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193 Cards in this Set
- Front
- Back
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Where would you place the stethoscope to hear apical pulse?
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At the midclavicular line at 5th left intercostal space
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Why do we administer O2 to clients with angina pectoris?
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Pain associated with angina pectoris is derived from ischemic myocardial cells. Supplemental O2 will help meet the added demands on the heart muscle.
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What lab tests are performed to r/o AMI?
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CKMB and troponin
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Client c/o chest pain. How do you differentiate chest pain of cardiac origin vs respiratory origin?
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Pain of pleuropulmonary origin usually becomes worse on inspiration
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What dietary restrictions are needed in CHF?
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Goal is to reduce fluid accumulation (less fluid intake, less salt intake)
Avoid ham, cheese, most cold cuts, potato chips Weigh youself daily Eat plenty of fresh fruits and vegetables |
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What are the risk factors of CAD?
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Modifiable: HTN, smoking, hyperlipidemia, glucose intolerance, obesity and stress
Non-Modifiable: age >40 |
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Post-AMI rehab includes:
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Healthy diet, activity, medications, follow-up appointments
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What EKG changes are noted in hypokalemia?
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Flat T wave
ST segment depression |
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What EKG changes are noted in hyperkalemia?
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Tall, peaked T waves
Prolonged PR interval Widening QRS complex May also lead to ventricular dysrhythmias-> cardiac arrest |
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What are the dietary restrictions for clients with CAD?
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Avoid foods high in saturated fats and cholesterol.
Use polyunsaturated oils to control hypercholesterolemia |
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What beverages should be avoided in clients with AMI?
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Caffeinated beverages (coffee, tea, cola)
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What should the post-op instructions include after an angioplasty (s/t angina pectoris)?
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Dietary instructions, lifestyle changes to prevent further atherosclerosis.
Need to stop smoking right away. Angioplasty doesn’t repair the heart! |
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What is CK-MM?
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Blood test that shows skeletal muscle injury
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Client came in with MI and is experiencing chest pain. Nurse administers a SL NTG. Chest pain is unrelieved. What should she do next?
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Give another SL NTG
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Client came in with MI and is experiencing chest pain (unrelieved by NTG). Nurse administers morphine sulfate. What should be monitored?
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Respirations and BP
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How would you position you client for a thoracentesis procedure?
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Upright and leaning forward with arms on an over-the-table bed
This position ensures accessing and draining the infusion (with the help of gravity) |
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Before initiating therapy with acetazolamide (Diamox) for management of glaucoma, a nurse should ask for allergy to what?
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Sulfa drugs
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A client recovering from left ventricular heart failure has a ND of activity intolerance. Nurse determines that client is best tolerating mild exercise if client exhibits:
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VS that remain near the baseline (indicate good cardiac reserve)
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After the vein ligation and stripping, one client calls the nurse to report that she has been experiencing sensations throughout the affected leg (falling asleep). What should the nurse do?
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Call the doctor immediately and report this
A sensation of pins and needles, or limb falling asleep, may indicate temporary or permanent nerve damage following surgery. |
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What is the surgical procedure for varicose vein removal?
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Ligation and stripping.
It involves tying off the varicose vein & large tributaries and then removing the vein using hook and wires via multiple small incisions in the leg. |
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What is sclerotherapy?
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Injection of a sclerosing agent into a varicosity
Agent damages the vessel & causes aseptic thrombosis that results in vein closure. With no blood flow through the vessel, distention will not occur. |
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Stable angina:
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Triggered by a predictable amount of effort or emotion
Goes away after rest |
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Unstable angina:
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Triggered by unpredictable amount of exertion or emotion
May occur at night Attacks increase in #, duration and severity over time |
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Variant (Prinzmetal’s) angina:
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Triggered by coronary artery spasm
Risk factors unknown Tend to occur early in the day and at rest Relatively unresponsive to nitrates Beta-blockers are NOT given, may worsen the spasms Normally treated with Ca++ channel blockers |
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Intractable angina:
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Chronic
Incapacitating Refractory to medical therapy |
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What lab test should be monitored in clients receiving Lasix?
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Potassium
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How do you spot a 1st degree HB on EKG?
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Prolonged PR interval
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Why would you give morphine sulfate to a client with pulmonary edema?
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Reduces anxiety and dyspnea
Also promotes peripheral vasodilation and causes blood to pool in the periphery Decreases pulmonary capillary pressures, which reduces fluid migration into the alveoli |
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Client with heart failure is scheduled to be d/c with Digoxin & Lasix qd. What should be reported immediately?
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Sudden weight gain of 2-3 lbs in a few days
Client should also report loss of appetite, SOB with activity, edema, persistent cough, & nocturia |
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What information would you provide to a client with CAD to encourage smoking cessation?
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"If you quit now, your risk of CVD will decrease to that of a non-smoker in 3-4 years.”
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A client with cardiac disease is placed on heart monitor. You see A. Fib with a ventricular rate of 150 bpm. What would you assess for?
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Hypotension
Client with uncontrolled A. Fib is at risk of low CO because of loss of atrial kick. Also assess the client for palpitations, chest pain or discomfort, pulse deficit, fatigue, weakness, dizziness, syncope, SOB & distended neck veins |
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Client is being d/c from the hospital after being treated for infective endocarditis. What should be included in d/c instructions?
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Notify all HCPs of the hx of infective endocarditis before any invasive procedures.
Providers should place the client on prophylactic antibiotics. Client should take a full course of ab therapy. |
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Nurse is concerned about the adequacy of peripheral tissue perfusion in a post-cardiac surgery client. What should the nurse avoid to do?
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Use of knee gatch on the bed
Also, nurse should plan measures to prevent post-op venous stasis (apply leg wraps/ elastic stockings, use pneumatic compression boots, discourage leg crossing, perform passive/ active ROM exercises, avoid placing pillows in popliteal space) |
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what activity limitations are needed for the 1st 6 weeks in post-cardiac surgery clients?
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Use arms for balance, not weight support, when getting out of bed or chair.
Do not lift anything heavier than 5 lbs. Do not drive Avoid any acivities that cause straining. These limitations allow sternal healing, which takes about 6 weeks. |
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What is sinus arrhythmia?
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Has all the characteristics of a NSR, except an irregular P-P interval.
May occur d/t phasic changes in firing of the SA node s/t vagal tone, respirations, coffee etc. CO is not affected. |
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Monitor shows sudden change in rhythm. No P wave, no QRS complexes. You only see wave lines on screen. What is it?
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Ventricular Fibrillation
May have course or fine fib. waves |
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Client with MI is experiencing new, multiform PVCs. Knowing that client is allergic to Lidocaine, what would you give?
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Procainamide (Pronestyl)
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Client with PVCs has received antidysrhythmic therapy. You would know the therapy is effective if the PVCs continued to:
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Decrease to a frequency of <6/min
PVCs are considered dangerous when they are frequent (>6/min), occur in pairs or couplets, are mulitfocal (multiform), or fall on the T wave. In each of these cases, client’s cardic rhythm is likely to degenerate into V. Tach or V. Fib, both of which are potentially life threatening. |
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What is quinidine sulfate (Quinidex Extentabs) used for?
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Chronic A. Fib
(for dysrhythmia suppression). |
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Adult client has been defib x3 unsuccessfully for V. Fib. CPR is resumed. Nurse notes that CPR is being administered effectively if:
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Carotid pulse is palpable with each compression
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What teaching points should be included in clients with an implantable cardioverter/ defibrillator?
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Should continue to take anti-dysrhythmic drugs after d/c from hospital
If client feels an internal defib shock, she/he should sit down Can’t have MRI |
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Client with complete heart block has a permanent demand ventricular pacemaker inserted. Pacemaker spikes should occur:
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Before each QRS complex
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where would you place conductive gel pads on chest for defibrillation (ACLS)?
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Right of sternum just below the clavicle and Left of the precordium
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Post-op instructions for vein ligation and stripping client include:
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Avoid standing or sitting for prolonged periods.
Remain lying down with legs elevated for the 1st few days. This reduces risk of edema in legs. Client should also avoid crossing legs. |
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what fruits & vegetables should a client with HD avoid?
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avocado, olives & coconut (all have high-fat content)
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1st signs of Digoxin toxicity
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abdominal pain, N/V, visual disturbances (blurred, yellow or green vision, halos around lights), bradycardia and other dysrhythmias
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characteristics of venous (stasis) ulcers
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more superficial than arterial ulcers.
ulcer bed is pink. edges are uneven, granulation tissue is evident. skin has brown pigmentation from accumulation of metabolic waste (from venous stasis), peripheral edema. |
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Major complication r/t abdominal aortic aneurysm resection or repair
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renal failure b/c often too much blood is lost during surgery & renal arteries maybe hypoperfused for a short time during surgery
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how do you assess client for renal failure
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hourly I&O,
urine output (should be >50 cc/hr), BUN, creatinine levels. |
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clinical manifestations of abdominal aortic aneurysm
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"heart beating" in the abdomen while supine or being able to feel the mass throbbing.
A pulsatile mass maybe palpated in the middle & upper abdomen. A systolic bruit may be auscultated over the mass. *not all clients exhibit these sx* |
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how would you know if pericardiocentesis was successful for a client with cardiac tamponade
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rise in BP
fall in CVP client usually expresses immediate relief heart sounds are no longer muffled or distant |
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Expected finding of NV assessment of a client who underwent aortoiliac bypass graft
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warmth, redness and edema in the affected extremity b/c of increased blood flow
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contraindication to thrombolytic therapy e.g. Streptokinase
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uncontrolled bleeding
severe uncontrolled hypertension d/t risk of cerebral hemorrhage |
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antidote of Coumadin
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Vit. K (AquaMEPHYTON)
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why do we start clients on Coumadin while they're on Heparin (for the last couple of days before d/c)
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Coumadin works in liver & inhibits synthesis of 4 Vit.K-dependent clotting factors but it takes 3-4 days before the therapeutic effect of Coumadin is exhibited.
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what's the therapeutic range of prothrombin time
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1.5 to 2x control value
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antidote for Heparin
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Protamine sulfate
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Do not take BP within ____ min after nicotine or caffeine ingestion
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30
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client had a percutaneous insertion of IVC filter & was on heparin before surgery.
You need to watch out for |
bleeding & infection
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client diagnosed with Raynaud's disease should
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eliminate caffeine
stop smoking Nifedipine (Procardia) may help decrease vessel spasms avoid exposure to cold |
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what is thromboangiitis obliterans (Buerger's disease)
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uncommon disorder
inflammation & thrombosis of smaller arteries and veins most common in young adult males who smoke cause unknown, suspected to have auto-immune component |
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pulmonary embolism (PE) is a life-threatening complication of
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DVT and thrombophlebitis
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most common sx of PE
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chest pain, shortness of breath
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most common complication of placing a permanent or temporary pacemaker
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pacing electrode dislodgement
limit client's activities |
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AICD (automatic internal cardioverter-defibrillator)
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detects and delivers an electrical shock to terminate life-threatening episodes of V. tach and V. Fib
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energy levels used to defibrillate a client in V. Fib:
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200-300-360
(1st-2nd-3rd shocks resp.) |
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V. Fib is characterized by
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irregular, chaotic undulations of varying amplitudes.
no measurable rate no visible P waves or QRS complexes |
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what is done for rapid-rate A. Fib
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carotid sinus massage- for vagal stimulation to decrease rapid HR and possibly terminate a tachydysrhythmia
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vagal stimulation can be done by
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carotid massage
gag reflex asking client to strain or bear down |
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A. Fib is characterized by
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loss of P waves
QRS is often normal irregular ventricular rate, range 60-100 bpm (controlled) or 100-160 (uncontrolled) |
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A. Fib rate: 150 bpm.
Assess client for |
hypotension and dizziness
risk of low CO (loss of atrial kick) also assess for palpitations, chest pain, pulse deficit, syncope, SOB, distended neck veins |
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client in unstable V. tach.
You instruct client to do what? |
perform cough CPR, i.e. Inhale deeply and cough forcefully q1-3 sec.
Cough CPR may terminate dysrhythmia or sustain cerebral & coronary circulation for a short time until other measures are implemented |
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client has just gone into V. Tach but is alert/awake and has good skin color.
What should you do? |
administer amiodrone (Cordarone) IV
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cardioversion vs defibrillation
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cardiovert when awake
Defib when unconscious |
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V. tach is characterized by
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no P waves
wide QRS intervals rate 100-250 impulses/min regular rhythm |
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_____ helps increase renal perfusion
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Dopamine
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pulmonary capillary wedge pressure is a reflection of
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left-ventricular end-diastolic pressure
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patient with MI is going into cardiogenic shock.
d/t myocardial ischemia, you would assess the patient for |
Ventricular dysrhythmias
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Digoxin works by
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exterting a + inotropic effect on heart, while slowing overall HR
#1 med for heart failure |
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Heart failure is caused (or exacerbated) by
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physical or emotional stress,
dysrhythmias, infections, anemia, thyroid disease, pregnancy, Paget's disease, nurtirional deficiencies (alcoholism, thiamine), pulmonary disease and hypervolemia |
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what should a client avoid before dipyridamole (Persantine) thallium-201 scan
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caffeine
alternative test to exercise thallium-201 scan |
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myocardial ischemia can be spotted on EKG by
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ST segment elevation or depression
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while performing CPR on adult client, sternum should be depressed ______ inches
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1-2
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Pulmonary edema is characterized by
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extreme breathlessness
dyspnea, air hunger, and production of pink-tinged sputum. Auscultation of lungs reveals crackles. |
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what medications should be avoided in a heart failure?
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Dilitiazem (Ca++ channel blocker), propranolol and metoprolol (B-adrenergic blockers) have negative inotropic effect and worsen a failing heart
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Spironolactone (Aldactone) is a
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K+ sparing diuretic
client should avoid foods high in K+while taking this drug (unless combined with another K+ losing diuretic) |
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Troponin T
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normal 0.1-0.2 ng/mL
anything >0.2 indicates MI |
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Tropinin I
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normal <0.6 ng/mL
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Troponin
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lab test ordered in clients with c/o chest pain to r/o MI
either Troponin T or I is checked more specific for heart injury as compared to CK-MB elevated for longer period of time (1-2 weeks) after MI |
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what does it mean if CK-MB, CK and myoglobin results are normal but Troponin results are elevated?
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either lesser degree of heart injury is present
or injury took place >24 hours ago |
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how reliable is Troponin test to r/o MI
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elevated Troponin should not be used alone to diagnose or r/o MI
some people having a MI have normal Troponin, while some people with elevated Troponin have no heart injury Troponin levels also increased in chronic or acute conditions (myocarditis, CHF, severe infections, kidney disease...) |
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How are LDH-1 and LDH-2 related to MI?
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LDH-1 and LDH-2 begin to elevate about 24 hrs after MI and peaks in 48-72 hrs.
They return to normal within 7-14 days thereafter. |
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If you give Lasix to client with K+ below normal range, what can happen?
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hypokalemia.
If client has hx of cardiac problems, it can precipitate ventricular dysrhythmias |
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normal PT value
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9.6-11.8 sec (Male)
9.5-11.3 sec (Female) Therapeutic PT level is 1.5-2x client's control value. |
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normal aPTT value
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20-36 sec (depending on the type of activator used for testing)
Therapeutic dose 1.5-2x normal range |
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normal Digoxin level
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0.5-2 ng/mL
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what is CPK
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cellular enzyme that can be fractioned into 3 isoenzymes:
CK-MB: elevates in MI CK-MM: skeletal muscle injury CK-BB: brain injury |
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client with varicose veins developed skin breakdown and secondary infection.
Legs should be elevated __________ |
higher than the heart.
to assist with return of venous blood to the heart. |
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normal Fibrinogen level is ________
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180-340 mg/dL for males and
190-420 mg/dL for females |
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critical Fibrinogen level is ________
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< 100 mg/dL
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with DIC, fibrinogen level ______
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decreases/ drops
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normal atrial pressure is _______
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1-10 mm Hg
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why is left atrial pressure recorded as mean (average) and not as systolic/ diastolic
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b/c left atrium does not generate significant pressure during atrial contraction
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pneumatic antishock garment is used to treat _____
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hypovolemic shock (to provide circulatory assistance)
temporary measure until definitive treatment is given can compromise blood flow to lower half of body |
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Quinidine sulfate is administered for A. Flutter or fibrillation only after the client has been __________
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digitalized
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Indications of right-sided heart failure
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peripheral or sacral edema,
JVD oraganomegaly |
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what assessment would elicit information about Left-sided heart failure
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lung sounds (crackles)
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Intraaortic balloon pump therapy (IABP) is most often used in treatment of ________
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cardiogenic shock
most effective if balloon is inserted early in the course of tx. contraindicated in clients with aortic insufficiency & thoracic and abdominal aneurysms. |
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Intraaortic balloon pump therapy (IABP)
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is a mechanical device used to decrease myocardial O2 demand and increase CO
It consists of a cylindrical balloon that sits in the aorta and counterpulsates. That is, it actively deflates in systole increasing forward blood flow by reducing afterload, and actively inflates in diastole increasing blood flow to the coronary arteries |
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normal INR levels for clients on Coumadin
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2-3
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recommended INR levels for clients with mechanical prosthetic heart valve (on Coumadin)
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2.5-3.5
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recommended INR levels for survivors of MI (on Coumadin)
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2.5-3.5
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Toxic shock syndrome
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caused by infection
often associated with tampon use complication: DIC |
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Captopril is a _____
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ACE inhibitor
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cardiac tamponade is characterized by
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tachycardia
distant or muffled heart sounds JVD, or falling BP accompanied by pulses paradoxus (drop in inspiratory BP >10 mm Hg) |
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Raynaud's disease is characterized by
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diminished or absent peripheral pulses
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Regarding smoking, what is meant by the term 'pack years'
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# of cigarettes smoked daily + duration of the habit
standard method of documenting smoking history |
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how would you position a client for pericardiocentesis
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supine with HOB elevated 45-60 degrees
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a complication of pericarditis
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cardiac tamponade
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PVCs are
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abnormal ectopic beats originating in the ventricles.
characterized by absence of P waves wide and bizzare QRS complexes & a compensatory pause that follows the ectopy |
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how do you differentiate pericarditis from other cardiopulmonary problems
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pericardial friction rub
chest pain that worsens on inspiration (pericarditis and pleurisy) |
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pericardial friction rub
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heard with inflammation of the pericardial sac during the inflammatory phase of pericarditis.
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Characteristics of arterial ulcers
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pale, deep base
surrounded by tissue that is cool to touch trophic changes: dry, soluble skin & loss of hair |
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arterial ulcers are caused by ______
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tissue ischemia from inadequate arterial supply of oxygen and nutrients
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Triamterene (Dyrenium) is a
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K+ sparing diuretic (anti-hypertensive medication)
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Name some fruits naturally high in K+
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avocado, bananas, fresh oranges, mangoes, nectarines, papayas and dried prunes
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d/c instructions for clients with Automatic Internal Cardioverter-defibrillator include
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avoid tight clothing or belts over AICD insertion site
avoid rough contact with insertion site avoid electromagnetic fields (e.g. electrical transformers, radio/TV/radar instruments, metal detectors. and running motors of cars or boats) avoid MRI |
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Digoxin maybe held ____hrs before cardioversion
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48 hrs
b/c it increases ventricular irritability and may cause ventricular dysrhythmias after the countershock |
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If a client is receiving oxygen via nasal cannula, what should you do BEFORE cardioverting the patient
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temporarily REMOVE oxygen
oxygen supports combustion and a fire could result from electrical arcing. |
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cardiomyopathy patients should be instructed to
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change positions slowly.
Risk of orthostatic hypotension r/t venous return obstruction sudden changes in BP may lead to falls |
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Ferrous sulfate is an iron preparation and should be taken with ______
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orange juice or other Vit.C containing product to increase absorption.
Milk products inhibit absorption |
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Edema is fluid accumulating in the _____
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intercellular spaces
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"pitting edema" leaves a ____ in the skin
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dent
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pitting edema is graded on a _____ point scale
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4
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1+ edema
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mild pitting
slight indentation no perceptible swelling of the leg |
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2+ edema
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moderate pitting, indentation subsides rapidly
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3+ edema
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deep pitting
indentation remains for a short time leg looks swollen |
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4+ edema
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very deep pitting
indentation lasts a long time leg is very swollen. |
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usual rate in V. Tachy is _______
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140-180 bpm or more
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what drug would help a client that has decreased CO, that would also help increase BP?
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Dopamine
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Dopamine receptors are found in _______
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renal blood vessels and the nerves
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A hypothermic client would exhibit ______________
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decreased HR and decreased BP
metabolic needs of body are reduced in this condition. |
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cardiac output is the _____
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total amount of blood ejected from the ventricle per minute.
CO= SV x HR |
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amount of blood ejected from the ventricles with each heart beat
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Stroke volume
Normal= 70 cc |
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% of left ventricular end-diastolic volume ejected during the systole
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Ejection fraction
Normal= 60-70% |
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3-layered vessels (intima, media, adventitia) that carry oxygenated blood from the heart to the tissues
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arteries
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small resistance vessels that feed into capillaries
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arterioles
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join arterioles and venules
Larger, lower-pressure vessels than arterioles where all the nutrients and wastes are exchanged |
capillaries
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join capillaries and veins
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venules
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large-capacity, low-pressure vessels that return unoxygenated blood to the heart
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veins
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non-invasive test that gives graphic representation of the heart's electrical activity
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Electrocardiogram (ECG/EKG)
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Holter monitoring
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Ambulatory (24-hr) EKG test
records heart's activity and cardiac events over a 24-hr period |
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Instructions for clients undergoing Holter test:
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- Keep an activity diary
- Do not take a shower/ bathe, operate machinery, use a microwave or an electrical shaver while wearing the monitor |
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Cardiac Catheterization and arteriography (angiography)
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injection of radioopaque dye through a catheter
then, fluoroscope is used to examine the coronary arteries and intracardiac structures also used for monitoring ICP, oxygenation, and CO |
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Instructions for client undergoing Cardiac catherization
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- NPO after midnight
- Baseline VS and peripheral pulses - Obtain written, informed consent - Instruct that flushing of face, nausea or sudden urge to urinate may occur immediately after dye injection - Allergies to iodine, seafood, dyes?? |
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Cardiac Catheterization post-op care
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- Monitor VS, peripheral pulses & injection site for bleeding
- Pressure dressing and bedrest for 8 hrs - Keep leg straight for 6-8 hrs (if femoral approach) and keep arm straight for 3 hrs (if AC approach) - Encourage fluids unless contraindicated - Report any c/o chest pain immediately |
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non-invasive examination of the heart that uses sound echoes to visualize intracardiac structures and monitor the direction of blood flow
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Echocardiography
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Client must be able to lie still for _________ for Echo
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30-60 min
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Stress test (exercise EKG)
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noninvasive test that studies the heart's electrical activity and monitors for ischemic events during increasing exercise
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The client should report ______ during a cardiac stress test
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- chest pain/ discomfort
- SOB - fatigue - Leg cramps - diziness |
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uses IV injection of radioisotopes to examine heart
helps determine myocardial perfusion and contractility |
Nuclear cardiology
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Digital subtraction angiography
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invasive procedure involving fluoroscopy with an image intensifier
allows COMPLETE visualization of arterial blood supply to a specific area |
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after the digital subtraction angio, encourage client to ______
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drink at least 1 qt (1 L) of fluid
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Hemodynamic monitoring (also called single procedure monitoring or continuous monitoring)
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uses a balloon-tipped, flow-directed pulmonary artery catheter
measures intra-cardiac pressures and CO |
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What needs to be done after hemodynamic monitoring device has been inserted?
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- monitor site for infection
- assess for arrhythmias, hemorrhage, clot formation, air embolus or spontaneous wedging of the cardiac balloon - monitor pressure tracings and record readings |
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chest x-ray can determine/ detect _______
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- size and position of the heart
- presence of fluid in the lungs - other abnormalities (e.g. pneumothorax) |
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Before chest x-ray, make sure ______
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- all jewelry is removed
- determine client's ability to hold breath |
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arterial blood gas (ABG) assess arterial blood for _______
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- oxygenation
- Ventilation - acid-base status |
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Before drawing an ABG from patient, _____
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- document patient's temperature
- note whether client is receiving supplemental O2 and the amount - note mechanical ventilation along with the ventilator settings |
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After drawing an ABG from patient, _______
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- apply continuous pressure for 5 min on the insertion site
- periodically check the site for bleeding |
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Doppler ultrasound
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transforms sound wave echoes into audible sounds
allows examination of blood flow to the peripheral circulation |
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Venogram
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dye injected to allow visualization of the veins
used to dx DVT or incompetent veins |
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Before venogram, the nurse needs to do what?
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- Keep pt. NPO after midnight
- Baseline VS and peripheral pulses - informed consent - allergies to seafood, iodine, dye?? - client may experience flushing of face or throat irritation from injection of dye |
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for all cardiac disorders, the goal is to _______
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decrease cardiac workload
and increase myocardial blood supply |
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How do you separate pulse ox reading from o2-sat obtained from ABGs?
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pulse ox: SPO2
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abdominal aortic aneurysm results from
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damage to the medial layer of abdominal portion of the aorta
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dissecting aneurysm
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vessel wall ruptures and a blood clot is retained in an outpouching of tissue
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3 types of aortic aneurysms
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false (pulsating hematoma s/t trauma )
fusiform (bilateral outpouching) saccular (unilateral outpouching) |
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S/S of abdominal aortic aneurysm
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-abdominal mass to the left of midline
-abdominal pulsations -bruits over the site of aneurysm -diminished femoral pulses -Lower back/abd pain -SBP in legs lower than SBP in arms |
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treatment for abdominal aortic aneurysm
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abdominal aortic aneurysm resection
rest |
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drug therapy for abdominal aortic aneurysm
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- Oxycodone
-B-blockers (metoprolol, propanolol) -anti-hypertensives (minipress, Nitropress, NTG) |
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#1 risk for patients with aortic aneurysm
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hypovemia --> shock
-monitor VS -I&Os -Lab results -S/S of shock |
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during anginal pain episode, EKG shows
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-ST depression
-inverted T |
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How do you differentiate anginal pain from MI pain
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MI pain lasts longer
-cardiac enzymes are abnormal in MI (not in angina) |
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treatment of angina
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-diet & lifestyle change
-PTCA, stent placement -CABG -oxygen 2-4L |
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meds for angina
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-Heparin
-aspirin -beta blockers -ca+ channel blockers -nitrates (NTG) |
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do not give NTG to patient who presents with angina whose SBP is <
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90
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do not give beta blockers to patients presenting with angina whose HR is <
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60
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clients with angina should seek medical attention if chest pain lasts longer than
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20 min
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Mitral Valve Stenosis
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Blood backs up into the left atrium and lungs, pulmonary congestion occurs and the right ventricle eventually dialates and fails.
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Central Venous Pressure (CVP)
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CVP measures preload and is used for the RIGHT side of the heart.
NORMAL VALUE: 2-8 mmHg ELOW 2: dehydration, blood loss ABOVE 8: Fluid Overload |
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What is Starling's Law?
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Starling's Law is the more preload the greater the cardiac output to a physiological point. After that physiological point the cardiac output decreases.
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Cardiomyopathy
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Enlarged heart
Chronic disease of cardiac muscle Cause unknown |
