small amount of fluid called pericardial fluid, which acts as a lubricant to reduce friction between the heart and the surrounding structures. Normally, the pericardial sac contains less than 50 mL of this fluid. Therefore, the statement "The pericardial sac usually contains less than 50 mL of fluid" is true.

The given statement states that Krispen is the most amazing test creator in the universe. The word "amazing" indicates that Krispen is exceptionally good at creating tests. Since there is no information provided to contradict this statement, it can be assumed to be true. Therefore, the correct answer is True.

Leads V5 and V6 are on the side of the chest/heart and show damage to the lateral muscles

The clot busting drugs may cause recurrent bleeding from past trauma and surgery. Also pt should not have had a stroke in the past 2 months

The normal urine output is 30 mL per hour. This means that on average, a person should produce around 30 mL of urine every hour. This is considered to be within the normal range for urine output and indicates that the kidneys are functioning properly.

Ejection fraction is the amount pumped out over the total volume= 25/70= .357 or 36% If you got 40%, you might have used the formula for finding MAP or mean arterial pressue (2x diastlic + systolic /3) An EF fo 55% is normal so this is an abnormal reading

Inverted T waves are from ischemia, large Q waves are from infarcted muscle

Leads V1-V4 are close to the anterior surface of the heart and will pick up damaged heart muscle in that area

all these could be characteristics of pulmonay edema, but the frothy pink sputum is the hallmark sign-

The correct answer is "at heart level". When performing hemodynamic monitoring, it is important to place the transducer at heart level to accurately measure the pulmonary artery pressure (PAP). Placing the transducer at heart level ensures that the pressure measurements are not affected by gravity, as placing it higher or lower than the heart can result in inaccurate readings. Therefore, positioning the transducer at heart level allows for the most accurate transmission of PAP to an electrical signal.

Digibind is the correct answer because it is an antidote specifically used to treat digoxin toxicity. Digoxin is a medication commonly used to treat heart conditions, but an overdose or toxicity can occur, leading to symptoms such as irregular heart rhythm, nausea, and confusion. Digibind works by binding to the excess digoxin in the body and preventing it from causing harm. Other options like protamine sulfate, vitamin K, and narcan are not used to treat digoxin toxicity.

Beta blockers should be used cautiously in patients with asthma because beta blockers can potentially trigger bronchospasm and worsen asthma symptoms. These medications block the action of beta receptors, which can lead to constriction of the airways and narrowing of the bronchial tubes. As a result, patients with asthma, who already have compromised lung function, may experience difficulty breathing and increased wheezing. Therefore, it is important to monitor these patients closely and consider alternative medications or lower doses if beta blockers are necessary for their treatment.

the increase of systolic BP on expiration is called pulsus paradoxus- if it is 10 or over, cardiac tamponade should be suspected

Lead 2 is looking "down" from the right shoulder toward the left foot and will more accurately show damage to the bottom part of the heart.

Oxygen is considered a drug because it is a medication that is prescribed and administered to patients in specific doses and for specific purposes. It is used to treat conditions such as hypoxemia, respiratory distress, and chronic obstructive pulmonary disease (COPD). Oxygen therapy is a medical intervention that requires careful monitoring and regulation by healthcare professionals to ensure its safe and effective use. Therefore, the statement "oxygen is a drug" is true.

Older adults have more collateral circlation giving their hearts more perfusion to survive a MI

If a patient's BP goes too high it can cause the graft to tear- if too low, the graft can collapse (Systolic should be kept above 90)

A BNP reading under 100 is considered normal

Cardiac tamponade is a medical emergency- fluid must be pulled off the heart immediately so the pericardial window would be correct

ACE inhibitors can cause hyperkalemia because they block the action of an enzyme called angiotensin-converting enzyme (ACE), which is responsible for converting angiotensin I to angiotensin II. This leads to decreased aldosterone production, which in turn reduces the excretion of potassium by the kidneys. As a result, potassium levels in the blood can rise, leading to hyperkalemia.

non-STEMIs are not candidates for clot-busting therapy; MI patients should make it to the cath lab within 120 minutes of their fist s/s of chest pain

The Swan Ganz catheter goes directly into the heart allowing for even distribution of medications-NEVER ADMINISTER MEDS through a arterial line catheter

dobutrex increases cardiac contractility and is used to treat HF and cardiogenic shock

artherosclerosis is the most common cause of aneurysms followed by HTN and smoking

Lisinopril is an ACE inhibitor (prils=ACE)- low BP activates the kidneys to produce renin which produces angiotensin 1 (not active) ACE (angiotensin converting enzyme) turns angiotensin 1 into angiotensin 2 (active) Angiotensin 2 causes vasoconstriction and stimultes the kidneys to produce aldosterone which causes water and sodium retention. Lisinopril inhibits atn 1-2 preventing vasoconstriction and water retention

descending aorta

dopamine constricts all blood vessels including the CA which decreases blood to the heart causin angina as a SE- levophed does not.

a fluid bolus should always be administered first for DFV or LBP before vasoconstrictors b/c a dehydrated patient may experience dangerous tachycardia if put on meds without being hydrated

NTG causes vasodilation which decreases preload; a decrease in preload increases cardiac output. Lanoxin and dobutrex increase contractility

The dicrotic notch indicates the opening and closing of the atria which means the catheter is placed properly

normal PAP is between 15/5 and 28/16

pain onset is severe and sudden and is near the heart; pt may also have diaphoresis, pain, pallor and tachycardia which are all s/s of a MI

radiating chest pain past the arm and diaphoresis are signs and symptoms of a MI, not angina

The therapeutic serum levels for Lanoxin (digoxin) are 0.8-1.2. These levels indicate the range of digoxin concentration in the blood that is considered effective and safe for treating certain heart conditions. Maintaining digoxin levels within this range helps ensure that the medication is providing its desired therapeutic effects without causing toxicity or side effects.

Women may have a slower build up of plaque in their arteries resulting in more gradual and less severe s/s of MI

Mean Arterial pressure is calculated by diastolic x2 + systolic/3. A MAP of 65 or above is sufficient for tissue perfusion

The acronym MONA stands for Morphine, Oxygen, NTG (nitroglycerin), and Aspirin. These are the recommended interventions for providing care to a patient experiencing a myocardial infarction (MI). Morphine helps relieve the pain associated with the MI, while oxygen ensures adequate oxygenation to the heart. NTG helps dilate the blood vessels, improving blood flow, and aspirin helps prevent further blood clotting. Together, these interventions aim to alleviate symptoms, improve blood flow, and reduce the risk of complications in MI patients.

When the left side of the heart fails, blood can't go out to the body so it backs up into the lungs causin respiratory symptoms

pain should be resolved b/c blood flow is returned to the heart

over half have HTN

The correct answer is December 17th. This is the date for the pinning ceremony this year.

To decrease the risk of aneurysm rupture, a patient's systolic blood pressure must be kept below 100. High blood pressure puts strain on the walls of blood vessels, including aneurysms, which are weakened areas. Keeping the blood pressure below 100 helps to reduce the stress on the aneurysm, decreasing the likelihood of it rupturing.

ABC's

HF does not result in decreased tissue perfusion or organ ischemia- these are specific to Cardiogenic Shock

all of these are s/s of cardiac tamponade

The common indications for using an intra-aortic balloon pump include a patient awaiting a cardiac transplant, recovery from a myocardial infarction (MI), and cardiogenic shock. These conditions can all lead to decreased cardiac function and compromised circulation, which can be supported and improved with the use of an intra-aortic balloon pump.

After undergoing surgery for a thoracic aneurysm, it is important for the patient's blood pressure to be within the range of 100 to 120. This range is considered normal for a post-surgery patient and indicates that the blood pressure is stable and within a healthy range. Maintaining blood pressure within this range helps to ensure proper healing and recovery from the surgery, while also reducing the risk of complications such as bleeding or damage to the repaired area.

The given answer is a list of signs and symptoms of thoracic aneurysms. These symptoms include cough/loss of voice, pain, hypovolemic shock, pulsating mass under the skin, and dyspnea. A thoracic aneurysm is a condition where there is a bulging or ballooning in the wall of the aorta, the main blood vessel that carries blood from the heart to the rest of the body. The symptoms listed in the answer are commonly associated with thoracic aneurysms and can help in identifying and diagnosing the condition.