Cardiac Flashcards
Review the most important cardiac diagnostic tests and diseases.
What is a cardiac catheterization with coronary angiogram (or coronary angiography)?
It’s the use of a tube inserted into an artery in the neck, groin or arm, and then dye is injected to visualize the heart and vessels.
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It is done to diagnose cardiac diseases or as an intervention to treat cardiac disease.
What are the pre-procedure interventions for a cardiac catheterization?
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- ensure informed consent is signed
- assess for dye allergies
- NPO beforehand
- assess pulses and vital signs
- mark pulses with a sharpie marker
- if needed, use a doppler to locate pulses
Teaching:
Cardiac catheterization and dye
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Tell client:
- that they may feel a warm flushing sensation
- an urge to urinate
- heart palpitations as the dye is being injected.
What are the post-procedure interventions for a cardiac catheterization?
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- keep leg straight for 4-6 hours to prevent bleeding
- if a closure device is used, in bed for only 1-2 hours
- assess pulses and vital signs
- encourage fluids to flush out dye
What is a percutaneous transluminal coronary angioplasty (PCTA)?
A PCTA is when a balloon is used to open up an artery due to plaque build-up.
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What is laser-assisted angioplasty?
Is when a laser is used to vaporize the plaque in the artery.
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What is a coronary stent?
It is placed in the artery to keep it open for adequate blood flow.
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What is a coronary artery bypass graft/surgery (CABG)?
A CABG is open-heart surgery that uses the client’s own veins or arteries to bypass clogged arteries.
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Teaching:
Coronary artery bypass surgery (CABG)
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- limit pushing and pulling for 6 weeks
- don’t cross legs
- wear compression socks and elevate limb that was used for the graft
- sex is OK if client can walk 1 block or climb 2 flights of stairs without symptoms
- weigh self daily
What is a vena cava filter?
A filter placed in the vena cava to trap blood clots.
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What do the following cardiac procedures all have in common?
- cardiac catheterization
- PTCA (percutaneous transluminal coronary angioplasty)
- laser-assisted angioplasty
- coronary stents
- CABG (coronary artery bypass surgery)
- vena cava filter
All these cardiac procedures are different ways to remove or bypass plaque in the cardiac arteries to re-establish blood flow and oxygen perfusion.
Teaching:
Cardiac pre-procedure
Stop taking anticoagulants or antiplatelets about 2-7 days before the cardiac procedure in order to prevent bleeding.
What are the general pre-procedure interventions for most cardiac procedures?
Perform a baseline cardiac assessment:
- check bleeding time
- assess for hematoma formation
- vital signs
- EKG rhythm and chest pain
- peripheral pulses
- level of consciousness
What are the general post-procedure interventions for most cardiac procedures?
Assess for complications such as:
- bleeding or hematoma formation at the insertion site
- cardiac dysrhythmias and chest pain
- embolisms
- infection
What is an embolectomy?
A blood clot (embolism) removed from an artery.
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What is a cardiac stress test?
Checks for coronary artery disease by making the heart work.
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It can be performed on a treadmill or with IV meds to increase workload of the heart - cardiac meds are usually held before test.
What is central venous pressure?
CVP is to check pressure in the superior vena cava for cardiogenic shock. It’s checked with a central line and normal is 3-8 cm H20.
* increased CVP = FVO
* decreased CVP = FVD
The client is placed supine and the transducer is at the 4th intercostal space/mid axillary line
Describe:
Angina
Chest pain caused by inadequate myocardial blood and oxygen supply.
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Explain the difference between:
1. stable angina
2. unstable angina
3. variant/prinzmetal angina
- stable angina is chest pain with physical exertion or stress: is usually relieved with nitroglycerin
- unstable angina is chest pain not related to exercise: not usually relieved with nitroglycerin and indicates a worsening situation
- variant/prinzmetal angina is from coronary artery spasm: may see ST segment elevation and client can still be considered stable
Describe:
Coronary artery disease
Plaque (fatty deposits) in the arteries that puts the client at high risk for myocardial infarction and other heart diseases.
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Treatment:
Coronary artery disease
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- remove plaque with cardiac procedures
-
medications
- nitrates
- antilipidemics
Teaching:
Coronary artery disease
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Teach about lifestyle changes:
- stop smoking
- limit alcohol
- DASH diet
- mild to moderate daily exercise
- decrease stress
- lower cholesterol levels
Describe the difference between right-sided heart failure and left-sided heart failure.
Heart failure is the back-up of fluids in the body:
- Right-sided heart failure causes peripheral edema
- Left-sided heart failure causes back up of fluids in the lungs
Signs and symptoms:
Right-sided heart failure
- weight gain and edema
- jugular vein distention
- increased blood pressure and bounding pulse
What is this?
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Pitting edema: a symptom a right-sided heart failure.
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It can be 1+, 2+, 3+, or 4+.
What is this?
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Jugular vein distention: a symptom of right-sided heart failure.
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