cv Flashcards
diagnostic tests for peripheral arterial disease
ankle-brachial index
doppler ultrasound
pharmacological therapy for peripheral arterial disease
ace inhibitors antiplatelet therapy (ASA, clopidogrel) pentoxifylline treats intermittent claudication
nursing interventions for peripheral arterial disease
Exercise therapy Nutritional therapy Care of the leg with critical limb ischemia Radiology catheter based procedures Stents Atherectomy Cryoplasty Surgical interventions Teach proper foot care
diagnostic criteria for metabolic syndrome
three or more: Waist circumference Men>102 cm Women>88 cm Triglyceride levels >1.7 mmol/L or being treated HDL cholesterol level men: <1.0mmol/L Women: <1.3 mmol/L Or being treated BP >130 mm Hg systolic or >85 mm Hg diastolic Or being treated Fasting blood level >5.6mmol/L or Being treated
nursing management for metabolic syndrome
Decrease cardiovascular risk factors: Lowering LDL Quitting smoking Lowering BP Lowering glucose levels
Decrease weight
Increase physical activity
Healthy dietary habits
No specific treatment for metabolic syndrome exists
types of cardiomyopathy
dilated
hypertrophic
restrictive
dilated cardiomyopathy
ventricular dilation, atrial enlargement
- ETOH,cocaine, genetic, HTN, CAD, valve disease, pregnancy, myocarditis, Muscular dystrophy
- Common type
hypertrophic cardiomyopathy
thickening of the heart’s walls
-genetic, aortic stenosis, HTN
restrictive cardiomyopathy
- This condition restricts heart from stretching properly, and limits the amount of blood that fills the heart’s chambers.
- rare
diagnostics for cardiomyopathy
Echocardiogram (Doppler) Chest x-ray ECG Serum B-type natriuretic peptide (BNP) History and physical- presence of heart failure Cardiac catheterization
aims of treatment in dilated cardiomyopathy
Decrease preload (nitrates, loop diuretics) Decrease afterload (ACE inhibitors) Prevent arrhythmias(i.e. amiodarone, digoxin) Maximize cardiac output This type of cardiomyopathy does not usually respond well and increased episodes of heart failure are common
aims of treatment in hypertrophic cardiomyopathy
Improve ventricular filling by decreasing contractility (i.e. metoprolol or calcium channel blockers i.e. verapamil)
Digoxin is contraindicated unless for atrial fib treatment
Antidysrhythmics (i.e. amiodarone)
Surgical treatment of hypertrophied septum for severe symptoms (ventriculotomy and myectomy)
nursing interventions for hypertrophic cardiomyopathy
Focus on relieving symptoms Prevent complications Psychosocial support Avoid strenuous activity and dehydration Teaching re activity, symptom management Management of chest pain by rest and elevating feet
aims of treatment in restrictive cardiomyopathy
No specific treatment exists
Treatment aimed at diastolic filling
Treatment of heart failure and arrhythmias
Avoiding strenuous activity
Risk of endocarditis- may have prophylactic antibiotics
pericarditis
Inflammation of the pericardial sac
when does pain increase with pericarditis
with deep inspiration and when lying supine
complications of pericarditis
pericardial effusion and cardiac tamponade
diagnosis of pericarditis
diffuse ST segment elevations
nursing interventions for pericarditis
pain and anxiety management
anti-inflammatory meds
PPIs
nursing management for preoperative care
Surgical Setting: Elective surgery versus emergency surgery
Patient Interview: Interdisciplinary approach
Nursing Specific Assessment
Interdisciplinary assessment: Including laboratory and diagnostic testing.
Preoperative Teaching: What to expect, how to manage anxiety, how to optimize health
Legal Preparation for Surgery: Informed consent
Day of Surgery preparation: pre-op checklist, ID verification, Pre-op medication
nursing management for intraoperative care
Psychosocial and Physical assessment
Chart Review: consent form, pre-op checklist, written history and physical exam
Admission to OR holding room
Room Preparation: transferring the patient, scrubbing, gowning, and gloving, basic aseptic technique, assisting the anesthesiologist, positioning the patient, preparing the surgical site
general anesthesia
IV induction, inhalation agents, and adjuncts(cholinergic, anti-cholinergics, Neuromuscular paralyzing agents, opioids, benzodiazepines, and antiemetic’s)
local anesthesia
Topical (e.g. Lido-inject, emla cream)
Local infiltration (e.g.Lidocaine injection via needle)
Regional (Peripheral) nerve block (e.g. injection of local anesthetic around a specific
Intravenous Regional block (Bier block)
Spinal anesthesia (block)
Epidural anesthesia (block)
procedural sedation
monitored and controlled setting
emergency events in the operating room
Anaphylactic Reactions(e.g. anesthetics, antibiotics, blood products, and plasma expanders) Malignant Hyperthermia(S&S: hyperthermia, rigidity of skeletal muscles, hypoxemia, lactic acidosis, hemodynamic, and cardiac alterations) Major Blood Loss
nursing management post operative care
Thorough report received from PACU: Breathing pattern and oxygenation Hemodynamics Fluid Balance Level of Consciousness Pain control Post-op nausea and vomiting
acute pacemaker disorder
External electrical therapy:
Transcutaneous
Mediastinal pacing leads implanted post open-heart surgery
possible complications and malfunctions of acute pacemakers
Failure to capture Undersensing Oversensing Loss of pacing Change in QRS shape Diaphramatic twitching, hiccups, chest wall twitching
chronic pacemaker disorder
Internal permanent pacemaker:
Endocardial leads inserted via the external jugular vein and attached to an implanted generator placed beneath the skin in a subcutaneous pocket.
possible complications and malfunctions of chronic pacemakers s
Possible complications and malfunction: Failure to capture Undersensing Oversensing Loss of pacing Change in QRS shape Hemorrhage Infection