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Med-surg ch 19
pt's w/Cardiac disorders
| Question | Answer |
|---|---|
| Ablation | surgical destruction of tissues that cause irrugular dysrhythmia, this is done when drug therapy does not work on patients. |
| Arrhythmia | these are are disruptions of the normal electrical conduction in the heart |
| Atrial Fibrillation | dysrhythmia that causes the atria to quiver rather than conatract; it causes a drop in cardiac output; predispose pt to clot formation in the atria; Pt's placed on coumadin therapy. |
| Cardiac Tamponade | is when excessive fluid builds up in the pericardial sac; the fluid restricts the filling and pumping of the heart and if untreated can cause death. |
| Cardiomyopathy | the degeneration of the heart, can be caused from a viral infection. |
| Dysrhythmia | these are are disruptions of the normal electrical conduction in the heart |
| effusion | accumulation of (serous) fluids in the pericardium |
| Endocarditis | infection of the lining of the heart |
| Friction Rub(pericardial) | this is the high pitched scratchy sound heard when a patient has pericarditis |
| Infarct | these cause Valvular disorders and are localized areas of necrosis produced by ischemia caused by obstructed aterial supply or inadequate venous drainage. |
| Orthopneic position | Patient sits up in bed with 2-3 pillows behind the back to aid breathing |
| Palpitation | these are abnormally rapid throbbing or flutterings of the heart. |
| Pericardial Effusion | this occurs when there is a excessive amount of fluid in the pericardial sac because of inflammation. |
| Pericardiocentesis | this procedure is opening up the pericardium and removing fluid, used to treat pericarditis, |
| Pericardiotomy | opening up of the pericardium, used to treat pericarditis |
| Pulsus Paradoxus | this is a drop in systolic BP greater than 10mm Hg upon inspiration |
| This disease is a complication of other cardiovascular diseases rather than a disease in itself | HF- heart failure |
| congestion | this is when the heart is unable to move blood as quickly as it should. this is what happens with HF |
| Left sided HF | <cardiac output; backup of fluids into pulmonary sys.; fatique; dyspnea; wheezing, orthopnea, pulmonary edema w/pink frothy sputum; pallor; clammy skin |
| Right sided HF | <contraction strength of rt atrium & ventricle because of thickening of Myocardium; fatigue; edema in sacrum-legs-feet-ankles; abdominal distention R/T ascites; weight gain; Dyspnea |
| Dependent or pitting edema is a sign of which type of heart failure? | 1st evident in the lower extremities when a patient has right-sided heart failure |
| <blood flow to and from the kidneys leads to what? | impaired renal function which prevents normal excrition of urine and causes more accumulation of body fluids |
| When u have inadequate circulation to and and from the brain what may happen? | The patient may become confused and irritable, and condition may progress to dilirium and coma |
| How is HF diagnosed? | via the signs and systoms, echocardiogram-ECG, and cardiac enzymes levels |
| What are the 6 treatments for heart failure? | ICD-implantabe cardioverter-defibrillators;LVADs; ventricular restoratation surgery; heart atransplant; IABP-intraaortic ballon pump; biventricular pacemaker-CTR cardiac resynchronization therapy. |
| what medical interventions are used to treat HF? | Beta-adrenergic blockers, ACE inhibitors, Diuretics, Digitalis, Venous Vasodialtors-nitroglycerin, Morphine, lifestyle modifications. |
| How does Digitalis work to aid in HF? | It > the force of heart contractions and slow the rate, thus > cardiac output. Ex:Digoxin-Lanoxin |
| How do Venous Vasodialtors work? | They relax and dilate blood vessels thus allowing them to accommodate larger %'s of the total blood volume. |
| How does Morphine work? | it relives anxiety and makes breathing easier. |
| Other signs of Heart failure? | >Fatigue, cough, feeling bloated, <appetite, jugular venous distention, feeling warm, anxiety , irritability, depression, pale cool skin, cyanosis of nail beds, dependent edema, <pheripherial pulses, <urine output, lung crackles, extra S3 sound. |
| When caring for patients with heart failure what should the nurse be prepared to do? | plan to give the patient extra time to performe ADL's because they tire early because of oxygen deficiency. |
| What 2 electrolytes are important to monitor when patients have heart failure because their imbalance can cause serious cardiac Dysrhythmias? | Sodium and Potassium |
| what things are important to check for when caring for patient with heart failure? | watch patient I&O, and watch for good skin care because Edematous tissue breaks down easily. |
| This complication of HF causes patient to have severe Dyspnea, cough w/frothy pink sputum, tachacardia, moist bubbling respirations with cyanosis. | Acute Pulmonary Edema |
| Patients with acute pulmonary Edema should be put in what position? | High Fowlers |
| Where do impulses originate in the heart? | The SA node and the Av node. |
| What is the NSR-normal sinus rhythm of a healthy heart? | 60-100 bpm |
| This type of dysrhythmia produces a pulse < 60 bpm and may drop cardiac output enough to < blood flow. | Bradycardia |
| This type of dysrhythmia produces a pulse >100-120 bpm and the ventricles don't have enough time to fill with blood and won't be able to pump effectively, and cardiac output falls. | Tachycardia |
| What med is used for patients that have atrial fibrillations? | Warfarin-Coumadin(anticoagulant); report bleeding and brusing with this medicine |
| What 2 test are done for patient that are on anticoagulants? | PT-prothrombin time, INR-internatinal mormalized ration |
| look at pg 472 for different types of dysrhythmias | |
| These are used to manage chronic and life threatening dysrhythmias? | Pacemakers |
| Patients that have a temoprary pace maker wire removed may have what? | Cardiac Tamponade,where excessive fluid builds up in the pericardium |
| patients that have supraventricular tachycardia or atrial fibrilation and don't respond to drug therapy are treated with this? | Cardioversion |
| When caring for a patient with a permenmant pacemaker, what should the nurse monitor? | HR, rhythm, inserstion site, dressing change, vital signs, perpheral pulses distal to the insertion site |
| Patients with a pace maker are prone to getting an infection of the lining of the heart called what? | Endocarditis |
| Inflammation of the heart muscle? | Myocarditis |
| Inflammation of the sac surrounding the heart, treated with antiinflammatories? | Pericarditis |
| Which conditions may cause Acute Pericarditis? | MI, Rheuamtic fever, Lupus, viral infection, renal failure, cancer treatments, or trauma. |
| When the inflammation in the Pericardium causes excess fluid build up this condition is called what? | Pericardial Effusion |
| What are the common infective agents that cause infections of the heart? | Staphylococci, Pneumococci, gonococci, bacilli, fungi |
| What is the most common cause of cardiac inflammation in children? | untreated Strep throat, caused by Streptococcus A |
| when there is inflammation of the heart what type of fluid is produced? | Serous Fluid |
| What may be affected if the effusion becomes excessive? | Cardiac Output |
| These are small deposites that accumulate on the valves and decrease the effectiveness of the valve and are commonly a cause for valve replacement? | Vegatation |
| Whic valve in the heart is the most common location of infection? | Mitral Valve |
| common causes of heart degeneration(cardiomyopathy? | alcohol, drug toxicity, crake cocaine use,pregnancy, immune disorders, nutritinal disorders. |
| name some signs of IE-infective Endocarditis? | >leukocyte count,slinter hemorrhages-thin black line under the nails, Pet.echiae inside the mouth |
| Each time the heart recovers from endocarditis there is scar tissue that causes what? | insufficiency(lack of closure) and the heart valves leak. |
| Stenosis | narrowing of the leaflet valves because of calcification and thickening. can be treated with valvoplasty of open the stenosed valves. |
| Symptoms of Pericarditis? | Tachycardia, chest pain eased by sitting and leaning foward, dyspnea, and pericardial friction rub. |
| Symptoms of cardiomyopathy | dyspnea, activity intolerance, angina, dizziness, hypertension, and palpations |
| What treatments are used to treat Pericarditis? | antiinflammatory agents |
| What treatments are used to treat Infective Endocarditis? | antiinflammatory agents and andiinfective agents. |
| When treating pericarditis and IE what test must be done frequently? | hearing test because some antibiotics can cause hearing loss |
| Which treatments are used for cardiomyopathy? | Digoxin, antihypertensives, diuretics, antidysrhymics, and anticoagulants. |
| patients with inflammatory heart disease are also prone to what other body system complications | respiratory and musculoskeletal problems |
| 2 types of valve disorders? | Stenosis, insufficiency |
| this valve disorder causes narrowing of the valve opening and an obstruction to normal blood flow? | valvular stenosis |
| In this valvular disorder the diseased valve is unable to close properly and blood flows back into th chamber after contraction, causing an overfilling. | valvular Insufficiency(incompetency or regurgitation) |
| Mitral Stenosis results in what? | the left atrium working harder to pump blood through the narrow mitral valve |
| Mitral insufficiency results in what? | blood flowing back into left atrium.both mitral stenosis and mitral insufficiency cause the atrium to dilate, thicken and work harder. |
| When atrial fibrillation occurs what may occur? | clots may form in the atria and be pumped into the circulatory system as a embloi, thus causing a MI. |
| With Aortic insufficiency what occurs? | blood backflows back into the left ventricle after it is pumped into the aorta. the ventricle will eventually fail because of the extra load of trying to pump out all the extra blood. |
| Signs and symptoms of mitral valve disorders? | cardiace murmur,progressive fatigue, external dyspnea, irregular HR. diagnosed by ECG or or cardiac catheterization |
| signs and symptoms of aortic valve disorder? | cardiac mumur, syncope , angina, dysrhythnmia, dyspnea, signs of HF |
| which kind of valve disorder had a greater chance of sudden death and why? | Aortic stenosis because there is a decrease blood flow to the coronary arteries. |
| What happens when cardiac output decreases? | venous pressure increases andand atrial blood pressure drops, followed by tachcardia |
| what can occur when there is chest trauma or contusion? | Dysrhythmias, and possibly cardiac tamponade if bleeding into the peicardial sac occurs |
| Cardiogenic shock | this is when the heart fails to pump sufficient amount of blood |
| Hypovelemia | < blood volume ,which may cause cardiogenic shock |
| signs of < cardiac output? | confusion, diaphoresis, restlessnes, rapid thready pulse,> respirations, cold clammy skin,< urine output |
| what signs indicate that a patient may need oxygen? | <Respirations, confusion, disorientation, irirability |
| normal O2 levels that patient should maintain?q | 90-100% |
| commonly used drug used to treat heart disorders? | Digitalis; has narrow theraputic range and can cause toxicity if increased by only 1/3 a dose |
| What drug is given when there is a overdose of digitoxin? | Digoxin Immune Fab(drug side effects are hypotension, hypokelemia, and worsened HF) |
| drug given to prevent clot formattion? | Heparin, ususally given by patient weight and their clotting time(PT-prothrombin time) |
Created by:
VRoberts
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