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22 Cards in this Set

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Cardiac output (CO)

CO=HR × SV


the average adult CO ranges between 4-8 L/min



CO is determined by the interaction of 4 major factors: heart rate, preload, afterload, and contractility.

Stroke Volume (SV)

The difference between the end- diastolic and rhe end-systolic volume. Average is about 70mL/beat and can range 60-100mL/beat in an adult.

Contractility

The ability of the cardiac muscle fibers to shorten.

Preload

The amount of cardiac muscle fiber tension, or stretch, that exists at the end of diastole, just before the contraction of the ventricles.

Afterload

The force the ventricles must overcome to eject their blood volume. It is the pressure in the arterial system ahead of the ventricles.

Nursing considerations for a Cardiac Catheterization

No food or drink for 6 to 8 hours. Assess for shellfish or iodine allergies. Assess for use of aspirin or NSAIDS, viagra, or hxt of renal disease. Take and record vital signs, including peripheral pulses. After procedure, monitor vital signs every 15 minutes for the first hour and then every 30 minutes until stable. Assess cardiac rythm and per. pulses distal to the insertion site. Monitor for bleeding and lay patient flat. Increase fluids.

Blood pool imaging

No special preperation needed.

Cardiolite scan

Avoid caffiene for 12 hrs before the test.

Chest x-ray

Ask for date of LMP if female.

CT-scan

Assess for allergies of iodine and shellfish, NPO for 4 hours before test, and no metformin before test if using contrast medium. Remove hairpins, earrings and dentures.

Echocardiogram

No special prep needed.

Electrocardiogram (ECG)

No special preperation needed.

Blood lipid test

No special preperation needed. Reccomend a low-fat meal the evening prior to the test, then no food 8-12 hours. No alcohol 24 hours before the test. Assess meds, blood lipids may be increased by thyroxine, estrogens, aspirin, antibiotics (tetracycline and neomycin), nicotinic acid, heparin, and colchicine.

Normal cholesterol levels

Cholesterol: 140-200 mg/dL


Triglycerides: 40-190 mg/dL


HDL:


Men: 37-70mg/dL


Women: 40-88mg/dL


LDL: < 1mg/dL

MRI

Check for metal implants, jewelry, and tattoos. Remove all transdermal patches. Ask if patient is pregnant.

Stable angina

Most common and predictable form of angina. Caused by physical exertion, exposure to cold, or by stress. Stable angina is treated with rest and nitrates.

Prinzmetal's (variant) angina

Atypical angina that occurs unpredictably (unrelated to activity), and often at night. Caused by coronary artery spasm.

Unstable Angina

Occurs with increasing frequency, severity, and duration. Pain is unpredictable and occurs with decreasing levels of activity or stress and may occur at rest. Patients are at risk for myocardial infarction.

Angina treatment

Nitroglycerin, beta blockers, calcium channel blockers, and aspirin.

Acute Coronary Syndrome (ACS)

A condition of unstable cardiac ischemia. ACS includes unstable Angina and acute myocardial ischemia with or without significant injury of myocardial tissue. Most common cause of sudden cardiac death.


Chest pain occurs at rest; increasing frequency and severity. Lasts >10 min. Radiates to neck, left shoulder and arm. Sometimes epigastric. Dyspnea, tachycardia, hypotension, with cool pale skin.


ECG: ST-SEGMANT depression, t-wave inversion.


Treated with:


Fibrolytics, nitrates, and beta blockers, antiplatelet drugs and possible purcutaneous coronary revascularization in the cardiac cath lab.

Coronary Artery Bypass Grafting (CABG)

Uses a section of a harvested Vienna artery to create a bypass between the aorta and the coronary artery beyond the obstruction.



Preoperative care: verify presence of lab and diagnostic tests including CBC, coagulation profile, urinalysis, chest x-ray, and coronary angiogram. Type and cross match 4 or more units of blood as ordered. Teach about the cardiac recovery unit, tubes, drains, and general appearance. Monitoring equipment. Respiratory support. Incisions and dressings. Pain management.


Post operative care: decreased cardiac output. Monitor vital signs, O2, and hemodynamic parameters every 15 min. Auscultate heart and breath sounds on admission and at least every 4 hours. Assess skin color, temp and Peripheral pulses, LOC with vital signs. Continuously monitor and record cardiac rythm. I & O's. Record chest tube output hourly. Monitor hemoglobin, hematocrit, and serum electolytes. Administer IV fluids, boluses, and blood transfusions as ordered. Administer meds as ordered. Keep a temp pacemaker at the bedside.


Monitor vital signs, O2, and hemodynamic parameters every 15 min. Auscultate heart and breath sounds on admission and at least every 4 hours. Assess skin color, temp and Peripheral pulses, LOC with vital signs. Continuously monitor and record cardiac rythm. I & O's. Record chest tube output hourly. Monitor hemoglobin, hematocrit, and serum electolytes. Administer IV fluids, boluses, and blood transfusions as ordered. Administer meds as ordered. Keep a temp pacemaker at the bedside.


Acute Myocardial Infarction (AMI)

Necrosis of myocardial cells.


Pain (crushing and severe), anxiety, tachycardia, tachypnea, cool clammy skin, impending sense of doom are manifestations.


Treatment: MONA, then amioderone, antifibrolytics, beta blockers, calcium channel blocker, ACE inhibitor, anticoagulants/antiplatelet, and anyilipemics. Possibly dopamine if pump failure and hypotension.