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