Cardiac

NCLEX® Points
 Heart Rate
• Normal sinus 60-100bpm
• Sinus tachycardia >100bpm
• Sinus bradycardia <60bpm
 Vascular System
• Arteries
– carry oxygenated blood to tissues
• Veins
– carry deoxygenated blood back to heart
 Cardiac Markers (CIP)

Troponin Most sensitive to 12 hours

cardiac damage
CK-MB Sensitive when 10-24 hours
skeletal damage
isn't present
Myoglobin (Mb) Low specificity to 2 hours
infarction
 Cardiac Labs
• Potassium (3.5 – 5) • BNP
– Hypokalemia – 100-300 pg/mL HF present
• ventricular dysrhythmias – 300-600 pg/mL moderate HF
• ↑ digoxin toxicity
– 600-900 pg/mL severe HF
• U wave
• Magnesium (1.5-2.5)
• ST depression
– Hyperkalemia – Hypermagnesemia
• Peaked T waves • Prolonged PR, QRS, QT, brady, blocks
• Wide QRS • Cardiopulmonary arrest
• Ventricular dysrhythmias • Hypotension
• ↑ Hematocrit (38-50M, 35-45F) – Hypomagnesemia
– dehydration • Tacycardia
• ↓Hematocrit and hemoglobin (12 – 17)
• Prolonged QT
– indicate anemia
• Torsades de Pointes
• Lipids
– Total cholesterol ↓200 mg/dL
– LDL ↓130 mg/dL
– HDL 30-70 mg/dL
 Holter Monitoring

24 hour EKG monitoring

Client should record any moment that they have chest
pain.

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 Cardiogenic Shock

•Heart is unable maintain effective cardiac output

•Assessment
•low urine output
•↓BP
•Assess CVP (pressure in superior vena cava representing
right atrial pressure preload)
•CVP: 2-8 mmHg
•reading should be taken at end expiration if ventilated
•Zero transducer at the fourth intercostal space along
the mid axillary line (location of the right atrium)