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61 Cards in this Set
- Front
- Back
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what is pulsus paradoxus?
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decrease in systolic bp > 10mmg
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what could cause a pulsus paradoxus?
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^ work of breathing, hypovolemia, pericardial effusion or tamponade
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what is a sinus arrythmia?
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hr increases during inhalation, decreases in exhalation
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who is sinus arrhythmia most common in?
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children and young adults
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what is pulsus alternans?
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alternating pulses, sign of left ventricular failure
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what is pulsus deficit?
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progressive stage of pulsus alternans where not all beats are palpable
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how do you assess for a carotid bruit?
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listening to high pitched sh-sh
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when judging jugular distension what are we looking for?
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right sided heart fx
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what else could the JDV mean?
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massive PE
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what does S1 signal?
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closure of the mitral and tricuspid valves
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what does the S2 heart sound represent?
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closing of the aortic and pulmonic valves
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where is s2 heart best?
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at the base of the heart
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what are triplet heart sounds called?
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gallops
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what is Ken tuc ky
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s1-s2-s3
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what is ten nes see?
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s4-s1-s2
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what does cheyne stokes breathing represent?
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left sided heart failure
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what is hemoptysis?
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frothy red salvia, right sided heart failure
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what could bladder distension mean in cardiac assessments?
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urine output is indicator of perfusion
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what lab results rise first in an MI?
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ck-mb creatine kinase
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when does myoglobin rise?
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it's an early MI marker 1-3 hours, 4-12 is peak and normal within 24 hrs
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what about tropinin T or I?
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only found in cardiac muscle, elevated for three weeks after an MI
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what is done before a cardiac cath?
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fast for 8-12 hrs, inform pt of risks, what is expected
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what needs to be done after a cardiac cath?
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assess for bleeding, peripheral pulses q 15 min x 1 hr, and 1-2 hrs til stable, assess for temp and color, watch for dsyrthmias, encourage rehydration, 2-6 hrs bedrest leg straight, monitor BUN and creatinine, I/o's for renal fx
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what do you need to educate the pt about after a cath?
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don't bend, lift or strain for 24 hrs, avoid baths shower is ok, call dr for bleeding, or temp > 101.5, learn about lifestyle change
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what is angina pectoris?
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chest pain caused by myocardial ischemia or lack of 02
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what is the problem in angina pectoris?
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the oxygen demand is greater than oxygen supply
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how does nitro work on heart muscle?
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decreases the myocardial demand
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what causes cardiogenic shock?
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decrease in CO which leads to inadequate tissue perfusion and the initiation of shock syndrome
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who is at risk for cardiogenic shock?
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> 65 y/o, females and diabetics, preexisting CAD, anterior wall MI
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what are the indications for a balloon pump or a IABP?
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cardiogenic shock, LV failure, post op open heart, unstable angina, post MI
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what is a PCI?
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percutaneous cardiac intervention aka angioplasty
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what causes cardiogenic shock?
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decrease in CO which leads to inadequate tissue perfusion and the initiation of shock syndrome
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what causes cardiogenic shock?
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decrease in CO which leads to inadequate tissue perfusion and the initiation of shock syndrome
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what nursing interventions are used with a PCI?
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assess for retroperitoneal bleeding, ck pulses, HOB <30 degrees, leg straight, direct pressure for 15-30 min after removal of sheath
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who is at risk for cardiogenic shock?
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> 65 y/o, females and diabetics, preexisting CAD, anterior wall MI
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what is the most common form of valvular disease?
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mitral value prolapse
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what are the indications for a balloon pump or a IABP?
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cardiogenic shock, LV failure, post op open heart, unstable angina, post MI
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who is at risk for cardiogenic shock?
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> 65 y/o, females and diabetics, preexisting CAD, anterior wall MI
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what are the known causes of cardiomyopathy?
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cardiotoxic agents ie: ETOH, cocaine, adriamycin, HTN, ischemia
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what are the indications for a balloon pump or a IABP?
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cardiogenic shock, LV failure, post op open heart, unstable angina, post MI
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what is a PCI?
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percutaneous cardiac intervention aka angioplasty
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what is a PCI?
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percutaneous cardiac intervention aka angioplasty
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what nursing interventions are used with a PCI?
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assess for retroperitoneal bleeding, ck pulses, HOB <30 degrees, leg straight, direct pressure for 15-30 min after removal of sheath
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what nursing interventions are used with a PCI?
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assess for retroperitoneal bleeding, ck pulses, HOB <30 degrees, leg straight, direct pressure for 15-30 min after removal of sheath
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what is the most common form of valvular disease?
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mitral value prolapse
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what is the most common form of valvular disease?
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mitral value prolapse
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what are the known causes of cardiomyopathy?
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cardiotoxic agents ie: ETOH, cocaine, adriamycin, HTN, ischemia
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what are the known causes of cardiomyopathy?
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cardiotoxic agents ie: ETOH, cocaine, adriamycin, HTN, ischemia
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what are the s/x of endocarditis?
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systemic signs: malaise, mild fever, mumur, chills, abd pain,dyspnea, petechiae on fingers and toes, clubbing anemia, ^ WBC and + cultures
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what are the known causes of cardiomyopathy
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cardiotoxic agents: ETOH, cocaine, adriamyacin, aortic stenosis,, HTN, ischemia
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what are the s/s of cardiomyopathy?
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tachycardia, fatigue, s3 s4 heart sounds, mumurs, s/s HF, ekg chgs.
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what is heart failure?
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clinical syndrome of fluid overload and inadequate tissue perfusion
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what are the two types of HF?
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systolic and diasystolic
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what is a characterization of systolic?
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weakened heart muscle
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what is a characterization of diasystolic HF?
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stiff and non compliant heart muscle making ventricular filling difficult.
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what are the s/s of left sided hf?
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tachypnea, tachycardia, cough, basilar crackles, s3 and s4 heart sounds, ^ PA pressure,hemoptysis,cyanosis, pulmonary edema
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what are the s/s of right sided HF?
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peripheral edema, hepatomegly, splenomegly, heptojugularmegly,ascites, JVD, ^CVP, pulmonary HTN
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what happens in acute HF?
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rapid onset, pulmonary edema, low CO, cardiogenic shock
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what happens in chronic HF?
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ongoing, hypervolemic, Na and h20 retention, structural changes in the heart ie: dilation or hypertrophy
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how do you pharmacologically manage chronic HF?
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ace inhibitors, bb, diuretics, digitalis, diet modifications, additional 02, ICD
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what is the nursing mgmt for HF pts?
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careful assessment and monitoring, fluid balance I/O's, daily wt, monitor JVD, and VS, monitor for complications related to diuretic therapy, K+, Na, and hyperurecemia
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