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