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RN cardio
| Question | Answer |
|---|---|
| Anemia manifestations | Fatigue Pale Tachycardia Murmurs and chest pain Tachypnea |
| Iron Deficiency Anemia | Tachycardia Tachypnea Glossitis |
| Diet rich in iron | Meats Whole grains/enriched cereal Eggs Dark green leafy vegetables Beans Fruits |
| Meds for iron deficiency anemia | Iron dextran complex (INFed) |
| Thalassemia manifestations | 1) Present by 2 years of age 2) Physical and mental retardation 3) Splenomegaly and hepatomegaly (excess iron) 4) slightly jaundice |
| Thalassemia care | 1) splenectomy 2) vaccinations |
| Thalessemia meds | Deferoxamine (Desferal) Zinc Ascorbic Acid |
| Megaloblastic Anemia (Cobalamin deficiency) manifestations | 1)Peresthesia of the hands 2)Impaired thought processes 3)Intrinsic factor deficiency |
| Megaloblastic Anemia (cobalamin deficiency) Diagnostic Studies | 1) Observation of large and immature cells 2) Check Vit B12 levels 3) Schilling test |
| Megaloblastic Anemia (folic acid deficiency) Manifestations | Smooth, beefy red tongue |
| Megaloblastic Anemia (folic acid deficiency) causes | 1) hemodialysis 2) poor nutrition or GI issues 3) methotrexate 4) alcoholics |
| Foods rich in Vit B12 | 1) Liver, beef 2) shell fish 3) milk and dairy products 4) fortified cereal |
| Aplastic Anemia manifestations | 1) anemia 2) risk for infection 3) risk for bleeding 4) petechiae |
| Aplastic Anemia (people at risk) | Chemo patients |
| Aplastic Anemia causes | 1) radiation 2) infections 3) prednisone, methotrexate |
| Acute Blood Loss manifestations | 1) bleeding 2) low B/P 3) increased HR 4) decreased urine output 5) cold and clammy 6) shock (KEY) |
| Acute blood loss care | 1) apply pressure (on artery above injury) 2) blood transfusion |
| Sickle cell disease manifestations | 1) severe pain (cells accumulate and cause occlusions) 2) Chronic anemia |
| Sickle cell episodes (causes) | 1) exercise 2) stress 3) infection 4) blood loss 5) dehydration 6) living in high altitudes |
| Sickle cell disease | 1) common in African-Americans & Mediterraneans 2) autosomal recessive 3) abnormal Hgb S 4) incurable and fatal by middle age |
| Sickle cell treatment | 1) pain meds 2) oxygen 3) hydroxyurea (hydrea) |
| Sickle cell teaching | 1) avoid living in high altitudes 2) immunize 3) genetic counseling |
| Polycythemia manifestations | 1) HTN 2) Chest pain |
| Polycythemia complications | 1) thrombosis 2) stroke |
| Polycythemia care | 1) phlebotomy 2) aspirin/plavix 3) fluid intake 4) bone marrow suppression (hydrea) |
| Thrombocytopenia | Abnormal destruction of platelets Platelet count: <150,000 |
| Immune Thrombocytopenia Purpura | Autoimmune disease |
| Immune thrombocytopenia purpura treatment | 1) immunesuppressants (corticosteroids) 2) Rituximab (Rituxan) |
| Thrombotic Thrombocytopenia Purpura | related to drug toxicity or infections |
| Thrombotic thrombocytopenia treatment | 1) treat primary cause (drug toxicity or infection) 2) corticosteroids 3) plasmathoresis |
| Heparin induced thrombocytopenia (HIT) treatment | 1) Protamine sulfate (reversal agent) 2) Lepirudin (Refludan), Argatroban |
| Thrombocytopenia manifestations | 1) low platelet count 2) bleeding 3) petecheia 4) bruising |
| Hemophilia | Sex-linked recessive disorder with deficient or defective clotting factors |
| Hemophilia A | Boys who do not have enough Factor 8 |
| Hemophilia B (AKA Christmas disease) | Boys who do not have enough Factor 9 |
| Von Willebrand's disease | Boys with hemophilia who do not have enough Von Willebrand's Factor |
| Hemophilia manifestations | Slow, persistent bleeding |
| Hemophilia nursing considerations | 1) stop the bleeding 2) give deficient factor 3) Rest and ice 4) Pain relief 5) avoid aspirin |
| Hemophilia care | 1) give lacking factor 2) Desmopressin (DDAVP)- incr. VW & F8 3) Aminocaproic acid (Amicar) - inhibits clot breakdown |
| Disseminated Intravascular Coagulation | Bleeding and clotting disorder seen in really sick patients. Can be caused by Levophed & Dopamine |
| Disseminated Intravascular Coagulation diagnostic studies | 1) low Hgb 2) Low platelets 3) low fibrinogen 4) increased D-dimer 5) petechaie |
| Neutropenia | Neutrophil < 1000 |
| Neutropenia treatment | 1) Filgrastim (Neupogen) 2) Treat infections aggresively |
| Neutropenia nursing considerations | 1) hand washing 2) neutropenic precautions 3) bottled water only 4) no fresh fruits, plants or flowers |
| Leukemia | Cancer of the bone marrow, lymph system and spleen |
| Acute Myelogenous Leukemia | 1) abrupt and dramatic onset 2) decreased Hgb, Hct, Platelets 3) Affects adult 60-70 years old |
| Leukemia care | Goal: remission 1) chemo 2) stem cell transplant |
| Leukemia nursing considerations | Infection prevention and treatment |
| Hodgkin's Lymphoma | Malignant tumor of the lymph nodes (Reed-Sternberg cells) Linked to Epstein-Barr virus |
| Hodgkin's Lymphona manifestations | 1) enlarged lymph nodes 2) weight loss 3) fatige |
| Non-Hodgkin's Lymphona | 1) Involves B or T cell malignancies |
| Non-Hodgkin's Lymphona risks | malignancy related to immune suppressants (corticosteroid or methotrexate) |
| Multiple Myeloma | Plasma cell infiltrate bone marrow and destroy bone. Usually diagnosed in advanced stages. |
| Multiple Myeloma manifestations | 1) bone pain 2) pathological fractures (increased risk for kidney stones) |
| Multiple Myeloma diagnostic studies | 1) blood contains M proteins 2) urine containes Bence Jones proteins 3) bone marrow biopsy |
| Multiple Myeloma care | 1) increase fluids (flush out excess calcium) 2) radiation and chemo (early stages) 3) supportive (advance stage) |
| Fresh Frozen Plasma | Contains clotting factors. 1) Given to patients who are bleeding or using up their clotting factors 2) reversal agent for coumadin |
| Acute hemolytic blood transfusion reaction | Worst reaction to blood transfusion. Happens with the wrong type of blood |
| Circulatory overload with blood transfusions | This happens because blood transfusions are hypertonic. Watch elderly or pt with heart disease as it can throw them into CHF |
| Circulatory blood transfusion overload manifestations | Crackles can be heard during blood transfusion |
| Circulatory blood transfusion overload prevention | Administer Lasix |
| Transfusion related acute lung injury | Pulmonary edema with severe lung inflamation that occurs 2-6 hours after blood infusion and lasts up to 48 hours |
| Massive blood transfusion reaction | This reaction happens with replacement of total blood volume |
| Massive blood transfusion reaction prevention | warm blood before administration |
| Massive blood transfusion reaction causes | 1) lack of FFP, cryoprecipitate, platelets & plasma 2) drop in temp 3) citrate toxicity |
| Massive blood transfusion reaction care | 1) STOP infusion 2) return blood to blood bank 3) Infuse normal saline 4) notify physician 5) administer bolus benadryl and solumedrol IVP |
| Right coronary artery | Involves occlusion of RCA and will cause SN, AV node and bundles of HIS to become eschemic (look for changes in ECG) |
| Left main coronary artery | Also known as the "widow maker". An occlusion at the left main CA will cause sudden cardiac death |
| Normal cardiac output | 4-8 L/min (60-100 mL/beat) |
| Contractility treatment | Digoxin & Dobutamine |
| Afterload treatment | 1) Nitroglycerin, Nipride 2) Beta blockers |
| CHF treatment | 1) diuretics 2) fluid restriction 3) low sodium diet |
| Cardiovascular risk factors | 1) family hx (blood relative before age 50) 2) smoking 3) weight 4) pregnancy 5) sex (female present different than male) 6) alcoholics 7) sedentary lifestyle 8) sleep apnea 9) females on birth control |
| Preferred sleeping position for CHF pt | Sleep in recliner or in semi-Fowler's position |
| Key assessment for cardiac pt | key to watch HR on this pt (should be <100) |
| B/P in lower extremities | B/P in these extremities are 10 points higher |
| Essential diagnostic test for CHF pt | Elevated BNP |
| Lipid profile | Overall value to be <200 |
| LDL diagnostic lab | <100 |
| This lipid can be increased with Omega 3 fatty acids | HDL |
| Triglycerides diagnostic | < 150 (note: pt should be NPO 8-12 hrs) |
| CK-MB diagnostic | Heart specific cardiac marker. 1) rises 6 hrs after onset 2) peaks in 18 hrs 3) returns to baseline in 24-36 hrs) |
| Troponin | < 1.15 = normal Enzyme released from the heart muscle when damaged 1) begins to rise 4-6 hrs 2) peaks 10-24 hrs 3) detected 10-14 days after event |
| Gold standard diagnostic test for chest pain | 12-lead ECG. Looking for ST elevations |
| Echocardiogram | Ultrasound of the heart. Used for: 1) ability to see valves 2) wall movement 3) ejection fraction |
| Normal ejection fraction | 55-75% |
| Transesophagel Echocardiogram (TEE) | This diagnostic test looks at the heart through the esophagus. Pt should be sedated and NPO before procedure |
| Angiography | This is a diagnostic test that looks at coronary arteries of the heart. Involves injection of dye (watch for shell fish allergies) |
| Right-sided angiograph | Diagnostic heart cath testing coronary veins. Entry through inferior vena cava via femoral vein (requires bed rest) |
| Left-sided antiograph | Diagnostic heart cath testing coronary arteries. Entry through femoral artery, brachial artery or radial artery. Bed rest not required. |
| Treadmill Stress Test (pre-procedure) | 1) no caffeine 2) no smoking 3) no beta blockers 24 hrs. prior to test |
| Used for people who cannot tolerate treadmill stress test | Dobutamine Adenosine/Dipyridamole |
| Diagnostic tests used to test for perfusion | 1) treadmill stress test 2) dobutamine/adenosine stress test 3) thallium scan |
| Hypertension | B/P = 130-140 |
| Leading risk factor for CAD & stroke | HTN is the major risk factor for these |
| Hypertensive heart disease | 1) CAD 2) Left ventricular hypertrophy 3) heart failure |
| HTN complications | 1) stroke 2) PVD 3) nephrosclerosis 4) retinal damage |
| HTN care | 1) weight reduction 2) DASH eating plan 3) Na+ restriction 4) Avoid alcohol 5) Physical exercise 6) stop smoking 7) stress management |
| HTN drug therapy | 1) diuretics 2) ACE & ARBs 3) Beta blockers 4) Alpha adrenergic blockers 5) vasodilators 6) Ca+ channel blockers |
| Hypertensive Crisis manifestations | 1) headache 2) blurred vision 3) nausea and vomiting 4) confusion and seizures |
| Hypertensive crisis risks | 1) stroke 2) kidney failure 3) aortic dissection |
| Hypertensive crisis | Diastolic B/P >140 |
| Hypertensive crisis treatment | Lower B/P slowly with meds (Nipride) |
| Coronary artery disease | cholesterol and lipids build up on the inner lining of the vessels |
| Fatty streak | earliest development stage of CAD (lesion present by the age of 15) |
| Fibrous Plaque | inflammatory result of fatty streak. Lesion begins to harden (begins at age 30) |
| CAD non-modifiable risk factors | 1) African-American 2) White middle-aged men above 65 3) Post-menopausal women |
| CAD modifiable risk factors | 1) Diabetes Mellitus 2) Metabolic syndrome 3) Phychological state 4) Elevated homocysteine |
| Treatment for CAD risk factors | 1) maintain ideal body weight 2) exercise 3) eat low sodium diet 4) quite smoking 5) avoid alcohol 6) intake of omega 3 fatty acids 7) limit red meat |
| Drug therapy for CAD risk factors | 1) cholesterol lowering 2) antiplatelet therapy |
| Chronic stable angina | Presents as intermittent and consistent chest pain lasting 3-5 min. Pt usually carries a small bottle of nitroglycerin |
| Silent ischemia | Chronic stable angina common in diabetics |
| Prinzmetal's angina | Chronic stable angina occuring at rest. Seen in pt who has a hx of migraines or raynaud's |
| Questions to ask a pt who presents with chest pain | 1) What were you doing? 2) When did the pain start? 3) Describe the pain 4) Does the pain radiate 5) WHAT WERE YOU DOING WHEN IT STARTED (KEY) |
| Drugs to treat angina | 1) nitroglycerin 2) beta blockers 3) Ca+ channel blockers 4) ACE inhibitors |
| Drugs that decrease workload of the heart | 1) Beta blockers 2) Ca+ channel blockers 3) ACE, ARB inhibitors |
| Cardiac catherization | 1) Done if pt has failed a stress test 2) Positive ECG findings |
| Acute Myocardial Infarction (MI) manifestations for women vs. men | Male: pressure on chest Female: fatigue, SOB or indigestion |
| Acute MI manifestations | 1) diaphoresis 2) chest pain 3) pale |
| Types of MIs | 1) STEMI (ST Elevation Myocardial Infarction) 2) Non-STEMI (no ST elevation) |
| Acute myocardial infarction complications | 1) dysrhythmias 2) heart failure 3) shock 4) papillary muscle dysfunction 5) ventricular aneurysm 6) pericarditis |
| Acute myocardial infarction diagnostic tests | 1) 12-lead ECG 2) serum cardiac markers 3) coronary angiography (difinitive) |
| Acute myocardial infarction care | 1) percutaneous coronary intervention 2) TPA 3) MONA |
| Post cath care meds | 1) Reopro or integrilin 2) Plavix 3) Aspirin 4) beta blocker |
| Benefits of Beta Blockers | 1) reduces B/P 2) prevents heart remodeling |
| Medications for A-fib | 1) Amiodorone 2) Cardizem |
| Medications for v-tach | Amiodorone |
| Indications for CABG | Surgical intervention used for significant left main occlusions. Done when pt has several vessels occluded. |
| Nursing care for CABG | 1) Watch for decreased platelets and Hgb 2) Splint chest |
| Mediastinal chest surgery | Chest tubes placed just under the xiphoid process |
| Patient teaching for surgical interventins | 1) Activity (pt should be up post-op day 1) 2) Diet (low fat, low cholesterol) 3) Meds (colace, IS, pain meds) 4) Sexual activity |
| Systolic heart failure | Failure to pump 1) low ejection fraction 2) sufficient blood coming in, but no strength to pump it out |
| Diastolic heart failure | Failure to fill 1) Loss of contractility due to thickened walls 2) May have normal ejection fraction |
| Neurohormonal compensatory mechanisms | 1) Renin-aldosterone 2) Anti-diuretic hormone (ADH) |
| Neurohormonal compensatory mechanisms treatment | ACE, ARB inhibitors |
| Hypertrophy compensatory mechanism treatment | Beta blockers |
| SNS activation compensatory mechanism treatment | Beta blockers |
| Heart failure | low cardiac output |
| Left-sided heart failure | Fluids back up in the lungs |
| Left-sided heart failure manifestations | 1) crackles 2) SOB |
| Right-sided heart failure | Fluids back up in the venous system |
| Right-sided heart failure manifestations | 1) peripheral edema 2) jugular vein distention 3) hepatomegaly |
| Heart failure counter-regulatory mechanism | BNP |
| Heart failure counter-regulatory mechanism treatment | Natrecor IV drip |
| Acute heart failure manifestations | 1) pulmonary edema 2) SOB 3) Pink, frothy sputum |
| Classic symptoms of heart failures | 1) weakness 2) dyspnea 3) cough 4) edema 5) weight gain |
| Skin changes with chronic heart failure | 1) pale 2) edema 3) clubbing of the fingers |
| Behavioral changes with chronic heart failure | 1) anxiety 2) apathy |
| Heart failure complications | 1) Pleural effusion 2) Dysrhythmias 3) Left ventricular thrombus 4) Hepatomegaly 5) Renal failure |
| Heart failure diagnostic studies | 1) CHF BNP 2) Echocardiogram (ejection fraction) 3) Hgb |
| These will decrease intravascular volume in heart failure | 1) Diuretics 2) Fluid restriction |
| Medications that Decrease venous return in heart failure | Nitrates (vasodilators) |
| Medications that decrease afterload in heart failure | 1) Beta blockers 2) Ca+ channel blockers |
| Medicine that improves cardiac function in heart failure | Digoxin |
| Nutritional consideration for heart failure that prevents fluid overload | Fluid restriction (2L/day) |
| AICD | Automated internal cardiac defibrilator |
| AICD pre-op teaching | no aspirin 5 days prior |
| AICD post-op teaching | 1) Pt should wear sling 2) ok to use microwave 3) no MRI 4) avoid airport security checkpoints |
| Artificial heart considerations | 1) only done for young pt 2) pt need to be anticoagulated |
| Sinus bradycardia manifestations | 1) light headed 2) orthostatic hypotension 3) syncope 4) pale, cool skin 5) valsalva maneuver 6) hypothermia |
| Sinus bradycardia causes | 1) Beta blockers 2) Ca+ channel blockers 3) Hyperkalemia (elevated T waves) |
| Hyperkalemia treatment | 1) calcium gluconate 2) sodium bicarb 3) D50W and insulin |
| Sinus bradycardia | < 60 bpm. Treat the cause. |
| Sinus bradycardia emergent treatment | 1) fluids 2) atropine |
| Sinus tachycardia | > 100 bpm. A response to something in the body that is not right. Identify cause and treat (KEY) |
| Sinus tachycardia causes | 1) infection 2) stress 3) fever 4) exercise 5) SNS stimulation 6) pain 7) decreased B/P 8) anemia 9) dehydration |
| Sinus tachycardia (HR >140, 150) treatment | Adenocard Amiodarone |
| PSVT | Proxismal SVT. SVTs start and stop on their own. Treat only when sustained |
| PSVT treatment with responsive pt | 1) Have pt bear down (valsalva) 2) adenocard, amiodarone 3) cardioversion with sedation (if meds don't work) 4) cardiac ablation |
| PSVT treatment with unresponsive pt | cardioversion |
| Atrial fibrillation/flutter causes | 1) chronic lung disease 2) MI 3) Alcoholics |
| A-fib/flutter goal of treatment | 1) rate control 2) convertion to sinus |
| A-fib/flutter manifestations | 1) light headed 2) syncope 3) palpitations |
| A-fib/flutter new onset medicinal treatment | 1) cardizem 2) amiodorane 3) coumadin/heparin |
| A-fib/flutter elective non-emergent treatment | cardioversion (sedate pt first) |
| A-fib/flutter chronic medicinal treatment | coumadin |
| Causes for junctional rhythms | 1) MI 2) Heart failure 3) Rheumatic heart disease (related to strep throat) |
| Treatment for junctional rhythms | 1) treat underlying cause (if MI, heart failure, etc) 2) Pacemaker |
| 2nd Degree Block Type I patho | 1) usually transient, well tolerated May progress to worse rhythm |
| 2nd Degree Block Type II causes | 1) MI 2) Digoxin toxicity |
| 2nd Degree Block interventions | Treat only if symptomatic (depends on how many beats are dropped and patient's B/P) Pacemaker |
| Third degree block causes | 1) MI 2) Overdose of Digoxin, Beta or Ca+ channel blockers |
| Treatment for Digoxin overdose | Digibind |
| Treatment for Calcium Blocker overdoes | Calcium treats this overdose |
| Treatment for Beta Blocker overdose | 1) Dobutamine (stimulates the SNS) 2) Glucose |
| Treatment for Third Degree Block | 1) treat overdose 2) correct rhythm in cath lab 3) pacemaker (if cannot correct rhythm) |
| 3rd Degree rhythm | P waves marching through (20-40 bpm) |
| Ventricular Tachycardia causes | 1) MI 2) Hypokalemia |
| Ventricular Tachycardia treatment | 1) check K+ and Mg levels 2) Amiodarone (stable pt) 3) Shock (unstable pt) |
| Ventricular Tachycardia Rhythm | > 100 bpm P waves absent No PR interval |
| Ventricular Fibrillation | Last rhythm before asystole Pt has electrical activity but no pulse |
| Ventricular Fibrillation treatment | Shock in addition to epinephrine |
| Synchronized Cardioversion indications | 1) SVT 2) A-fib 3) V-tach with pulse |
| AICD | Used for heart failure patients with risk for runs of V-tach and sudden cardiac death. Shocks pt from the inside |
| Synchronized Cardioversion pre-procedure considerations | Patient will be sedated with Propofol for this procedure and should be NPO |
| Defibrillation | This procedure used in code situations where pt has no pulse |
| Transcutanous pacemaker | This device shocks the pt from the outside. It is temporary. Pt should received pain meds |
| Permanent pacemaker Pre-Op considerations | 1) NPO 2) Lab: INR |
| Permanent pacement Post-Op care | Pt should wear sling to avoid pulling out wires and to promote scar tissue formation |
| Pacemaker patient monitoring | Check perfusion (femoral pulse). This rate should equal paced rate |
| Infective/bacterial endocarditis causes | 1) Staph 2) Strep |
| Infective/bacterial endocarditis risk factors | 1) previous endocarditis 2) prosthetic valves 3) rheumatic heart disease 4) IV drug abuse |
| Infective/bacterial endocarditis manifestations | 1) low grade fever 2) splint or hemorrhage in nail beds 3) petechiae 4) MURMUR (new onset) |
| Infective/bacterial endocarditis diagnostics | 1) Echocardiogram (reveals vegetative growth on valves) 2) Blood cultures (WBC) |
| Considerations for pt with valve replacements | Pt should be on phophylatic antibiotic for routine dental cleaning or surgical procedures |
| Infective/bacterial endocarditis treatment | IV or oral antibiotics for 4-6 weeks Treat fever |
| Acute pericarditis manifestations | 1) SOB 2) SHARP PAIN THAT WORSENS WITH DEEP BREATHS 3) PERICARDIAL/FRICTION RUB |
| Acute pericarditis complications | 1) Pericardial effusion 2) cardiac tamponade |
| Acute periarditis treatment | 1) corticosteroids 2) NSAIDs 3) Antibiotics |
| Nursing considerations for acute pericarditis | Pt will be more comfortable sitting or having HOB at least 40 degrees |
| Rheumatic Fever & Heart Disease | This is an inflammatory reponse in the heart in response to untreated strep throat |
| Rheumatic Fever & Heart Disease manifestations | 1) rub/murmur 2) arthritis signs and symptoms 3) Chorea (involuntary movements of face & limbs as well as speech and gait changes) |
| Aschoff's bodies | scarring and nodules that form as a result of rheumatic fever and heart disease |
| Rheumatic Fever & Heart Disease treatment | 1) Antibiotics 2) Corticosteroids 3) NSAIDs |
| Mitral Valve Stenosis | Mitral valve does not OPEN appropriately resulting in enlarged left atrium from blood not being allowed to enter LV. Will eventually back up in the lungs |
| Mitral Valve Stenosis manifestations | 1) exertional dyspnea 2) murmur 3) hemoptysis from pulmonary edema |
| Mitral Valve Regurgitation | Mitral valve does not CLOSE appropriately. Blood flows back into atrium |
| Mitral Valve Regurgitation manifestations | 1) weakness 2) orthopnea 3) murmur |
| Mitral Valve Regurgitation treatment | Beta blockers (goal is to keep B/P low) |
| Mitral Valve Diagnostics | Echocardiogram |
| Mitral Valve Prolapse | Papillary muscles and chordae tendonae torn apart (from MI) causing the valve to flop |
| Aortic Valve Stenosis manifestations | 1) DYSPNEA ON EXERTION 2) chest pain 3) murmur |
| Aortic Valve Stenosis complications | 1) Left ventricular hypertrophy 2) heart failure |
| Aortic Valve Regurgitation | Aortic valve does not CLOSE appropriately causing blood to back up into LV. LV enlarges and loses contractility |
| Aortic Valve Regurgitation causes | 1) syphillis 2) congenital 3) aortic dissection |
| Treatment for stenotic mitral valve | Balloon valvuloplasty |
| Mechanical valve considerations | 1) Pt will need to be anticoagulated with high INR of 2.5-3 2) last longer |
| Biologic valve considerations | 1) Pt does not need lifelong anticoagulation 2) Only last 10 years |
| Nursing care for valvular surgeries | 1) maintain B/P 2) monitor urine output |
| Dilated Cardiomyopathy | This results in ventricular dilation and systolic failure. Heart loses its shape and contractility |
| Dilated Cardiomyopathy therapy | Digoxin will help treat this type of cardiomyopathy |
| Goals of therapy for dilated cardiomyopathy | 1) increase contractility 2) decrease afterload |
| Hypertrophic Cardiomyopathy | This is considered a young person's heart disease. Common in men. Can cause sudden cardiac death |
| Hypertrophic cardiomyopathy manifestations | 1) dyspnea 2) fatigue 3) syncope 4) dysrhythmias common |
| Hypertrophic cardiomyopathy treatment | Goal here is to decrease ventricular contractility and relax the heart 1) Beta blockers 2) Ca+ channel blockers 3) AICD |
| Hypertrophic cardiomyopathy | Problem with this heart condition is great contraction but diastolic filling problem. Heart unable to relax |
| Cardiomyopathy complications | 1) dysrhythmias 2) heart failure |
| Aortic Aneurysm | Weakening of the aortic wall. Most common in men. |
| Aortic Aneurysm manifestations | 1) Decreased blood flow to the legs 2) May have sexual dysfunction 3) Decreased urine output |
| This stent procedure is is done in cath lab and is less invasive than surgery. It maintains blood pressure while allowing for smooth movement of blood flow through the aorta | Endovascular graft |
| These assessments/interventions are important for pt with aortic aneurysm | 1) Important to keep blood pressure low in this pt to avoid rupture 2) Check for pulses (distal to the site) |
| These two topics to discuss with pt who has been diagnosed with aortic aneurysm | 1) no heavy lifting for 4-6 weeks 2) sexual dysfunction |
| The classic manifestations of this vascular disorder is sudden severe pain that feels like tearing or ripping. Can radiate down spine to legs | Aortic Dissection manifestations |
| The innermost lining of the artery is torn resulting in a false lumen | Aortic Dissection patho |
| Chronic HTN will often lead to this vascular disease | Aortic Dissection risk factor |
| These are complications of aortic dissection | 1) cardiac tamponade 2) rupture and/or organ damage |
| This is a key assessment for post-op aortic dissection surgery | CMS important for this vascular disorder. |
| HTN, DM & smoing can all lead to these vascular disorders | common risk factors/causes for these: 1) aortic aneurysm 2) aortic dissection 3) peripheral artery disease 4) acute arterial ischemia |
| Patho of peripheral artery disease of LE | exertional pain in legs caused by inadequate blood flow that resolves with rest |
| These are manifestations associated with peripheral artery disease of the LE | 1) shooting pain down affected leg 2) thin skin with loss of hair and diminished or absent pulses |
| These are four big modifiable risk factors for peripheral artery disease | 1) smoking 2) HTN 3) DM 4) Hyperlipidemia |
| Conservative therapy for peripheral artery disease | Aspirin and plavix |
| Important teaching for pt with peripheral artery disease of the LE | 1) wound prevention 2) walk with shoes 3) avoid cold temps |
| These are key nursing considerations/care for pt who is undergoing surgery for peripheral artery disease of the LE | 1) pt should NOT sit at a 90 degree angle 2) pulse should be checked pre- and post-op |
| The manifestation of this vascular disease is sudden onset of severe pain with peresthesias and can happen in any extremity | Acute arterial ischemia |
| clinical manifestations for this vascular disease include warmth, redness and edema | Venous thrombosis manifestations |
| Moving or ambulating is the best option to prevent this vascular disease | Venous thrombosis prevention |
| These are dilated and tortuous veins | Vericose veins patho |
| The manifestations of this vascular disease involves mainly pain and cramps with long standing | Vericose veins manifestations |
| Etiology of this vascular disease involves incompetent vein valves | Chronic venous insufficiency patho |
| Edema, leathery brown skin on LE are manifestations of this vascular disorder | Chronic venous insufficiency manifestations |
| Post cath lab nursing assessments | 1) bleeding 2) pulse 3) ECG changes |
| Medications for pt with history of MI | 1) aspirin 2) plavix 3) beta blockers 4) statin |
| Treatment options for SVT | Valsalva maneuver Adenosine (antecubital or central line) ECG (pt will be asystole) Beta blockers Synchronized cardioversion (if symptomatic) |
| Treatment of sinus tach | Treat underlying cause (pain, fever, etc) |
| Treatment of V-tach (pt with pulse) | 1) Amiodarone 2) synchronized cardioversion (NPO and sedate) |
| Treatment of V-tach (pt with no pulse) | 1) CPR 2) Defibrilator |
| Considerations with transcutanous pacemaker | 1) shocks and paces 2) pt should be medicated |
| Treatment options for V-fib | 1) shock 2) epinephrine |
| Treatment options for junctional rhythm | No treatment necessary unless pt is symptomatic |
| Dopamine (incr. HR) and Levophed | Potent vasoconstrictors Administer through central line |
| STAT diagnostic test for pt presenting with chest pain | 12-lead ECG |
| These cardiac markers indicate that damage has occurred in the last 24 hours | Elevated CK & troponin |
| Emergent nursing interventions with ST elevations | 1) MONA 2) send pt to cath lab |
| Nitroglycerin considerations | Check blood pressure before admin. Sublingual: Every 5 min. up to 3 times |
| Goals of MONA | 1) reverse ischemia 2) reperfusion |
| Evaluation of effective transcutaneous pacing | Pulse match rhythm |
| Purpose of Reopro | Used with cath lab pt. Blocks platelet aggregation. |
| Treatment of new onset of A-fib | 1) Cardizem 2) Heparin drip 3) Amiodarone 4) Elective cardioversion (if meds do not work) |
| Goal of Cardizem | 1) convert to sinus 2) rate control |
| Benefits of Amiodarone | This medicine does not drop heart rate and ideal for converting a-fib in bradycardic pt |
| Only time you do not use synchronized cardioversion | pulseless V-tach or V-fib do not require this type of treatment |
| Treatment of chronic A-fib | 1) Coumadin Heparin drip will continue until coumadin is therapeutic (2-3) 2) Beta blockers 3) Calcium channel blockers 4) Digoxin |
| Watch for this with Digoxin toxicity | Vision changes seen with this type of med |
| Considerations when giving Adenosine | Used if other meds do not work 1) Adm thru antecubital or central line 2) Hard and fast 3) ECG |
| Cardiovert when pt has these symptoms | 1) low B/P 2) decreased level of consciousness |
| Hydroxyurea used to treat these disorders | 1) sickle cell (produces Hgb F) 2) bone marrow suppression (Polycythemia) |
| These decrease preload | 1) diuretics 2) vasodilators 3) fluid restriction |
| These increase preload | 1) vasoconstrition 2) ADH |
| These decrease afterload | 1) Beta blockers 2) Calcium channel blockers 3) ACE 4) ARB |
| These increase afterload | 1) levophed 2) dopamine |
| You want to teach men this about Beta blockers | Potential for impotence especially with Viagra |
| A- blood type can receive this type of blood | A- or O- blood type |
| Bone marrow biopsy is done here | Iliac crest |
| Symptoms of Vit B12 deficiency | Neurological symptoms |
| This causes sickling in sickle cell anemia patients | Hypoxia causes this |
| Nursing interventions for sickling crisis | 1) oxygen 2) IV fluids 3) pain meds |
| This is the name of the cell in Hodgkins Lymphona | Reed-Sternberg cell |
| Nursing assessment/intervention for myltiple myeloma | 1) kidney stones 2) increase fluids |
| Key nursing assessment/intervention for abdominal aortic aneurysm | 1) keep B/P low 2) pulse 3) CMS |
| Risk factors for peripheral artery disease | HTN Diabetes Smoking Hyperlipidemia |
| Treatment for existing DVT | Heparin is used to treat this existing condition |
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spagnoni
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