cardiac med surg
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| Risk factors of cardiac disease (modifiable) | smoking, Obesity, high cholesterol, physical activity, diets (fats, sodium) harmful use of alcoholic drinks
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| Risk factors of cardiac disease (Non-modifiable) | Family HX, ethnicity, Age, Gender
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| Blood flow through the heart | Unoxygenated blood> Superior & inferior vena cava> Right atrium> Tricuspid valve,> Right Ventricle, Pulmonic> Pulmonary Artery,> Lungs,> Oxygenated, > Pulmonary Veins, > Left Atrium,> Mitral Valve,> Left Ventricle,> Aortic valve,> Aorta.
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| Cardiac Conduction | Sa Node,>AV Node,> Bundle Of HIS,> Right & Left Bundle Branches,> Purkinje Fibers
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| SA Node | Pacemaker of the heart
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| AV Node | located between the right atria & ventricle carries electricle signal from the SA Node to the Bundle of HIS
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| Caridiac Output | Amount of blood ejected from the left ventricle in 1 min.
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| Epinephirne | increases HR, force of contraction, cardiac output, systolic BP
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| Aldosterone | Regulates Sodium/Potassium: regulates BP
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| Normal BP | SYStolic <120 Diastolic <80
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| Aging Cardivascular system | conduction cells less effective, Atherosclerosis, resting BP increases, Decreased HR, Vein Valves Incompetent
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| Conduction cells less effective | Dysrhythmias
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| Atherosclerosis | Narrowed Vessels lumens, rough surfaces>clot formation> decreased blood flow to the heart and organs.
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| Resting BP increases | Left ventricular work load increase>Left sided Heart Failure> Stroke
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| Decreased HR | Fatigue
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| Vein valves Incompetent | Venous statsis ulcerations
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| Cardiovascular Disease | #1 killer in the US
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| Poikilothermy | loss of normal thermal regulation: temp varies with climate of the enviornment
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| EKG Electrocardiogram | records cardiac electrical activity
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| Ambulatory Electrocardiogram monitoring | Holter monitoring
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| Echocardiogram | Ultrasound, records motion, heart structures, Valves, heart size, shape, and position
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| Transesophageal Echocardiogram | Probe in Esophagus, gives a clearer Picture, NPO until Gag reflex returns
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| Exercise stress test (Video) | Cardiac stress Test= Cardiac response to exercise and O2 demands. Peripheral Vascular stress test= Vascular response to walking.
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| Plethysmography | Diagnoses Deep Vein Thrombosis, Pulmonary Emboli, Peripheral Vascular Disease
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| Pressure Measurment | BP readings along Extremity
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| Arterial Stiffness Index | Atherosclerosis/ Cardiovascular Disease
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| Tilt Table Test | Lying to Standing BP and HR
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| Doppler Ultrasound | Detects impaired bloodflow reduces sound waves
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| Radioisotopes IV, Gamma Camera Scan | Detects cardiac ischemia/damage/perfusion Thallium Imagining, Technetium Pyrophosphate Scan, Technetium 99m Sestamibi MUGA scan
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| Blood Lipids | Triglycerides(40-150), Cholesterol(<200), Phospholipids
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| Cardiac Biomarkers | Creatine Kinase (F-10-79) (M- 17-148), Troponin(0-0.5), Myoglobin
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| Magnesium | Norm= 1.7-2.2
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| Angiography | Proceudre that uses a special dye and xrays to see how blood flows through the arteries of the heart.
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| Cardiac Cath | Insertion of catheter into a chan=mber or vessel of the heart. Done for diagnostic and interventional purposes. Insertion is made through the femorla artery in the groin.
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| Cardiac Cath Monitor | After the procedure the Nurse must assess the site for bleeding and swelling; monitor VS especially BP for signs of bleeding, pedal pulses, and maintain pressure dressing
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| Cardiac Cath Nursing Interventions | Patient must not sit up, HOB must remain flat on bedrest for 4-6 hours after procedure. Log roll for bedpan assistance.
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| Electrophysiology study | Done during cardiac cath procedure, Used to test for various complex cardiac arrythmias of the heart. Post procedure is same as Cardiac cath.
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| Therapeutic Interventions for Cardiac disease | Exercise; walking, cardiac rehab, smoking cessation, balanced diet, weiht loss, O2, Antiembolism Devices- Elastic Stockings, SCD's.
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| HTN | Increase with age, More common in blacks
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| Normal BP | 120/80, Average of two or more readings on different dates. Highest reading determines category.
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| Pre-hypertension | 120-139 or 80-89
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| Stage 1 Hypertension | 140-159 or 90-99
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| Stage 2 Hypertension | >160or >100
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| Blood Pressure | Pressure exerted by blood on walls of blood vessels. Determined by cardiac output, peripheral Vascular resistance, Vessel Strech, Blood Viscosity & Volume
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| Primary HTN | Unknown Cause
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| Secondary HTN | From another medical Cause; ex. renal disease, heart disease, etc..
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| Isolated Systolic HTN | SBP > 140
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| Risk Factors of HTN (Nonmodifiable) | Family HX, Age, Ethnicity, Diabetes
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| Risk Factors of HTn (Modifiable) | Weight, diet(dash, limit Sodium, limit caffeine, limit alcohol use, exercising; walking 3-4X er wk, smoking censsation, stress management, adequate sleep.Never make suggestions to patient out of these guide lines, refer them to MD if need be.
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| Signs and Symptoms of HTN | None "Silent Killer" Rare= headache, bloody nose, anxiety, dyspnea
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| Diagnosis of HTN | HX, S&S, kidney or heart disease, meds, home BP readings, ECG, blood glucose, HCT, K+, CA+, lipoprotein, cholesterol, triglycerides
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| Complications of HTN | Atherosclerosis, CAD, MI, Left Ventricular Hypertrophy, Stroke, Kidney/Eye Damage
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| Emergency HTN | Targets Organ dysfunction, immediate reduction of BP to protect target organs, SBP will be >180 & DBP > 120 TX: NITROPRUSSIDE (Nipride) IV
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| Antihypertensive Meds | Initial therapy is (Thiazide-type diuretics), calcium channel blockers, vasodialtors, ASA 100mg @ HS
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| Nursing TX for HTN | PT education, Lifelong BP control(self care measures, prescribed Meds)
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| Mitral Valve Prolapse (MVP) | One or both flaps bulge into left atrium. This valve normal close during ventricular systole.
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| Mitral regurgitation | Bulging flaps do not fit together
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| Mitral Valve Prolapse (MVP) Eitology | Unknown cause, seen in women 20-55 years of age
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| Mitral Valve Prolapse (MVP) S | Often none, CP, anxiety, dysrhythmias, dyspnea, fatigue, palpitations.
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| Mitral Valve Prolapse (MVP) Complications | Dilation of left side of heart, HF, inefective endocarditis, emboli
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| Mitral Valve Prolapse (MVP) Diagnostic test | Murmur heard, 2-D or doppler Echocardigram, Coronary Angiogram
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| Mitral Valve Prolapse (MVP) Therapeutic Interventions | None unless symptoms present, healthy lifestle, Avoid stimulants/caffine, stress managment, Beta blockers for tachycardia, Valve Surgery for severe MVP
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| Mitral Valve Prolapse (MVP) Complication | Mitral valve Regurgitation
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| Mitral Valve regurgitation Patho | MItral valve incomplete closure, >back flow of blood to left atrium, > left atrium dilates,> extra blood volume to left ventricle,> left ventricle to dilates from extra volume,> eventually may fail
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| Mitral Valve regurgitation Causes | Rheumatic Heart Disease ( Most), endocarditis, congenital defects, chordae tenineae dysfunction, mitral valve prolapse.
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| Mitral Valve regurgitation S | None Early, Murmur, dyspnea, cough, hemoptysis, fatigue, palpitations, ATRIAL FibRIllation, CP
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| Mitral Valve regurgitation Complications | Atrial Fibrillation, Pulmonary HTN, HF
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| Mitral Valve regurgitation Diagnostic test | ECG=reveals P wave Changes; Chest xray= enlarged Chambers; 2-d doppler echo, Coronary angiogram
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| Mitral Valve regurgitation Interventions | o
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| Aortic Stenosis Patho | Aortic Valve narrows> Left ventrical contracts more forcefully,> left ventricale hypertrophies,> decreased cardiac output,> Heart failure.
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| Aortic Stenosis Causes | Congenital Defects, Rheumatic Heart Disease, calcification with aging
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| Aortic Stenosis S | None early, Angina, murmur, syncope, orthopena, dyspnea on excertion, fatigue, Pulmonary edema.
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| Aortic Stenosis Complications | Heart failure, Dysrhythmias, endocarditis
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| Aortic Stenosis Diagnostics | ECG, Chest Xray= enlarged Left ventricle, 2-d doppler echo, Serial echocardiography, cardiac cath.
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| Aortic Stenosis Interventions | Surgery, Aortic valve replacement, Valvotomy, Treat heart failure symptoms, Propholatic ABX per criteria.
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| Aortic Stenosis Nursing care | Pain relief (rating scale, nitro, pace activities (rest periods, conserve energy), VS, Maintain fluid volume (I&O, daily weights), sodium restrict, smoking cessation, meds as ordered (diuretics and monitor K+ level), asssess for edema.
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| Aortic Stenosis Teaching | Meds, use anticoagulants monthly (INR/Pt test), medic alert ID, include caregivers,
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| Aortic Stenosis Eval of care | Reports no pain,
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