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Nursing Cardiac Dis.
Caring for client with cardiac disorders "Medical surgical nursing care"
| Question | Answer |
|---|---|
| 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
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