Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
55 Cards in this Set
- Front
- Back
|
Key Concept |
Cardiovascular disorders include those conditions that interfere with the heart's ability to pump, those that disrupt blood flow within the coronary or cerebral vessels, and those peripheral vascular disease that disrupt blood flow to a localized are (e.g., an extremity). |
|
|
CARDIOLOGY |
The field of medicine that examines the cardiovascular system and its disorders.
Nurses who work in this field are cardiac nurses. |
|
|
THE CORONARY CARE UNIT (CCU) OR CORONARY INTENSIVE CARE UNIT (CICU) |
A specialized hospital unit designed for the care of people with heart disorders.
The staff is specially trained in emergency measures and coronary care. |
|
|
Diagnostic tests for clients with cardiovascular disorders serum enzyme tests: |
- Creatinine kinase (CK; formerly creatinine phosphokinase [CPK]) and isoenzyme CK, (or CK-MB)
- Lactic dehydrogenase (LDH)
- Aspartate aminotransferase (AST; formerly serum glutamic oxaloacetic transaminase [SGOT])
- Troponins; troponin I and troponin T (TnI or cTnI and TnT or cTnT)
- Myoglobin |
|
|
Key Concept |
Troponin levels rise within 3 to 4 hours of the onset of chest pain, Troponin I and Troponin T are specific cardiac markers for myocardial injury. Of the cardiac enzymes, troponin I returns to normal within 5 to 9 days and troponin T returns to normal in 10 to 14 days.
|
|
|
Key Concept |
Blood lipid (fat) studies may be ordered to determine hyperlipidemia (excess fat in the blood). Cholesterol is a blood lipid often associated with coronary artery disease (CAD). |
|
|
Key Concept |
Other important tests measure the serum electrolytes such as potassium, sodium and magnesium. An increase or decrease in the level of these electrolytes may cause cardiac dysrhythmia (irregular heartbeat). |
|
|
ANGIOCARDIOGRAM (angiogram) |
An x-ray study of the heart and major vessels performed after injection of a radiopaque dye into a vessel.
The angiogram shows the movement of the dye from the heart to the lungs, back to the heart, then out through the aorta.
(b/c these procedures are invasive, uncomfortable, and carry some risk, clients must sign an informed consent before these test can be done.) |
|
|
ARTERIOGRAM |
An x-ray study of an artery.
(b/c these procedures are invasive, uncomfortable, and carry some risk, clients must sign an informed consent before these test can be done.) |
|
|
Nursing Alert |
Ask clients if they are allergic to shellfish or iodine before performing any test using radiopaque dye. This dye could cause a severe anaphylactic reaction. |
|
|
Nursing Considerations |
Be alert for a possible allergic reaction to the dye during or after the procedure. Watch for signs of a delayed reaction after returning to the room, such as rapid pulse, diaphoresis (sweating), shakiness, skin rash, or a drop in BP. The client may complain of swollen throat or difficulty swallowing. |
|
|
Nursing Considerations |
Check peripheral pulses distal to the site. Also check the color and warmth of the affected extremity and assess motor and sensory function. Clots or other blockages in blood vessels are possible. If pulses are absent, take emergency measures. |
|
|
Nursing Alert |
After any study in which the femoral site is used, the client should lie flat for up to 8 hours. Lying flat helps prevent swelling, bruising, and bleeding at the puncture site. Follow physician orders for activity level. |
|
|
ELECTROCARDIOGRAM (ECG) |
A graphic record or tracing that represents the heart's electrical action.
It provides essential information about the heart, including rate, rhythm, and the presence of certain disorders. |
|
|
STRESS TEST |
Is performed to assess the severity of symptomatic and asymptomatic (without symptoms) cardiac disease.
The client pedals a stationary bicycle or walks on a treadmill while ECG and BP measurements are taken. Various chemicals or meds (thallium,dipyridomole [Persantine], dobutamine HCI [Dobutrex]) may also be injected before or during the test or used instead of exercise for older adults and those who cannot tolerate activity. |
|
|
ECHOCARDIOGRAPHY |
Uses sound waves to produce a three dimensional view of the heart and its blood flow.
An echocardiogram can assess heart size, detect the presence of excess fluid in the pericardial sac, assess valvular function, and it can show atrophy or distention of individual heart chambers. It is useful in the diagnosis and differentiation of heart murmurs, congestive heart failure, and the amount of blood each ventricle ejects (pumps out) with every heart beat. |
|
|
ejection fraction |
The percentage of blood ejected from a chamber. |
|
|
TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) |
Another means of monitoring the heart.
It is performed by inserting the ultrasound probe directly into the esophagus.
This provides for a better visualization of the heart through the esophageal wall. |
|
|
nuclear scan |
is generally performed to detect ishemic patterns (lack of blood supply) and to assess for viable myocardium.
During the scan the client receives a weak radioactive chemical (thallium, technetium, sestamibi, or teboroxime) intravenously to allow for a better view of the heart's chambers or myocardium. |
|
|
electrophysiology study (EPS) |
provides valuable information about the electrical activity of the heart by locating the source of a dysrhythmia (abnormal heart beat rhythm) and determining the most effective medication and/or the need for a cardiac pacemaker to control the dysrhythmia. The EPS is done in the cardiovascular laboratory and takes approximately 2 to 3 hours.
The cardiologist will attempt to recreate the abnormal heart rhythm by using a special catheter with multiple electrodes. These electrodes are connected to transducers to study impulses from conductive tissue and identify abnormalities. After the dysrhythmia occurs, various meds are administered to determine the most effective preventive agent; it may be determined that a cardiac pacemaker is needed. |
|
|
Nursing Considerations (electrophysiology study) |
Check the clients vital signs every 15 minutes initially and less frequently once they have stabilized. |
|
|
CARDIAC CATHETERIZATION |
Is performed to obtain information about congenital or acquired heart defects, measure oxygen concentration, determine cardiac output, or assess the status of the heart's structures and chambers.
It may be performed during an angiocardiogram to study the function of the heart or blood supply.
Therapeutic treatments may be done during the catheterization to repair the heart, open valves or dilate arteries. |
|
|
Nursing Considerations (cardiac catheterization) |
A signed informed consent is required, and the client is NPO for at least 6 hours before the procedure. Exceptions to the NPO order are specific meds ordered by the physician.
Check the clients peripheral pulses every 15 min for an hour after the test and then frequently thereafter for up to 8 hours. |
|
|
Nursing Alert |
Immediately report a clients rapid or irregular pulse after cardiac catheterization. It may indicate heart or valve damage, clot formation or hemorrhage. Also immediately report any complaint of chest or insertion site pain. |
|
|
Nursing Alert |
Clots cause occlusion(blockage) of the blood flow in situations such as acute MI. Pharmacologic agents called thrombolytics or fibrinolytics, such as streptokinase (Streptase), urokinase (Abbokinase), and alteplase (Activase), also known as tissue plasminogen activator, t-PA, have been shown to dissolve these clots in arterial or venous blood vessels. |
|
|
Clients for thromolytic therapy are selected by the following criteria: |
- History of chest pain within the past 6 hours
- Ischemia (lack of blood supply) of the heart that persists even after the administration of sublingual nitroglycerin.
- No recent history of surgery, organ biopsy, cardiopulmonary resuscitation, hemorrhagic CVA, bleeding abnormalities, intracranial neoplasm, recent head injury, pregnancy, or allergy to streptokinase. |
|
|
percutaneous transluminal coronary angioplasty (PTCA) |
A surgeon inserts a balloon-tipped catheter into a clients narrowed coronary artery. |
|
|
Angioplasty |
widens the artery's opening and improves the blood flow to the heart muscles. |
|
|
Atherectomy |
involves use of a cutting device (rotoblator) with a rotating shaver (burr) at the tip of the catheter.
This is used to shave away plaque from the coronary artery. |
|
|
Stent |
a wire coil similar to the coil of a ball point pen, although other types are used.
The surgeon leaves the stent in the artery when removing the balloon catheter, thus the stent keeps the artery open. |
|
|
Closed heart surgery |
surgical procedures that done without stopping the heart. |
|
|
Open heart surgery |
involves opening or operating on the heart in such a way that the heart must be stopped and the circulated blood is oxygenated by a device such as a pump oxygenator (heart lung pump). |
|
|
Extracorporeal Circulation |
Outside the body |
|
|
Coronary artery bypass grafting (CABG) |
When surgeons use healthy vessels, usually including the saphenous vein from a leg, and place it around the blockage in the coronary artery. One end of the vein is grafted to the aorta and the other end to the area of the heart that is not receiving blood from the blocked artery. The grafted vein supplies oxygenated blood from the aorta to the heart. |
|
|
Indications for heart valve surgery: |
- Major cardiac symptoms: chest pain, angina, dyspnea, syncope, heart failure
- Mitral or aortic valvular insufficiency caused by regurgitation (The valves do not close completely, which allows blood flow to leak backward)
- Mitral or aortic valvular insufficiency cause by stenosis (the valves are stiff and do not open completely.)
- Damage to valves caused by infection (endocarditis), trauma, blood clots, bleeding or deterioration of previously replaced valves.
- Mitral valve prolapsed
- Pulmonary valve stenosis
- Tricuspid regurgitation |
|
|
Key Concept |
Of the four heart valves, most repairs are needed on the leaflets (flaps) of the ventricular valves (i.e, the mitral or aortic.) |
|
|
Nursing Considerations (Cardiac surgery) |
- preoperative teaching (deep breathing, expectations after surgery)
- Discharge planning, including plans for cardiac rehabilitation
- Clients nutrition and capacity for healing
- Supplemental oxygenation needs before and after surgery
- Vitamin and mineral therapy
- Routine Tests and procedures |
|
|
for clients with cardiovascular disorders, measuring the levels of serum enzymes is important. the enzymes include ______ |
>creatinine kinase (CK; formerly creatinine phosphokinase [CPK] and isoenzyme ck2 (or CK-MB) |
|
|
NURSING ALERT |
Priority nursing concerns for NCLEX options include the ABC's (airway, breathing, circulation), nursing interventions, lab test results, medication uses and side effects, and teaching concepts for client and family. |
|
|
Arteriosclerosis |
applies to several pathologic conditions in which the walls of the arteries thicken, harden, and lose elasticity. Sometimes referred to as "hardening of the arteries." |
|
|
Atherosclerosis |
The most common type of arteriosclerosis, is characterized by fatty deterioration of the arterial smooth muscle walls.
Gradually, over several years, the walls absorb increasing amounts of circulating lipids and the lumen of arteries narrows (stenosis) or may close completely. |
|
|
Plaque |
Buildup of fat and mineral deposits. |
|
|
HDL |
Good cholesterol |
|
|
LDL |
Bad cholesterol |
|
|
Hypertension (HTN) |
High blood pressure. Leading cause of MI, cardiac damage, kidney damage, congestive heart failure, and CVA.
Although HTN cannot be cured, treatment can usually bring blood pressure to within the normal range. |
|
|
Hypertrophy |
Enlargement of the heart muscle. |
|
|
Nursing Considerations (HTN) |
Encourage clients to exercise, observe moderation in eating, and avoid tension and anxiety. Advise to avoid smoking and to limit intake of alcoholic beverages, caffeine, and sodium. Symptoms of HTN may become sever, with headache, fatigue, dyspnea, edema and nocturia. |
|
|
Malignant hypertension |
is not cancer, refers to a sudden onset of severely elevated blood pressure that is controllable.
Onset is sudden, and the disease progresses rapidly.
Malignant hypertension is known to cause rapid necrosis(death) of vital organs, such as the heart, brain, and kidney. Clients with malignant hypertension rarely survive more than a few years. |
|
|
Hypotension |
low blood pressure
Causes: a heart rate problem, a heart muscle or pump problem, or a volume problem. |
|
|
Rate problems |
a heart rate that is too fast or too slow. |
|
|
Pump problems |
result from MI |
|
|
CARDIOMYOPATHY |
The heart cavity is enlarged and stretched |
|
|
Cardiac tamponade |
heart compression, caused by fluid buildup |
|
|
Volume Problems |
hemorrhage, gastrointestinal fluid loss, renal injury or disease, central nervous system injur, spinal injury, sepsis, medications or disease processes that affect vascular tone. |
|
|
Signs and Symptoms of Cardiovascular Disorders |
- Changes in the rate, quality and rhythm of the pulse
- Rise or fall in blood pressure or central venous pressure
- edema
- Weight gain due to excess fluid in the tissues
- Difficulty breathing and the presence of a cough, often caused by pulmonary edema
- cyanosis
- Clubbing of the fingers
- Needing to squat to breathe
- Pain
- Fatigue for no apparent reason
- Intermittent claudication, which denotes a decrease in blood supply to the legs and feet ( A person with arterial blockage will fill pain within 1 minute after beginning to walk) |
