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112 Cards in this Set
- Front
- Back
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Angina
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chest discomfort or pain that occurs when myocardial O2 demand exceed supply
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What are some causes of angina?
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atherosclerosis, hypertension, coronary artery spasm, hypertrophic cardiomyopathy
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How would a patient describe angina?
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heavy, squeezing, pressing, burning, choking aching, feeling of apprehension
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How does angina pain radiate?
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radiates to left arm and or shoulder, jaw, right shoulder
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what would be some signs and symptoms of angina?
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dyspnea, tachycardia, palpitations, nausea, vomiting, fatigue, diaphoresis, pallor, weakness, synoscope, dysrhythmia
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Who is at higher risk for angina? (gender)
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male> female until menopause then =
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Who is higher risk for angina? (race)
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African americans
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When a patient is suffering from an angina, what is the nurse response?
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provide rest, take vitals, record an EKG, 3 nitro tabs 5 minutes apart
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What is a myocardial infarction?
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disruption in or deficiency of coronary artery blood supply resulting in necrosis of myocardial tissue
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What are some causes of MI?
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thrombus or clotting, shock, hemorrhage
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How would a patient describe a MI?
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heavy and vise-like pain often radiates to the shoulder and down arms,
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How does the pain of angina and MI differ?
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pain of MI is a sudden onsent
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If a patient had diabetic neuropathy, how would they describe a MI?
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no pain
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What are some S&S of MI?
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rapid, irregular and feeble pulse, decreased LOC, cardiac dysrhythmias, cardiogenic shock, fluid retention, narrowed pulse pressure, high pitched or absent bowel sounds.
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Out of the four, which would be appropriate for acute angina?
A: Digoxin B: Nitro C: Atropine D: Propranolol |
B: NItro
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Out of the four, which would be appropriate for long term management of angina?
A: Digoxin B: Nitro C: Atropine D: Propranolol |
D: Propranolol
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After an MI what is the nursing care?
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obtain vitals, give O2 @ 2-6l per nasal canula, obtain cardiac enzymes, assess breath sounds for rales, monitor fluid balance, keep in semi-fowlers position, maintain bed rest for 24 hr
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What medications increase BP?
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steriods and estrogen
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What is the number 1 cause of CVA in hypertensive clients?
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noncompliance with medication regimes
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what is the most important nursing implications for hypertensive patients?
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teaching
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Peripheral vascular disease
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circulatory problems that can be due to arterial or venous pathology
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95% of all cases of PVD are caused by what?
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arteriosclerosis
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What kind of pain does an arterial PVD experience?
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sharp, increase with waling and elevation, intermittent claudication - relieved by rest, rest pain - when horizontal
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What kind of pain does a venous PVD patient experience?
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persistent, aching, full feeling, dull sensation, relieved when horizontal
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What nursing implementations should be done for clients with PVD?
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monitor extremities, encourage nonrestrictive clothing, don't cross legs, change position frequently, encourage rest @ first signs of pain
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What kind of preoperative care do you give a patient with PVD?
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maintain affected extremity level (venous) or slightly dependent (arterial) @ room temp, protect from trauma
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What kind of postoperative care do you give a patient with PVD?
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assess surgical site for hemorrhage
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Why is sensation diminished with PVD?
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reduced blood flow
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Abdominal aortic aneurysm
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dilation of the abdominal aorta caused by a n alteration in the integrity of it's walls
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What is the most common cause of AAA?
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atherosclerosis
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What are the most common S&S for AAA?
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abdominal pain or lower back pain with the complaint of feeling their heart beat
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Why is it important to assess urinary output?
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decreased urinary output COULD be the first sign of cardiovascular problems
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How much blood do the kidneys filter a minute?
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1 l/min
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How much urine do the kidneys make?
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30 ml/hr
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If a patient comes in with a dissecting aortic aneurysm what should a nurse do?
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vital signs every hour, neurological vital signs, respiratory status, urinary output, peripheral pulses
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What is a possible side effect from clamping of arteries during an aortic aneurysm repair?
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kidney damge
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Thrombophlebitis
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inflammation of the venous walls with the formation of a clot
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If a person for sure has a DVT should you do the Homan sign?
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no - increased risk for embolism
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What is the Homan sign?
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squeezing the calf while dorisiflexing the foot - pain = positive for DVT
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What is the test that determines efficiency of heparin?
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partial thromboplasitin time PTT
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What is the test that determines efficiency of coumadin?
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prothrombin time PT
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Dysthythmias
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disturbances in heart rate or heart rhythm
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What causes dysrhythmias?
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disturbances in the electrical conduction of the heart
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What do people usually complain of when having dysrhtythmias?
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palpitations, synoscope, pain, dyspnea
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Atrial fibrillation
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chaotic activity in the AV node, no true P waves, visible irregular ventricular rhythm
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What is the treatment for atrial fibrillation?
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anticoagulant therapy, antiarythmic drugs, cardioversion
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Atrail flutter
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saw toothed wave form, fluttering in chest, ventricular rhythm states regular
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What do you do to treat atrial flutter?
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cardioversion, antiarrhythmic drugs, radiofrequency catheter ablation
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What is cardioversion?
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delivery of synchronized electrical shocks to the myocardium
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Ventricular tachycardia
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wide bizarre QRS
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What do you do and see if a patient id having ventricular tachycardia?
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check pulses, impaired CO, synchronized cardioverion, antarrhythmic drugs
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Ventricular fibrillation
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cardiac emergency, No cardiac output
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What is the assessment and treatment of ventricular fibrillation?
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CPR, defibrillation, antiarryythmic drugs
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What is a synchronous pacemaker?
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fires only when a patient's heart rate falls below a rate set on a generator
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What is a asynchronous pacemaker?
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fires at a constant rate
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Heart failure
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inability of the heart to pump enough blood to meet the tissue's oxygen demands
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What are the conditions that cause HF?
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ischemic heart disease, MI, cardiomyopathy, valvular heart disease, hypertension
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Does left sided HF result in pulmonary or peripheral edema?
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pulmonary
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Does right sided HF result in pulmonary of peripheral edema?
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peripheral
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What are the S&S of left sided HF?
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dyspnea, orthopnea, wet lung sounds, cough, fatigue, tachycardia, anxiety, restlessness, confusion
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What are the S&S of right sided HF?
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weight gain, distended neck veins, anorexia, nausea, nocturia, weakness
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Witha patient with HF how often should you take vital?
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Q4H
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Endocarditis
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an inflammatory disease involving the inner surface of the heart
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Pericarditis
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inflammation of the outer lining of the heart
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What are the S&S of endocarditis?
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fever, chills, malaise, night sweats, fatigue, murmurs, symptoms of HF, atrial embolism
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What are the S&S of pericarditis?
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sharp sudden sever pain, pericardial friction rub, fever
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What type if endocarditis effects healthy hearts?
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acute
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Which type of endocarditis effects those with preexisting problems?
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subacute
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Valvular heart disease
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heart valves that are unable to open fully or close fully
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Which valves are most commonly affected by valvular heart disease?
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left sidemitral then aortic
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Stenosis
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Valves don't open fully
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upon assessment of a patient with valvular heart disease what would you find?
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fatigue, dyspnea, orthopnea, hemoptysis, pulmonary edema, murmurs, angina, irregular cardiac rhythm
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Essential hypertension
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no known cause
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Secondary hypertension
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develops in response to an identifiable mechanism
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When doing a CV evaluation, what's the first thing you do?
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take a history
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When inspecting a patient for a CV problem, what do you look for?
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visible pulsations, color, exaggerated lifts, dyspnea
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What is the precodium?
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the external surface of the body overlying the heart and stomach
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When do men start having CV problems? Women?
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Men> 60
Women - after menopause |
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What do you palpate for on a patient with expected CV problems?
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thrills, pulses, edema, PMI
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Is S1 or S2 diastole?
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S2
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Is S1 or S2 systole?
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S1
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Is S1 or S2 Lub?
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S1
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Is S1 or S2 Dub?
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S2
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What is S3?
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rapid ventricular filling
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Who is S3 heard in?
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children and adults
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What is S4?
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atrial contraction to help ventricular filling
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Who is S4 heard in?
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healthy older adults, children, athletes
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when is the heart filling up?
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rest - diastole
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Which way do you turn a patient to hear heart sounds better?
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left
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Where do you listen for S1 and S2?
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S1 - apex
S2 - base |
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How do you listen for S3 and S4?
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apex of heart with patient on left side with the bell
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What may be the earliest sign of HF over 30?
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S3 - rapid ventricular filling
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Which valves are closed during S1 or systole?
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Mitral and tricuspid
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Which vales are closed during S2 or diastole?
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aortic and pulmonary
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When checking peripheral pulses, what is the main concern?
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that they are equal and regular
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When palpating an aneurysm what will it feel like?
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pulses go outward
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How long do you press to assess edema?
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5 seconds
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Where do you check for peripheral lymphedema?
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groin
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What could peripheral lymphedema signify?
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infection
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Do you use bell or diaphragm for carotids?
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bell
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What is a murmur heard between S1 and S2?
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systole murmur
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How do you know if leg pain is vascular or musculoskeletal?
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vascular pain increases with activity
musculoskeletal doesn't ease during rest |
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What grade is a murmur that is barely audible in a quiet room?
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grade 1
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What grade is a murmur that is clearly audible but quiet?
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grade 2
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What grade is a murmur that is moderately loud?
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grade 3
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What grade is a murmur that is loud with associate thrill?
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grade 4
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What grade is a murmur that is very loud with an easily palpated thrill?
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grade 5
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What grade is a murmur that is so loud you don't need a stethoscope with a palpable and visible thrill?
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grade 6
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What murmur sounds like Kentucky?
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S3 or ventricular gallop
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What murmur sounds like Tennessee?
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S4 or atrial gallop
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Pulse deficit
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radial pulse is slower than atrial
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How do you measure venous pressure?
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measure the vertical distance between the Angle of Louis and the highest level of the visible part of the internal jugular vein pulsation
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