Cathy Shared "Perfusion" - 23 Picmonics
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Perfusion
ECG Interpretation
- Rate
- Rhythm
- P Waves
- Upright, Rounded, Before Every QRS
- PR Interval (< 0.20 seconds)
- Normal QRS (< 0.12 seconds)
2 mins
Parts of an ECG
- PQRST
- P Wave
- Atrial Depolarization
- QRS Complex
- Ventricular Depolarization
- T Wave
- Ventricular Repolarization
2 mins
12 Lead Contiguous Leads - Anterior Wall MI
- Leads Elevated
- Lead V3
- Lead V4
- Artery Affected
- Left Anterior Descending (LAD)
56 secs
Cardiac Enzyme Evaluation: Creatine Kinase CK-MB
- Measures
- Skeletal or Cardiac Muscle Injury
- Time Ranges
- Onset: 4-8 Hours
- Peak: 12-24 Hours
- Return to Normal: 2-3 Days
1 min
Cardiac Enzyme Evaluation: Troponin
- Measures
- Cardiac Muscle Injury
- Time Ranges
- Detection in Blood: 4 Hours
- Peak: 24 - 36 Hours
- Return to Normal: 5 - 14 Days
- Considerations
- Most Specific for Cardiac Muscle
- Treat Aggressively
2 mins
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
2 mins
Blood Pressure Classification (ACC/AHA 2017)
- Classifications
- Normal
- Systolic Less than 120
- Diastolic Less than 80
- Elevated
- Systolic +10 (120-129)
- Diastolic Less than 80
- Stage 1 Hypertension
- Systolic +10 (130-139)
- Diastolic +10 (80-89)
- Stage 2 Hypertension
- Systolic +40 (140-179)
- Diastolic +30 (90-119)
- Hypertensive Crisis
- Systolic greater than or equal to 180
- Diastolic greater than or equal to 120
5 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
2 mins
Hypertension Intervention
- Lifestyle Modifications
- Weight Reduction and Exercise
- Diet Changes
- Relaxation Techniques
- Smoking Cessation
- Medications
- Encourage Self Monitoring
1 min
Hypertension Medications
- Diuretics
- ACE Inhibitors
- Angiotensin Receptor Blockers (ARBs)
- Beta Blockers
- Dihydropyridine Calcium Channel Blockers
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
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
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
2 mins
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
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)
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
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
2 mins
Evolution of Myocardial Infarction and Complications
- Hours to Days
- Arrhythmia
- Before 7 Days
- Fibrinous Pericarditis
- Papillary Muscle Rupture
- Interventricular Septum Rupture
- Before 14 Days
- Ventricular Pseudoaneurysm
- Ventricular Free Wall Rupture
- After 14 Days
- True Ventricular Aneurysm
- Dressler Syndrome
- Other
- Left Ventricular Failure
2 mins
Peripheral Artery Disease (PAD)
- Mechanism
- Atherosclerosis
- Assessment
- Intermittent Claudication
- Pain with Exercise
- Paresthesias
- Arterial Ulcers
- Critical Limb Ischemia
- Amputation
- Consideration
- Ankle-Brachial Index (ABI)
2 mins
Arterial Ulcer Assessment
- Absent or Decreased Pulses
- Intermittent Claudication
- Sharp Pain
- Dependent Rubor
- Well Defined Edges
- Over Bony Areas
- Smooth, Shiny Skin
- Toes, Heels, Lateral Lower Legs
- Cool
2 mins
