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CARDIAC KQ

Cardiac Bullets

FACTFACT
the nurse should assess for dependent edema in the lower extremities such as the ankles in the ambulatory patient or the sacrum in the w/c bound patient in acute venous insufficiency collateral blood flow doesnt have an oportunity to develop
The normal pH of arterial blood is 7.35 - 7.45 pulse deficit is the difference between the apical pulse and the peripheral pulse (such as the radial pulse)
During heparin therapy, the pateint shoudl receive tylenol not aspirin for headaches in chronic venous insufficiency collateral blood flow develops to the affected area
a milliequivelent (mEq) is the nunit of measurement used to describe the chemical activity of electrolytes - mEq is the number of milligrams per 100 milliliters of a solution pulse pressure is the difference between the systolic and diastolic pressures. For example if blood pressure is 120/80 the pulse pressure is 40 mm/hg
the nurse should weigh the patient at the same time every day using the same scale and with the patient wearing the same type of clothing before engaging in strenuous activity a patient with angina pectoris should take a nitroglycerin tablet
a pteint with orthopnea must sit or stand to breathe deeply or comfortably a positiv eHomans sign is a sign of DVT
before administering protamine sulfate as an antidote for heparin overdose the nurse should verify that the patient doesn't have an allergy to fish patients with heart failure should avoid canned or processed foods, which are high in sodium
during lasix therapy the patient is at risk for potassium loss which can lead to hypokalemia in a dark skinned pateint the nurse should assess for petechiae on teh oral mucosa rather than on the skin
a patient with heart failue should avoid canned or processed foods which are high in sodium in a dark skinned pt the nurse should assess for petechiae on the oral mucosa rather than on the skin
biological death with the irreversible destruction and death of brain tissue a tilt table allows gradual movment from horizontal to a vertical position
using a tilt table allows the pt body to compensate for position changes stable angina pectoris is characterized by substernal pain thats caused by myocardial ischemia and lasts 2-3 min
angina that lasts for more than 20 minutes and isnt relieved by ntg indicates a developing myocardial infarction the results of ntg test are positive if ntg adminstration relieves angina
for a patient with angina pectoris the goal of treatment is to reduce the hearts workload ntg causes genralized vasodilation which promotes blood flow to the heart muscle
the nurse should teach a patient who has angina and is receiving sublingual ntg to place a tablet under the tongue at the first sign of chest pain the patient may repoeat the ntg dosage every 5 to 15 minutes for maximum of 3 tablets
if hcest pain peresists for longer than 15 minutes the pt should be instructed to go to the nearest health care facility to administer subcutaneous heparin the nurse should insert the needle into the skin at a 45 degree angle
for the post op patient who is at risk for deep veing thrombosis, heparin or Lovenox is usually given oral anticoagulants such as warfarin to prevent thrombus formation
anitcoagulants cant dissolve a throumbus that has already formed anticoagulant therapy is contraindicated in patients who has severe diabetes liver or kidney disease or ulcers
to assess a pt for thrombophlebitis the nurse should compare the measurements of the affected and unaffected limbs every day ntg tablets are considered expired 5 to 6 months after the bottle is opened
signs of a pacemaker failure include dizziness, fainting palpitations hiccups and chest pain before getting the pt out of bed for the first time after surgery, the nurse should have the pt dangle his legs over the edge of the bed
a pacemaker surgical or orthopedic clips or shrapnel will interfere with the results of a magnetic resonance imaging scan the optimal schedule for adminstering an around the clock antibiotic is 6 am 12 pm 6pm and 12am
a pt who has unstable angina experiences pain at rest atelectasiss typically occurs 24 to 48 hours after surgery
in dark skinned persons skin color changes can best be seen in areas of less pigmentation such as lips, mucous membranes ear lobes palms and soles therapeutic range for digoxin is 0.5 to 2 mg/ml
a pt who is taking anticoagulants as an outpatient should be instructed to call the physician if he has black tarry feces the nurse should monitor the partial thromboplastin time of the patient who is recieving heparin
to determine whether a patient has a pulse deficit one nurse should measure the apical pulse while a second nurse measures the radial pulse at the same time using the same watch before contrast medium is injected the nurse should tell the pt to expect a transient burning sensation and a metallic taste in his mouth
the most reliable way to identify a pt is to check his id bracelet the nurse should being d/c planning when the pt is admitted
dangling the pt legs before getting him out of bed helps prevnent pooling of blood and orthostatic hypotension green leafy veggies are good sources of Magnesium
sodium is the major cation in extracellular fluid hemoglobin is an oxygen carrying pigment in red blood cells
abnormal breath sounds are called adventitious the most common cause of pulmonary edema is left sided heart failure
the most common cause of pulmonary edema is left sided heart failure diuretic use is the leading cause of potassium deficit
potassium is the major cation in intracellular fluid the SA node is the heart's pacemaker
the T wave represents repolarization of the ventricles after a diagnostic study in which the femoral site is used, the patient must lie flat for 8 hours
when caring for a patient who has undergone a cardiac catheterization the nurse must report a rapid or irregular pulse immediately yellowing of vision is a symptom of digoxin toxicity
digoxin causes a slower stronger heartbeat and allows the heart to rest between beats a bounding pulse indicates excess fluid volume
muscle weakness and cardiac arrhythmia are common in patients with hypokalemia or hyperkalemia a bruit or rushing sound heard with a stethoscope over the thydroid gland indicates a hypermetabolic state
to conserve energy in a patient who is in a weakened state the nurse may need to alternate care procdedures with rest periods a decreased vitamin K level causes a prolonged PT
the pt with serum K level of less than 3mEq/L needs potassium replacement therapy about 85% of arterial emboli originate from thrombi in the heart chambers
when caring for pt with an embolus in an arm or leg the nurse should keep the affected part at or below the horizontal plane during the early stage of shock , the pt blood pressure may be nromal but the resp. and HR increase
cool moist pale skin as is seen during shock results from diversion of blood from the skin to major organs to assess cap refill the nurse applies pressure over the nailbed until blanching occurs quickly releases the pressure and notes how quickly the blanching fades
the nurse should suspect thrombophlebitis in the patient with homan's sign petechiae are tiny round red purplish spots that may appear on the skin and mucous membranes
the antidote for heparin overdose is protamine sulfate the antidote for warfarin overdose is vitamin K
all pts older than age 65 should be assessed for aneurysm because of the normal vascular changes that accompany aging Raynaud's disease is characterized by recurrent inflammation of the intermediate small veins of the extremities
As raynaud's disease progressses the pt may have ulcers and superficial gangrene of the hands ascites is excess fluid in the peritoneal cavity
a thready pulse is fine and scarcely perceptible when taking a pt radial pulse the nurse should assess its rate rhythm quality and force
to obtain an accurate flood pressure raeding the nurse should pump the bulb until the mercury column or aneroid dial reaches 20-30mm Hg before the point at which the pulse disappears or above the pts baseline systolic pressure the nurse shouldnt massage a leg with a blood clot because this could dislodge the clot
mydriatic drugs dilate the pupils miotic drugs constrict the pupils
when placing a ntg patch on a pt the nurse should avoid touching the medicated disc and should wash her hands after application however gloves aren't required the nurse should count an irregular pulse for 1 full minute
a pt who has MV stenosis typically has signs and symptoms associated with improper emptying of the left atrium and subsequent pulmonary congestion MV stenosis usually arises as a complication of rheumatic fever
atelectasis is an abnormal condition thats characterized by the collapse of the lung tissue and incomplete expansion of lobules or a lung segment to perform a CPR the nurse should place the vicitim on a flat and solid surface
for the pt with heart failure decreasing the workload of the heart is one of the nurses most important goals antiembolism stockings provide gradual compression of the superficial blood vessels helping to prevent thrombus formation
a pt who no longer requires bed rest after a femoral politeal bypass graft should be permitted to walk and stand the nurse should give aluminum hydroxide separately and at least 1 hour before or after the administration of enteric coated medications
acid base balance is the body's hydrogen ion concentration buffers are substances in teh blood that prevent body fluid from becoming overly acidic or alkaline
metabolic acidosis results from excessive loss of bicarbonate or excessive production or retention of acid nausea vominting restlessness and twitching are signs of disequilibrium syndrome caused by rapid fluid shift
early signs and symptoms of ketoacidosis include polyuria polyphagia faigue malaise drowsiness headache and abdominal pain prothrombin is a clotting factor thats produced by the liver
the pt is usually the best source of health history information the cardiovascular and respiratory systems are regulated by the ANS
to guard against a charge of malpractice the nurse should provide care in a reasonable and prudent manner crackles indicate lung congestion caused by fluid or pus
wheezing is an abnormal high pitched breath soudn that indicates obstruction or closure of the bronchi when caring for a pt with heart failure the nurse should elevate the head of the bed
after chest surgery the nurse should encourage the pt to raise the arm on the affected side above the head frequently in a pt who is receiving digoxin a below normal serum K level increases the risk of digoxin toxicity
a silent MI causes no symptoms adverse effects of verapamil include dizziness headache constipation hypotension and AV condction disturbances
foods high in vitamin D include fortified milk fish liver liver oil and egg yolk bread and cereal are good sources of thiamine iron niacin and riboflavin
central cyanosis is the most significant sign of hypoxia when taking BP the nurse should support the pts arm rather than letting the pt use his own strenght to hold the arm up
nonmodifiable risk factors for coronary artery disease include heredity, sex, race, and age foods that are high in sodium can cause fluid retention
when prioritizing nursing diagnosis the nurse houdl give life-threatening problems top priority spinal shock is loss of all spinal reflexes and sensations below the level of injury after spinal cord transection
in R sided cardiac cath, a radiopaque catheter passes through the antecubital or femoral vein and into the pts right atrium right ventricle and pulmonary vasculature in a stroke, blood vessels in the brain are blocked by an embolus or a hemmorrahge. As a result blood supply is decrased to brain tissues that are nromally perfused by damaged vessels
the nurse shouldn't administer atropoine to a pt who has glaucoma smooth muslces are controlled by the ANS
Inderal blocks sympathetic nerve stimulation that increases the cardiac workload during exercise or stress ECG changes usually appear during the first 24 hours after a myocardial infarction but in some cases they are delayed 5 to 6 days
cottage cheese fish canned beans chuck steak chocolate pudding Italian salad dressing dill pickles and beef broth are extremely high in sodium prunes watermelons dired lima beans soybeans bananas oranges nectarines and cantelopes are high in potassium
pulmonary congestion may lead to accumulation of fluid throughout the body the nurse should use the bell of the stethoscope to listen for venous hums and murmurs
the normal serum Ca level is 4.5 to 5.5 mEq/L the normal serum sodium level is 135 - 145 MEq/L
the normal serum potassium level is 3.5 - 5.0 mEq/L lactated ringers solution is an isotonic solution
a serum sodium level of less than 135 mEq/L indicates hyponatremia one unti of blood is 500ml
heparin is the drug of choice to treat thrombembolitic disease the surgeon can use a Fogarty emoblectomy catheter to extract an embolus from a large artery
blockage of a large artery by an embolus is a life threatening emergency that requires immediate surgery acute iliofemoral veous thrombosis causes limb enlargement It can be detected by measuring the affected part and comparing it with the opposite extremity
the ares that sustain the greatest damage from arteriosclerosis are the brain heart GI tract kidneys and extremities Warfarin is an anticoagulant
foods that are high in iron include organ meats such as liver, nuts, legumes, dired fruits, eggs, whole grains, fortified cereals, and green leafy veggies the best sources of vitamin B6 are liver kidney muslce meats soybeans corn and whole grain cereals
signs of arterial obstruction cuased by an embolism inlcude absent pulse anesthesia paralysis and pale cool skin the heart has 4 valves tricuspid, mitral, pulmonic and aortic
heparin incactivates thromboplastin and thrombin the cause of essential hypertension is unknown
administration of inderal reduces portal pressure and decreases the risk of bleeding from esophageal varices the most common vascular complication of diabetes mellitus is atherosclerosis
the PMI is located at the fifth intercostal space near the apex of the heart the first heart sound represents closure of the mitral and tricuspid valves
the second heart sound represents clousre of the aortic and pulmonic valves the coronary artery supplies blood to the myocardium
the nurse should instruct a pt who is following a low salt diet to avoid canned veggies a pt who is taking Lasix should eat bananas and citrus fruits becasue they are a good source of K
dyspnea is a common sign of left ventricle failure if the pt BP rises 30 mm Hg above the baseline value the nurse should notify the physician
after cardiac surgery the pt should follow a diet that provides 2gm of sodium and 300 mg of cholestrol daily the kidneys play a major role in maintaining the bodys fluid balance
orange juice and green leafy veggies are good sources of folic acid sodium regulates extracellular osmolality
in the early stage of shock, teh heart and brain maintain blood circulation a trauma pt who has received multiple blood transfusions is at risk for hypocalcemia and hypothermia
Lidocaine is the drug of choice to treat PVCs the ventricles usually sustain the greateast damage during MI
during MI pain occurs when anorexia causes myocardial ischemia the pt with diabetic ketoacidosis is at risk for shock
the pt with DM is susceptible to atherosclerosis tetany may result from hypocalcemia
alcohol interferes with the absorption of vitamin B 12 in the GI tract K is the most abundant cation in intracellular fluid
hypovolemia occurs when 15-25% of the bodys total blood volume is lost CPR shouldnt be interrupted unless the rescuer is alone and must stop to get help
in balloon angioplasty a small balloon tipped catheter is inflated inside an artery to exert pressure against a plaque and flatten it a clear liquid diet consists of clear fluids and foods that become liquid at body temperature
a full liquid diet consist of simple easily digested foods this diet provides fluids and calories but may be inadequate in folic acid iron Vitamin B 6 and fiber a pureed diet supplies all of the patients nutritional needs
a soft diet includes semisolid foods and is often supplemented with between meal snacks a mechanical soft diet is used for the pt who has difficulty chewing or tolerating a reg diet
the pt who requires no dietary modifications can recieve a regular diet a bland diet doesnt include foods that cause gastric irritation or excess acid secretions unless they provide a neutralizing effect
respiratory acidosis may occur in conditions such as drug overdose, guillain Barre syndrome, myasthenia gravis, and COPD respiratory alkalosis may occur in such conditions as high fever, servere hypoxia, asthma, and pulmonary embolism
metabolic acidosis may result from renal failure, diarrhea, diabetic ketosis, or lactic ketosis metabolic alkalosis may result from nasal and gastric suctioning, excessive diuretic use, or steroid therapy
during cardiac catheterization the pt may experience a thudding sensation in the chest as a result of maniupulation of the catheter signs of acute rheumatic fecer include chorea, fever, carditis, migratory polyarthritis, skin rash and subcutaneous nodules
A pt how has a history rheumatic fever should take prophylactic antibiotic s before undergoing dental or invasive procedures after an MI most pts are permitted to resume sexual activity when they can climb 2 flights of stair without fatigue or dyspnea
hypercapnia is an excess of CO 2 in the blood hemorrhage is the most common post op problem
Kussmauls respirations are the body's attemtp to blow off excess CO2 green leafy veggies are high in fiber
drinking too much plain water can lead to electrolyte imbalances brain damage occurs 4 to 6 minutes after cardiopulmonary function ceases
metabolic acidosis results from excessive loss of Bicarb or excessive production or retention of acid arterial blood is bright red flows rapidly and spurts with each heartbeat
venous blood is dark red and tends to ooze from a wound atropine blocks the effects of acetylcholine
the nurse should suspect respiratory alkalosis in a patient whose partial pressure of CO 2 is less than 35 mm Hg angiotensin converting enzyme inhibitors decrease blood pressure by interfering with the renin angiotensin mechanism
the nromal value for arterial blood oxygen saturation is 94 - 100% if a pt is receiving propranolol the nurse should tell the pt not to discontinue the medication suddenly
the radial artery is most commonly used for obtaing ABGs almost all external bleeding can be stopped with direct pressure
verapamil is a calcium channel blocker when administering heparin subcutaneously the nurse should not aspirate
the normal serum creatinine level is 0 - 200 / 24 hours a low fat low sodium diet includes chicken and fresh salad
pts with varicose veins may have achiness heaviness and pain in the affected leg claudication is pain on ambulation the most likely cuase is inadequate arterial blood flow
the best method to relieve the pain associated with varicose veins is to elevate the affected lef periodically throughout the day stasis ulcers first appear as darkly pigmented scaly areas and progress to skin breakdown and craters that are difficult to heal
for the pt who has had vein stripping and vein ligation surgery the MD usually orders walking hourly in the immediate post op period caffeine can impair blood flow because it constricts arteries and arterioles it should be avoided by patients who have a history of venous stasis
signs of adequate circulation in a leg include warm toes and feet and CR < 3 sec anaphylactic reaction causes dyspnea hypotension and loss of consciousness
a treatment for anaphylaxis is epinephrine a sign of diabetic ketoacidosis is ketones which ar by products of fat metabolism fat metabolism occurs when the body cant use glucose as energy source and breaks down fat as a substitute
the best method to prevent blood clots after surgery is ambulation the pt who is taking mannitol should have a catheter because the osmtoic effect of the drug causes increased urination
adverse effects associated with mannitol therapy include dehydration, electrolyte imbalance and diarrhea decreasing blood pressure increased pulse and increased respirations are signs of impending shock in the postoperative patient
the organ that usually sustains damage from hypertension is the eye administration of diuretics in the morning minimizes disruption of sleep for urination
cholesterol is animal fat that attaches to the intimal layer or the arteries It enlarges to form plaque that occludes the passageway of the vessels causingn atherosclerosis a stress ECG should be stopped if the patient has chest pain, dangerous cardiac rhythm changes or a significant incrase in blood pressure
adverse effects of ntg tablets include headache, flushing and dizziness concentrated urine is one of the first signs of dehydration
tomatoe juice is high in vitamin C night blindness is associated with vitamin A deficiency
before putting antiembolism stockings on the patient the nurse should have the patient lie down with the feet elevated for 20 to 30 minutes the daily dose of digoxin is 0.125 to 0.5 mg daily
a sign that heart failure is resolving is increasing urine output a sign or pericarditis is friction rub
a pt who recieves an organ transplant must take an mmunosupressant for life frothy blood tinged sputum is a sign of pulmonary edema
normal central venous pressure is 2 ot 8 mm Hg or 5 to 10 cm H2O a decrease in central venous pressure indicates a decrease in circulating fluid as is seen in renal failure
If a central venous pressure is associated with an incrase in circulating fluid volume as seen in renal failure to ensure an accurate baseline CVP reading the zero point of the transducer must be at the level of the right atrium
CKMB is an isoenzyme of CK that's specific to the heart increases 4 ot 6 hours after a MI peaks at 12 to 18 hours and returns to nromal in 3 to 4 days a pt who survives an M I and has no other cardiopathology usually requires 6 ot 12 weeks for a full recovery
risk factors associated with embolism are increased blood viscocity decreased circulation, prolonged bed rest and increased blood coagulability dependent edema is an early sign of right sided heart failure
If contrast medium is used during MRI the pt may experience diuresis when the medium is flushed from his body (blank)
Created by: Kelly Quijano