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Nursing Cardiac Dis.

Caring for client with cardiac disorders "Medical surgical nursing care"

QuestionAnswer
Third leading nonobsteric cuase of hospital admmisons in the united states Heart Failure
Heart failure may result from 3 Impairs effective contraction of the heart muscle Chronically increases the workload of the heart Acutely increase the workload of the heart
pt 75 or older are 10% increase risk for Heart Failure
African americans who have hypertension are at risk for Heart failure
Damage to teh heart muscle, the most common cause of heart failire is a result of this Myocardial infarction
A decrease in cardiac output also activates this kidney system to increase blood volume. Renin-angiotension-aldosteron system
Teaching cardiac function for older adults Allow longer warm-up and cool-down periods during exercise Engage in regular excercise such as walking for to five times a week REst with feet elevated when fatigued Maintain adequate fluid intake Reduce sodium intake by using herbs
Is the ability of the heart to adjustits output to meet the metabolic needs of the body. Cardiac reserve
Accumulation of fluid in the interstitial spaces and alveoli of teh lungs may occur with severe left-ventricular failure. Acute pulmonary edema
Breathing difficulty while lieing down Orthopnea
Heart failure resulting from fluid overload, hyperthyroidism or fever can be refered to as High-output failure
Heart failure classification ABCD A? High risk for heart failure, but no current structural or functional damage (hypertension)
Heart failure classification ABCD B? Structural heart disease but no symptoms of heart failure (Rheumatic pericarditis, aortic stenosis)
Heart failure classification ABCD C? Structural heart disease with current or prior symptoms of heart failure
Heart failure classification ABCD D? Advanced heart disease with symptoms of heart failure at rest despite treatment
Most common cause of Right sided heart failure? Left sided heart failure
Manifestions of both right and lefsided heart failure is termed biventricular heart failure
Frightening ondion in which the client awakes at night acutely short of breath? Paroxymal nocturnal dyspnea
an MI can cause this kind of heart failure Acute heart failure
Main goal of care for client with heart failure is Reduce cardiac workload Improve cardiac pumping ability Control fluid retension
Two hormones that are specific to heart failure: Atrial natriuretic peptide (ANP) Brain Naturetic peptide
Is the study of the pressure inolved in blood circulation? Hemodynamic monitoring
Main drug classes used to treat heart failure? Angiotension-converting enzyme (Ace ihibitors) Angiotension II receptor blockers (Arbs), Beta blockers, diuretics, inotropic medications and direct vasodilators
Drugs that increase the strength of the heart contrations? Inotropic medications.
Fixed dose combination of two vasodilators (hydralazine and isosorbide) is approved for HF in african americans BiDil
This potent loop diuretic is given introvenously if a client has pulmonary edema in a life threatening situation Furosemide
Besides being a diuretic furosemide also acts as a Vasodilator
With acute pulmonary edema client may recieve these direct vaso dilators Nitroglycerin,nitropursside, isosorbride, or nesiritide
Nesiritide (Natrecor), a syntheic form of BNP is a potent vasodialator and also has this effect? Diuretic
An opioid that can be given an acute pulmonary edema. Morphine sulfate, help reduce anxiety, improves breathing, venous dialator
Has a positive inotropic effect on the heart, increasing the strenth of myocardial contration Digitalis
Digitalis has this type of window Narrow therapeutic window
The therapeutic window for digitalis is? 0.5 and 0.8 ng/ml higher than 1.0 can cause toxicity
Anorexia, nausea, vomiting, headache, alterations in vision, confusion, an number of dysthrymias are associated signs with this positive inotropic medication toxicity Digitalis
Low serum potassium levels increase the risk of this when in conjunction with digitalis Digitalis toxicity
A nurse knows to do this before giving digitalis Take an apical pulse
Sodium intake on a HF, CHF paitient per day 1.5 - 2.0 g of sodium
What happens in a piggyback heart transplant Client's heart is left in place and teh donor heart is sutured to it
VAD Ventricular assist devices.
Major concern in early postoperative period after heart transplant? Bleeding
Other frequently monitored parameters after heart transplant are? Chest tube drainage, urniary output, heart rhythm,
leading cause of death in transplant recipients? Rejection of the transplanted organ
A major nursing care goal for HF or CHF is to? Reduce the oxygen demand of the heart
Pink frothy sputum is a hallmark sign of what? Cardiogenic pulmonary edema
Severe CHF patients may develop? Liver failure as a result of chronic congestion
Impaired perfusion of this organ to lead to it's failure? renal failure
Expected outcome for decreased cardiac ouput? Skin will be pink, warm, and dry, and vital signs will be within normal limits for client.
Sytemic inflammatory disease caused by abnormal immune response to infection by Group A beta-hemolytic streptocci (usually strep throat) Rheumatic fever
Layers of the heart involved in rheumatic fever? Endocarditis, myocarditis, and pericarditis
Slowly progressive (insidious) valve deformity that van occur after acute or repeated attacs of rheumatic fever? Rheumatic Heart disease
General age affected for rheumatic fever? 5 to 15 years old
Valve most often affected with Rheumatic fever Mitral valve
Manifestation of rheumatic fever develop after how many weeks after strep infection? 2 - 3 weeks
Manifestation of rheumatic fever? Fever, migratory join pain and inflammation, rash on trunk and proximal extremities, chest pain or discomfort, tachycardia, shortness of breath, cardiac friction rub, possible rub, involuntary muscle spasms, dificulty concentrating
Managment of RF focus on treatment of? Primary infection, maniging manifestations and preventing complications and reccurances
In clients with Acute carditis treatment focus's on? Decreasing cardiac workload
Activity is generally increased after having acute carditis after Blank weeks? 4 - 5 weeks
Risk factors associated with RF Crowded living conditons, poor nutrition, immunodeficiency, and poor access to health care
has abrupt onset, rapidly progressive, infection agent is staphylococcus aureus? Acute endocarditis
studies indicate that up to 25 of all cases of infective endocarditis involve prothetic heart valves
Early onset endocarditis for people who have Prosthetic vavle endocarditis have a mortality rate up to 70%
Peripheral manifestations of endocarditis may include? petechia
Eradicate teh infecting organism and minimize valve damage and complications of the disease Nurse managment priorities
With endocarditis because the fibrin covering that protects them from antibiotic, an extended coursle of multiple intraveous antibiotics is required. Intravenous drug therapy is continued for? 2-4 weeks.
When infective endocarditis has not responded to antibiotics how long before they may replace with the valve to eliminate the organsim? 7 - 10 days
Nursing care includes managins manifestations, administering antibiotics and educating the client and family members endocarditis
Prioritizing infectious process, maintaining heart function, and proventing complications are the priorities for? infective endocarditis
Corticosteriods or other immunosuppressive agents may be given to reduce inflammation in this condition? myocarditis
May follow a MI or open heart surgery? Pericarditis
Is the characteristic sign of pericarditis pericardial friction rub.
A halmark sign of cardiac tamponade is a? Paradoxical pulse
Pulse drops more than 10mm hg during inspiration is termed? Paradoxical pulse
Removal of fluid from the pericardial sac? pericardiocentesis
distant muffled heart sounds indicates? Cardiac tamponade
Characteristic sign of valvular disease is? Murmur
Dyspnea on exertion is a sign of? mitral stenosis
Purplish-red lesions on pams and soles is indicative of? Infective endocarditis
May have a high-pitched, late systolic murmur? Mitral valve prolapse
Created by: lenbot on 2010-12-04



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