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77 Cards in this Set

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Central Venous Pressure
~provides an indication of pressure in R atrium
~>10 is overloading
~5-10cm of water
Arteriography/Arteriogram
~injection of contrast medium in2 vascular system 2 outline heart/blood vessels
~PRE:NPO
~informed consent
~allergies 2 iodine
~POST:check 4 bleeding
~check distal pulses
Cardiac Catheterization
Etio
~cath is introduced in2 R or L side of the heart
~measures O2 concentration
~measure pressure in chambers
~detect shunts
~determine concentrated O2/blood flow
~determines need 4 cardiac bypass
Angina
etio
~insufficient coronary blood flow resulting in inadeq O2 supply causing intermittent chest pain
~no blood/O2 leads 2 pain leads 2 ischemia
~duration: 5mins
Cardiac Catheterization
NI
~PRE:informed consent
~NPO
~assess 4 allergies 2 iodine
~POST:check distal pulses
~keep extremity extended
~pressure in insertion site
Angina
S/S
~depends on location, character, duration, prev events
Angina
Teaching
~avoid excessive activity in cold weather
~avoid overeating
~avoid constipation
~rest after meals
~exercise in moderation
~medications
Myocardial Infarction
Etio
~when myocardium tissue is destroyed d/t reduced coronary blood flow
~depressed ST segments
Myocardial Infarction
Causes
~atherosclerosis
~arteriosclerosis
Myocardial Infarction
S/S
~heavy chest pain that radiates down L arm, hand, jaw, neck
~N/V
~diaphoresis
~vertigo
~decr BP
~EKG changes
~denial (coping mech)
~CPK, LDH, Troponin levels elev
Myocardial Infarction
NI
~tx arrhythmias (lidocaine)
~analgesics (morphine)
~O2
~stool softeners
~low fat, low chol, low Na, high fiber
~teach risk factors
Congestive Heart Failure
Etio
~inability of the heart to meet tissue requirements for O2
~heart isnt pumping enough
Congestive Heart Failure
Left Ventricular Failure
S/S
~backflow 2 lungs
~dyspnea
~moist cough
~crackles
~wheezing
~orthopnea
~appears b4 RHF
Congestive Heart Failure
Right Ventricular Failure
S/S
~backflow in2 system
~peripheral edema
~distended neck vein
~wt gain
~enlarged liver
~enlarged spleen
~hypotension
~tachycardia
Congestive Heart Failure
NI
~reduce pain/anxiety
~improve O2 (2L NC)
~reduce congestion
~improve myocardial contraction
AV Heart Block
Etio
~altered transmission of impulse 4m SA node through AV node
~unconscious control
~SA -> AV -> purkinje's fibers -> muscles
~AV node stops conduction
AV Heart Block
First Degree
~delayed transmission of impulse through AV node
~delayed 'PR' interval
AV Heart Block
Second Degree
~some impulses pass through AV node & some dont
~atropine
~if HR <30, need ext pacemaker
AV Heart Block
Third Degree
~No impulses pass through AV nodes @ all
~atrium/ven beat indep
~heart is quivering
~need perm pacemaker
~anormal EKG
Pacemaker
Etio
~electronic device that provides repetitive elec stimulant 2 heart muscle 4 control of heart rate
~2nd clavicle
Pacemaker
Temp & Perm
~Temp: emergency situation
~Perm: monitor EKG/pulses
Pacemaker
Types
~Transvenous
~Nx Dx: alteration of body image
~NI: regular activity in 6wks
~Myocardial (transthoracic) implantation
Pacemaker
NI
~maintain safe environment
~nurse changes temp batt replacement
Pacemaker
Complications
~local infection
~erythema
~disloding of electrodes
~malfunction (vertigo, BP, faint)
~check battery
Pacemaker
Teaching
~check pulses daily
~no contact sports
~carry med ID
~no microwave ovens
~no electrical generators
~battery replacement (lithium 3-15yrs)
~regular activity after 6wks
Arterial Disorders
Causes
~arteriosclerosis
~atherosclerosis
Arterial Disorders
S/S
~intermittent claudication
~tingling/numbness of toes
~cool extremities
Arterial Disorders
Buerger-Allen exercises
~keep legs straight when sitting/lying on bed with legs dangling
Arterial Disorders
Teaching
~no smoking
~no stressful sits
~keep legs straight
Arteriosclerosis Obliterans (ASO)
S/S
~pain @ rest (in PM)
~diabetes
Arteriosclerosis Obliterans (ASO)
Surgical
~vascular graft or patch graft
~open carotid artery (endarectomy)
Arteriosclerosis Obliterans (ASO)
NI
~check distal pulses
~ted hose
~small dose Heparin
Buerger's Disease (Thromboangiitis Obliterans)
Etio
~recurring inflam of arteries of lower and upper extremities resulting in thrombus & occlusion
Buerger's Disease (Thromboangiitis Obliterans)
S/S
~occurs in 20-35yrs M
~pain in legs relieved by rest
~numbness/tingling toes/fingers
~cold weather
~hands turn white 2 blue 2 red
Buerger's Disease (Thromboangiitis Obliterans)
NI
~no smoking
Raynaud's Phenomenon
Etio
~vasospastic condition of arteries with exposure 2 cold or stress and affects primarily hands (mostly F)
Raynaud's Phenomenon
Teaching
~avoid cold weather
~no smoking
Raynaud's Phenomenon
S/S
~vasoconstrict in coldness
~pain
~ulcerations
Aortic Aneurysm
Etio
~local distension of artery wall usually thoracic or abd
Aortic Aneurysm
Cause
~infection
~congenital
~atherosclerosis
Aortic Aneurysm
S/S - Thoracic
~pain
~dyspnea
~hoarseness
~cough
~dysphagia
~supine, able 2 see movement/pulsating abd mass
Aortic Aneurysm
S/S - Abd
~abd pain
~persistent/intermittent
~low back pain
~supine, visible pulsating abd mass
Aortic Aneurysm
Tx
~surgery
~POST: turn, cough, deep breathe
Hypertension
Etio
~persistent BP >140 systolic & >90 diastolic
~"silent killer"
~appears 2-3x b4 correctly Dx w/hypertension
Hypertension
Essential Hypertension
~90%
~hereditary
~cause unknown
~headache (#1) qD
~fatigue
~dyspnea
~edema
~nocturia w/no UTI or reason
Hypertension
Secondary Hypertension
~due to indentifiable probles
~dont comply w/meds
~pheochromocytoma
Hypertension
NI
~modify lifestyle
~no stimulants
~low stress
~no salt diet
~low NA
Thrombophlebitis
Etio
~clot in vein w/inflam of the wall
Thrombophlebitis
Causes
~stasis
~incr coag in the blood
~damage 2 inside of blood vessels
Thrombophlebitis
S/S
~edema of affected limb
~bumpy/knot
~swelling
~redness
~tender
~local induration
Thrombophlebitis
NI
~bed rest
~elev leg
~moist warm compress
~Heparin therapy
~ted hose
Varicose Veins
Cause
~pregnancy
~obesity
~prolonged standing
~hereditary
Varicose Veins
S/S
~enlarged tortous veins in lower extremities
~pain
~edema
Varicose Veins
NI
~elev legs
~ted hose
~no constrictive clothing
~no prolonged sitting/standing
~no crossing legs
Shock
Types
~cardiogenic
~hypovolemic
~neurogenic
~anaphylactic
~septic
Cardiogenic shock
~failure of heart to pump adeq
hypovolemic shock
~decr blood vol
neurogenic shock
~incr size of vascular bed d/t loss of vascular tone
anaphylactic
~hypersensitivity reaction 2 drugs
septic
~systemic reaction d/t infection
Shock
S/S
~tachycardia
~tachypnea
~oliguria
~cold moist skin
~clammy
~ashen-grey skin
~hypotensive
Shock
NI
~elev feet 2 incr venous rtn
~IV
~O2
~V/S
Shock
Drugs
~Lidocaine
~Epinephrine/Adrenaline
~Atropine
~Norepinephrine
~Sodium bicarbonate
CPR
Purpose
~establish effective circulation & respiration 2 prev irreversible anoxic damage
CPR
Procedure
~airway (head tilt/chin lift)
~breathing (2 breaths)
~circulation
~1 rescuer (15:2)
~2 rescuer (5:2)
CPR
Complications
~fractured ribs
~punctured lungs
~lacerated liver
~abd distension
CPR
Stop when...
~physician pronounces dead
~exhausted
~when help arrives
~when HB rtns
Obstructed airway
conscious
~ask permission first
~heimlich
Obstructed airway
unconscious
~est unresponsiveness
~attempt to ventilate
~reposition/ventilate
~tongue-jaw lift, fingersweep
~reattempt ventilation
~abdominal thrust
~repeat d thru f
myocardial infaction
meds
~procardiam (nifedipine)
~propanol (inderal)
congestive heart failure
left ventricular failure
etio
~inadeq ejection of blood in2 systemic circulation
~dont take care of LHF leads 2 pulm edema
~result cause excess qty of fluid
~excess fluid, marked dyspnea
~appears b4 RHF
congestive heart failure
right ventricular failure
etio
~congestion d/t blood not adeq pumped 4m systemic 2 lungs
congestive heart failure
meds
~digitalis
Digitalis Toxicity
~S/S: halo around lights
~anorexia
~diarrhea
~NV
~bradycardia
~NI: mon K levels
Arteriosclerosis Obliterans (ASO)
etio
~affects aorta & arteries of lower extrem
sclerotherapy
~injec dye 2 shrink vein
~no circulation
~POST:mon circulation, elev ft
CPR
adults/infants
~infants - 8yr: 5/2
~8yr - adults: 15/2