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RN cardio

QuestionAnswer
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
Created by: spagnoni