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34 Cards in this Set
- Front
- Back
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Regurgitation
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a backflow of blood into the atria during systole (L & B p. 985)
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Valvuloplasty
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general term for reconstruction or repair of the heart valve. Methods include patching the perforated protion of the leaflet, resection excess tissue, debriding vegetations or calcification, and others. (L & B 1060)
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Ventricular Assist Device
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VADs aid the failing heart. It temporarily takes partial or complete control of cardiac function, depending on the type of device used.
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Annuloplasty
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repairs a narrowed or an enlarged or dilated valve annulus, the supporting ring of the valve. A prosthetic ring may be used to resize the opening, or stitches and purse-string sutures may be used to reduce and gather excess tissue. Used for either stenotic or regurgitant valves (L & B 1060)
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Stenosis
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a narrowed fused valve obstructs forward blood flow. Regurgitation occurs when valves fail, allowing blood back through it. Usually left side of heart..Mitral most (L&B 1043)
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What is the nursing care for a VAD
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supportive and includes assessing hemodynamic status and for complicaitons associated with the device like infection (aseptic technique), pneumonia (immobility). Mechanical failure is life threatening and requires immediate intervention. (L & B p. 990)
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Cardiac Output (CO)
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CO is the am ount of blood pumped by the ventricles into the pulmonary and systemic circulation in 1 minute. CO=SV X HR (L&B p. 940)
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Stroke Volume (SV)
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SV is the difference between end -diastolic volume and end- systolic volume. SV ranges from 60 -100 mL/beat and averages 70 mL/beat in and adult. (L & B p. 940)
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HEART RATE
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Direct stimulation through innervation of the heart muscle by the sympathetic (increase) and parasympathetic nerves (decrease). Indirect can be a response to BP. (L & B p. 940)
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what affects preload
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influenced by venous return and compliance of the ventricles. Greater volume, greater stretch, greater force (starling law) (L& B 940)
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what affects afterload
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alterations in vascular tone (L & B 940)
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What types of drugs do you give a patient who is having an MI
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analgesia: aspiring, morphine sulfate
fibrinolyntics: tPA, TNK antidysrhythmics:verapamil, esmolol Beta blockers anticoagulants: heparin, MOAN |
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What are the signs of MI?
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1.pain is classic- radiating to neck, jaw shoulder lasting more than 15-20 minutes
2. decreased LOC 3. cool clammy skin, diphoresis 4. hiccuping can be first sign due to diaphramatic irritation |
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Which test is best for diagnosis of MI
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Troponin T and I as they are specific to heart muscle
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what is he desired LDL
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130mg/dL
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what is the desired cholesterol
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under 200mg/dL
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what is the desired HDL
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over 35 mg/dL
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what is the suggested triglyceride level
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less than 150 mg/dL
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what is the treatment of MI
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1. Medications
2. Oxygen 3. IV 4. bed rest 5. possible IABP, VADs, 6. liquid diet |
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IABP
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intra-aortic balloon pump
temprorarily supports cardiac function by allowing the heart to recover from MI |
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when does the IABP catheter inflate
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during diastole so as to increase perfusion of the coronary and renal arteries (p. 990)
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when does the IABP deflate
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just prior to systole to decrease afterload and cardiac workload (990)
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what is the most common health issue after MI
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cardiac dysrythmia
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what is the affect of an anterior wall infarct
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decrease CO
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what is percutaneous coronary revascularzation
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catheter threaded to heart where angioplasty balloon is inflated, stent added
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what artery is commonly used for CABG
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internal mammary
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what vein is commonly used for CABG
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saphenous vein in the leg
NOTE: it is reversed so that its valves do not interfere with blood flow (p. 978) |
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why do we m onitor I/O, electrolytes, BUN, Creatinine, and CBC after PCR
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contrast dye causes osmotic diuresis and may cause renal damage or hypersensitivity reaction. Electrolyte imbalances increase the risk of dysrhythmias.
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what is atropine's effect on vagal tone and heart rate
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decreases vagal tone, increases heart rate.
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what are the signs of cardiac tamponade
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increased HR
decreased BP decreased Urine Output Muffled/distant heart sounds dimished peripheral pulses NOTIFY DOCTOR IMMEDIATELY |
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why do we want to avoid cardiac tamponade.
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interferes with the ventricle filling and contraction, decreasing cardiac output. Untreated it leads to cardiogenic shock and possible cardiac arrest.
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what are rewarming measures for hypothermia after CABG
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warmed IV solutions or blood transfusion
warm blankets warm inspired gases, radiant heat lamp give thorazine, morphine, or diltasem to relieve shivering |
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why do we want a cardiac patient to not be hypothermic
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shivering causes increased oxygen demand and consumption. Hypothermia can also increase risk of hypoxia, metabolic acidosis, vasoconstriction, and increased cardiac work, altered clotting, and dysrhythmias.
(p. 981) |
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what is cardiac tamponade
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compression of the heart that occurs when blood or fluid builds up in the space between the myocardium (heart muscle) and the pericardium (outer covering sac of the heart)
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