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Medicine | Paramedic School Study Aid

Cardiovascular
38 Picmonics to Learn | 1 hr 11 mins
Cardiac Cycle - Diastole
Characteristics
Aortic Valve Closes
Pulmonary Valve Closes
Ventricles Relax
Mitral Valve Opens
Tricuspid Valve Opens
Ventricles Fill
Sinoatrial (SA) Node Fires
Atrial Contraction
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3 mins
Cardiac Cycle - Systole
Characteristics
AV Node
AV Node Conducts Signal to Bundle of His
Bundle of His Signals Purkinje Fibers to Contract Ventricles
Tricuspid Valve Closes
Pulmonary Valve Opens
Mitral Valve Closes
Aortic Valve Opens
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2 mins
High Blood Pressure Response
Characteristics
Atria Release Atrial Natriuretic Peptide
Vasodilation
Antagonizes Aldosterone
Na+ and Water Excreted
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1 min
Primary Hypertension Risk Factors
Excessive Alcohol Consumption
High Sodium Diet
Dyslipidemia
Obesity
People of African Descent
Advanced Age
Vitamin D Deficiency
Reduced Nephron Number
Diabetes
Lack of Physical Activity
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2 mins
Hypertension Assessment
Mechanism
Essential Hypertension
Secondary Hypertension
Assessment
Headache
Vision Changes
Nosebleed (Epistaxis)
Chest Pain
Syncope (Fainting)
Diagnosis
Average 2 Sets, 2 Minutes Apart
After 2 or More Visits (within 1-4 weeks)
Nursing Considerations
Take BP Both Arms
Common in African Americans
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2 mins
Varicose Veins Assessment
Cause
Increased Venous Pressure
Incompetent Valves
Assessment
Telangiectasias
Small Reticular Veins
Dilated and Tortuous Veins
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1 min
Superficial Thrombophlebitis
Cause/Mechanism
IV Catheter Irritation
Assessment
Erythema
Cord-like Vein
Edema
Interventions
Remove IV Catheter
Elevate
Warm Compress
Considerations
Rotate Sites Q3 Days
Aseptic Technique
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2 mins
Venous Thromboembolism (DVT) Assessment
Mechanism
Venous Wall Inflammation caused by Thrombus
Assessment
Tenderness
Edema
Warmth
Asymmetry
Considerations
Could be Asymptomatic
Monitor for Pulmonary Embolism
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58 secs
Venous Thromboembolism (DVT) Interventions
Anticoagulants
Prevention Education
Frequent Ambulation
Leg Exercises
Compression Stockings or SCD's
Avoid Nicotine and Oral Contraceptives
Surgery
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1 min
Deep Vein Thrombosis (DVT) Characteristics
Mechanism
Virchow's Triad
Venous Stasis
Endothelial Damage
Hypercoagulability
Symptoms
Tenderness
Homan's Sign
Warmth
Redness
Swelling
Asymptomatic
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1 min
Pulmonary Embolism Causes
Causes
FAT BAT Mnemonic
Fat
Air
Deep Vein Thrombosis (DVT)
Bacteria
Amniotic Fluid
Tumor
Risk Factors
Hypercoagulable
Central Venous Lines
Immobilized
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1 min
Pulmonary Embolism Presentation and Diagnosis
Presentation
Sudden onset Shortness of Breath (S.O.B.)
Tachypnea
Pleuritic Chest Pain
Hemoptysis
Hypoxemia
Sudden Death
Diagnosis
Gold Standard: CT Pulmonary Angiography
X-Ray
D-Dimer
V/Q Scan
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1 min
Pulmonary Embolism Assessment
Assessment
Shortness of Breath (SOB)
Pleuritic Chest Pain
Tachypnea
Hemoptysis
Hypoxemia
Considerations
Sudden Death
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52 secs
Abdominal Aortic Aneurysm
Screening
Screen Males 65-75 Who've Ever Smoked
Diagnosis
Ultrasound
Treatment
Observation
Asymptomatic and < 5 cm in Size
Surgical Repair
> 5.5 cm in Abdomen
Emergent Surgery
Ruptured or Symptomatic
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2 mins
Abdominal Aortic Aneurysm (AAA) Assessment
Mechanism
Atherosclerosis
Assessment
Bruit
Pulsation in Abdomen
Abdominal or Lower Back Pain
Tearing Pain
Diagnosis
Ultrasound
Considerations
Rupture
Shock
Surgical Repair
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1 min
Hypercholesterolemia Disease
Risk Factors
Diabetes
Smoking
Family History
Hypertension
HDL < 40
Men Older than 45 Years of Age
Women Older than 55 Years of Age
Signs and Symptoms
Atheromas
Plaques in Blood Vessel Walls
Tissue Ischemia
Xanthomas
Lipemia Retinalis
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2 mins
Stable Angina
Assessment
Chest Pain with Exertion
Relieved within 15 Minutes
ST Depression
Interventions
Nitroglycerin
Up to 3 Doses q 5 Minutes
Rest
Antiplatelet Medication
CABG
Angioplasty
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2 mins
Unstable Angina
Assessment
Chest Pain with Rest or Exertion
Limits ADLs
> 15 Minutes
Less Likely Relieved by Nitroglycerin
ST Depression
Fatigue
Considerations
Acute Coronary Syndrome (ACS) Treatment
Emergency Treatment
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2 mins
Myocardial Infarction Assessment
Assessment
Substernal Chest Pain
Crushing or Dull Sensation
Arm, Jaw, and Neck
> 20 Minutes
Unrelieved by Nitro
Palpitations
Diaphoresis
Fear of Impending Doom
Nausea and Vomiting
Shortness of Breath
Considerations
Monitor for Arrhythmias
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2 mins
Left Heart Failure Assessment
Pulmonary Assessment
Pulmonary Congestion
Pink Frothy Sputum
Wheezing or Crackles
Dyspnea with Exertion
Cough
Systemic Assessment
Fatigue
Tachycardia
Weak Peripheral Pulse
S3, S4 Heart Sounds
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1 min
Right Heart Failure Assessment
Jugular Venous Distention (JVD)
Peripheral Edema
Hepatosplenomegaly
Nocturia
Weight Gain
Ascites
Fatigue
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1 min
Myocardial Infarction Diagnosis
Diagnosis
12 Lead ECG
ST Elevation
Q Wave
T Wave Inversion
Troponin T and I
CK-MB
Considerations
Early ECG
Cardiac Stress Test
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2 mins
Myocardial Infarction Interventions
MONA
Morphine
Oxygen
Nitrates
Aspirin
Thrombolytics (tPA)
Invasive Procedures
Cardiac Catheterization
Stent Placement
Angioplasty
Coronary Artery Bypass Grafting (CABG)
Considerations
Decrease Modifiable Risk Factors
Resuming Activity (Physical, Sexual)
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2 mins
Cardiac Catheterization
Considerations
Fluttering Sensation
Contrast Media
NPO 6-12 Hours
After Procedure
Bed Rest
Assess Circulation
Assess for Bleeding
Monitor Vital Signs
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2 mins
Coronary Artery Bypass Grafting (CABG)
Indications
ST-Segment Elevation Myocardial Infarction (STEMI)
Cardiovascular Disease (CAD)
Uncontrolled Angina
Considerations
Internal Mammary Artery
Saphenous (Leg) Vein
Transient Limb Edema
Closely Monitor Patients
Venous Thromboembolism (VTE) Prophylaxis
Incentive Spirometer
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2 mins
Heart Failure Interventions
Diagnostic Tests
Echocardiogram
Invasive Hemodynamic Monitoring
Improve Gas Exchange
High Fowler's Position
Oxygen
Advanced Airway
Drugs and Devices
Diuretics
Beta Blockers
Angiotensin II Receptor Blockers (ARBs)
ACE Inhibitors
Digoxin (Lanoxin)
Pacemaker
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2 mins
Acute Pericarditis Assessment
Pericardial Sac Inflammation
Assessment
Sharp Chest Pain
Increased with Inspiration
Pain Decreased by Leaning Forward
Pericardial Friction Rub
Diffuse ST-Elevation
T Wave Inversion
Fever
Considerations
May Be Asymptomatic
Cardiac Tamponade
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2 mins
Acute Pericarditis Causes
Idiopathic
Infection
Trauma
Cardiac
Myocardial Infarction
Autoimmune Diseases
Uremia
Tumor
Radiation
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2 mins
Acute Pericarditis Interventions
Interventions
Treat Underlying Disorder
Antibiotics
Colchicine + NSAIDs
Corticosteroids
Place Patient Upright with Head of Bed at 45°
Pericardiocentesis
Pericardial Window
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2 mins
Cardiac Tamponade
Mechanism
Fluid in the Pericardial Sac
Pericarditis
Decreased Cardiac Output
Signs/Symptoms
Beck's Triad
Hypotension
Jugular Venous Distention (JVD)
Distant Heart Sounds
Pulsus Paradoxus
Electrical Alternans
Treatment
Pericardiocentesis
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1 min
Hypertrophic Cardiomyopathy Signs, Symptoms and Treatment
Signs and Symptoms
Sudden Death Of Young Athlete
Heart Failure
Angina
Arrhythmias
Syncope
Harsh Systolic Ejection Murmur
S4 Heart Sound
Treatment
Beta Blocker
Non-dihydropyridine Calcium Channel Blocker
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2 mins
Dilated Cardiomyopathy
Chronic Alcohol Abuse
Doxorubicin Toxicity
Cocaine Use
Wet Beriberi
Hemochromatosis
Coxsackie B
Chagas Disease
Peripartum
S3
Eccentric Hypertrophy
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2 mins
Pregnant Cardiac Patient Assessment
Mechanism
Cardiac Decompensation
Signs and Symptoms
Frequent Cough
Dyspnea
Palpitations
Excessive Fatigue
Pulse > 100 bpm
Crackles
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2 mins
Hyperkalemia
Assessment
> 5.0 mEq/L K+
Abdominal Cramps
Muscle Weakness
Diarrhea
Arrhythmia
Tall, Peaked T Waves
Interventions
IV Calcium
Infusion of Glucose and Insulin
Loop or Thiazide Diuretics
Kayexalate
Dialysis
Prevention Education
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2 mins
Hypokalemia
Assessment
< 3.5 mEq/L
Muscle Weakness
Arrhythmia
U Wave
Ileus
Hyporeflexia
Interventions
IV K+ Infusion at 5-10 mEq/hr
Give Orally with Food
Nursing Considerations
Monitor Respiratory Status
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3 mins
Hypernatremia
Assessment
> 145 mEq/L Na+
Change in LOC
Extreme Thirst
Orthostatic Hypotension
Dry Flushed Skin
Muscle Twitching
Seizures
Priority Interventions
Treat and Prevent Dehydration
Hypotonic Solutions (0.225% or 0.45% NaCl)
Sodium Restriction
Diuretics
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2 mins
Hypermagnesemia
Assessment
Flushing
Lethargy
Muscle Weakness
Decreased Deep Tendon Reflexes (DTRs)
Decreased Respirations
Bradycardia
Hypotension
Interventions
Dialysis
IV Calcium Gluconate
Diuretics
Avoid Antacids and Laxatives containing Mg2+
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2 mins
Phases of Cardiac Rehabilitation
Scores
MET Levels
Phase 1
Acute Phase
Assessment
Education
Discharge
Goals
Phase 2
Outpatient Phase
Reinforcing Phase 1
Ergonomic Approach
Phase 3
Community Based
Therapy Settings and Cardiac Rehab
Acute Care
Long-Term Acute Care
Skilled Nursing Facilities (SNF)
Independent Living
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5 mins

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