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Patients with Cardia
Patients with Cardiac Dysfunction
| Question | Answer |
|---|---|
| diffuculty breathing (symptom commonly assoc with cardiac disease) - blood backs up into the left atrium into the pulmonary artery and causes the alveoli to fill with fluid. | dyspnea |
| What is an early sign of LEFT ventricular failure. Shortness of breath on physical exertion that is relieved at rest. | Dyspnea on Exertion (DOE) |
| SOB that occurs suddenly at night while sleeping...patient awakens with sudden feeling of suffocation. May be accompanied by wheezing, sweating, occurs related to supine position fluid back-up into lungs usually relieved by sitting up. OFTEN A SIGN O CHF | Paroxsysmal Nocturnal Dyspnea (PND) |
| SOB anytime the patient lies down, resolves when sits up or uses MORE PILLOWS | ORTHOPNEA |
| Nursing interventions for dyspnea | check O2 stats, RR, Lung sounds (may reveal fine crackles which is common in cardiac failure) *ELEVATE HOB* O2 if ordered and call MD |
| lack of oxygen to cardiac muscle | ischemia |
| pain that is typically substernal then spreads across chest, and may radiate down left shoulder and arm, to jaw and even back again | ANGINA PECTORIS |
| pain from inflammation of the pericardium (outer lining of the heart), SHARP PAIN more intermittent and worsening on inspiration or movement | PERICARDITIS CHEST PAIN |
| What is the timing of nitroglycerin | 3 to 5 minutes apart and monitoring between doses. |
| Symptoms caused by nitroglycerin | HEADACHE, dizziness, hypotension, flushing |
| fainting or a transient loss of consciousness caused by cerebral hypoxia related to hypertension | SYNCOPE |
| abnormal accumulation of fluid in the soft tissues due to excess fluid seeping through capillary walls into tissues | EDEMA |
| edema that leaves NO INDENTATION WHEN PRESSED DOWN WITH FINGER...usually from venous insuffiency | NON PITTING EDEMA |
| type of edema where the skin maintains an indentation for up to 30 SECONDS after pressed with a finger | PITTING EDEMA |
| edema leaves a 2mm indentation | 1+ pitting edema |
| edema leaves a 4mm indentation | 2+ pitting edema |
| edema leaves a 6mm indentation | 3+ pitting edema |
| edema leaves a 8mm indentation | 4+ pitting edema |
| the amount of force exerted against arterial walls | Blood Pressure |
| What is the primary cause of hypertension | atherosclerosis |
| heart sounds - closing of the mitral and tricuspid valve = normal systole | S1 right side |
| heart sounds - closing of the aortic and pulmonic valves = normal = diastole | S2 left side |
| heart sounds - may indicate LEFT VENTRICULAR FAILURE, (CHF), PULMONARY EDEMA. though is normal in children and young adults | S3 |
| heart sounds - may indicate hypertension, CAD | S4 |
| swishing sound graded from very soft = grade 1 to very loud = grade VI | murmurs |
| jugular veins remain distended even when HOB is elevated 30-45 degrees and could indicate elevated venous pressure | Jugular Venous Distention (JVD) |
| How long should capillary refill take when you press down on the nailbed | 3 seconds |
| very serious and late symptom of oxygen deprivation related to decreased HgB | CYANOSIS |
| MOST SERIOUSdecreased oxygenation in the blood or blood flow will show blue-grey around lips and mouth | Central cyanosis |
| blue-grey extremities, nose, earlobe = blood flow to peripheral areas decreased though blood flow to "THE CORE" may be OK. | Perpheral cyanosis |
| condition related to HgB or blood flow to superficial vessels | Pallor |
| related to inadequate oxygen supply to body's tissues accompanied by increased oxygen body demand | fatigue |
| increased angle of nailbeds over 180 degrees, fingertips enlarged, looks like "CLUBS" related to decreased O2 over several years time....ie COPD patients | CLUBBING |
| condition related to cardiac output to kidneys = decreased perfusion = activates renin - angiotensin 1 to 2 = increased BLOOD PRESSURE | ALTERED RENAL FUNCTION |
| Risk factors for cardia disease | cigarettes, stress, oral contraceptives |
| test can see the silhouette of heart, size of congestion, lung fields | CXR |
| test like a CXR in motion while heart beating and lungs in motion, used during cardiat catheterization | FLOUROSCOPY |
| test that records electrical activity of the heart, determines rate, rhythm, and many times ISCHEMIC OR INFARCTED TISSUE | ECK (ECG) |
| atrial depolarization | P WAVE |
| ventricular depolarization | QRS COMPLEX |
| repolarization of ventricles | T WAVE |
| interval should be between 0.12 sec and no longer than 0.20 sec, otherwise is a FIRST DEGREE BLOCK | P-R Interval |
| the rhythm initiated in SA NODE with normal intervals, regular rhythm, one "p" wave with each "qrs" | Normal Sinus Rhythm |
| EKG during excerise | Stress Test |
| Ambulatory EKG monitor - allows for 24 hour ECK while at home to observe any daily changes, patient keeps daily log of activities | Holter Monitor |
| an invasive procedure that determines the functional status of the heart AND the status of the coronary arteries.....any valve disease | CARDIAC CATHETERIZATION |
| Post Cath care | check pedal pulses frequently, CSM along with other vital signs, WATCH FOR BLEEDING AT THE SITE! |
| certain enzymes are released when cardiac tissue is damaged or infarcted lab studies would check *SHOW UP ONLY FOR AN MI!!* | CPK < TROPININ < AST < LDH |
| MB Band one of the first enzymes to elevate within 3 - 6 hours after a myocardial infarction | Creatinine Phosphokinase (CPK) |
| Enzyme show up around 4 hours after a myocardial infarction | TROPININ |
| enzyme shows up 6 hours after a myocardial infarction | Aspartate Aminotransferase (AST) |
| last enzyme to show up after a myocardial infarction 24 - 48 hours late to the party | Lactate Dehydrogenase (LDH) |
| signs and sympotoms of cardiovascular disease | visual disturbances though could be trippin on the Dig* (check the levels) |
| What won't Digoxin fix | MI |
| coronary artery dilator used to help prevent and treat angina pectoris, venous dilator | NITRATES |
| action of this drug is to block the enzyme that converts angiotensin 1 to angiotensin 2 THEREFORE blocking VASOCONSTRICTION. Used for heart failure or hypertension | ACE INHIBITORS |
| What side effect of an ACE INHIBITOR would prompt you to "slap the meds right out of the patients hand" and discontinue use | cough |
| Calcium Channel Blockers | slows the movement of Ca++ resulting in DILATION of arteries and coronary arteries DECREASING BP **also slows heartrate** |
| Why must you be careful with calcium channel blockers | negative inotrope slows heartbeat and lowers BP be sure to check before administering |
| the action of this medication is to BLOCK BETA RECEPTORS IN THE HEART that therefore decreases action of spinephrine on the heart and blood vessels. decreases BP AND HR sooo check before administering | BETA BLOCKERS |
| What medications are used for Cardiac Arrhymias | ANTIARRYTHMICS |
| what medications are used to reduce LDL's | ANTILIPEMICS |
| what medications ACTUALLY DISSOLVE CLOTS for certain patients have an MI, msut meet certain criteri.....CAN ACTUALLY REVERSE AN MI IF TREATED EARLY | THROMBOLYTICS |
| What is the side effect of THROMBOLYTICS | Bleeding |
| What medication can decrease potassium levels, UNLESS IT IS A POTASSIUM SPARING | DIURETICS |
| What is a Cabbage (CABG) | coronary artery bypass surgery or open heart surgery |
| Use of what would allow the heart to be still and empty during DELICATE surgery | cardiopulmonary bypass machine |
| what does the cardiopulmonary bypass machine do? | oxygenates blood, removes CO2, and provides bloodflow to the body to meet body needs while the heart is motionless |
| someone who has had a heart transplant or "OPEN HEART SURGERY" will be on anti-rejection drugs for life. Name one | CYCLOSPORIN |
| Balloon catheter inserted inserted via cardiac catheter lab inserted thru artery | Balloon Valvuloplasty |
Created by:
Beezle
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