Chronic Cardiac (adults) Flashcards
(61 cards)
0
Q
diastolic heart failure
A
ventricle cannot relax and fill
EF > 40%
Often > 60%
Appear (CO down but still pumping all blood out)
1
Q
systolic heart failure
A
inability of the ventricle to contract
EF < 40%
2
Q
causes of left-sided heart failure
A
- htn
- valve disease
- coronary disease
3
Q
left-sided heart failure interventions
A
- body positioning
- breathing
- education (fluids, safety, compliance)
4
Q
left-sided heart formerly known as…
A
CHF
5
Q
cor pulmonale
A
right-sided heart failure caused by pulmonary disease
6
Q
right-sided heart failure
A
- coronary disease
- left-sided failure
- pulmonary hypertension (not necessarily extension of systemic)
7
Q
left-sided heart failure nursing implications
A
ALWAYS SAFETY
- afterload management
- activity intolerance
- airway clearance
- fluid management
8
Q
right-sided heart failure nursing implications
A
ALWAYS SAFETY
- nutrition
- infection
- ventilation
- comfort
9
Q
evaluation of heart failure: blood work
A
- organ function
- BNP
- anemias
10
Q
evaluation of heart failure: diagnostics
A
- EKG
- echocardiogram
- chest x-ray
11
Q
Class I heart failure
A
- patients with cardiac disease but without resulting limitations of physical activity
- ordinary physical activity does not cause undue fatigue, palpitation, dyspnea, or a anginal pain
13
Q
Class II heart failure
A
- patients with cardiac disease resulting in sight limitation of physical activity
- they are comfortable at rest
- ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain
14
Q
Class III heart failure
A
- patients with cardiac disease resulting in marked limitation of physical activity
- comfortable at rest
- less than ordinary physical activity causes fatigue, palpitation, dyspnea, or anginal pain
15
Q
Class IV heart failure
A
- patients with cardiac disease resulting in inability to carry on any physical activity without discomfort
- symptoms of cardiac insufficiency or of the anginal syndrome may be present, even at rest
- if any physical activity is undertaken, discomfort is increased
16
Q
medical therapies for heart failure (x3)
A
- cardiac resynchronization therapy
- ventricular assist device
- myocardia reduction surgery
17
Q
myocardial reduction surgery why & how
A
- indicated for altering ventricular size
- alcohol ablation
- surgical resection of LV and/or septum
18
Q
mitral stenosis is…
A
- fibrotic or calcified valve
- can’t open
- incomplete filling
19
Q
mitral stenosis common cause
A
rheumatic fever
20
Q
mitral regurgitation
A
- fibrotic or calcified valve
- can’t close
- backflow of blood
21
Q
mitral regurgitation common cause
A
endocarditis
22
Q
mitral prolapse is…
A
- valve is enlarged
- leaflets don’t come together well
- more common in younger
23
Q
aortic stenosis is…
A
- “wear and tear” of aortic valve
- fibrotic or calcified valve
- obstructs outflow
- huge afterload increase can cause obstructive shock
24
Q
aortic regurgitation why/how/result
A
- valvular leaflets can’t come together
- fibrosis or calcification
- LV dilation
25
aortic regurgitation common cause
endocarditis
| congenital
26
non-invasive valve repair (x2)
- balloon valvuloplasty
| - mitral clip
27
transcatheter aortic valve replacement is...
- for high risk clients
- non-emergent
- medically stable
28
nursings implications for valve replacement
- drug therapy (anticoag, afterload reducer)
- plan activities
- surgical site
- client education
- assess for: vital sign trends, mental status, chest pain, edema, syncope, cyanosis, dyspnea
29
arteriosclerosis
hardening of the arterial wal
30
atherosclerosis
```
plaque formation
risks!!
- intimal layer damage
- hyperglycemia
- hyperlipidemia
- hypercholesterolemia
- hypertension
```
31
hypertension: normal
SBP < 120
| DBP < 80
32
pre-hypertension
SBP 120-139
OR
DBP 80-89
33
Stage 1 hypertension
SBP 140-159
OR
DBP 90-99
34
Stage 2 hypertension
SBP > 160
| DBP > 100
35
arterial baroreceptors
carotid sinus receptors (internal) - stim by sinus nerve to nerve IX
aortic arch receptors - stim by vague nerve X
36
RAAS problems (x2)
renal artery stenosis
| renal disease
37
causes of RAAS problems
- hyperthyroidism
- hyperaldosteronism
- Cushing's Syndrome
- pheochromocytoma
38
peripheral artery disease stages (I-IV)
I - asymptomatic
II - claudication
III - rest pain
IV - necrosis/gangrene
39
claudication
too little blood flow after exercise
40
PAD assessment findings
- decreased capillary refill
- decreased pulses (palpable, doppler)
- cool/pale skin
41
PAD non-surgical interventions
- warmth (not hot!!)
- minimize exposure
- minimize vasoconstriction (pharm and non)
42
PAD surgical interventions
- angioplasty
- stent
- atherectomy
- revascularization (vascular bypass)
43
arterial aneurysm is...
- can occur in any artery
| - weakening of vascular wall (aorta, cerebral arteries)
44
aneurysm presentations (x4)
- pulsatile mass
- aching, "gnawing" pain
- "tearing" (possible radiation)
- bruit
45
aneurysm non-surgical management
monitor
bp management
stress management
46
aneurysm surgical management
endograft
clipping
coiling
47
aneurysm post-procedure care
- bleeding/infection
- neuromuscular function
- graft/vessel occlusion (heart, brain, abdominal cavity, spinal cord, limb)
- client education
48
peripheral venous disease
- venous thromboembolism (DVT, phlebitis, thrombophlebitis)
49
PVD non-surgical interventions
- pharmacologic (antiplatelet, anticoag, thrombolytic)
- elevate extremity
- SCDs
50
PVD surgical interventions
- thromboectomy
| - inferior vena cava filter
51
PVD nursing implications
- prevention
- improve venous return
- DON'T RUB
- hydration
- remove causative factors
- warm compresses
- pharm management
BOOM BOOM!
52
sinus bradycardia presentation
- dizzy
- nausea
- diaphoretic
some people have normally low HR (athletes, elderly) but can be related to lower CO and very symptomatic esp. 60-70
53
sinus tachycardia presentation
- dizzy
- fluttering in chest
- heart pounding
HR up, heart has less time to fill. elderly: decreased ability to compensate = severe presentation
54
a fib and a flutter presentation
- fluttering in chest
- heart racing
- chest pain
no benefit from atrial kick, so decrease in CO -> fatigue and chest pain
55
atrial kick
when atria contracts, it adds 25% more blood to ventricle than via passive filling
56
v tach presentation
- syncopal
- chest pain
- palpitations
- dizziness
- pulseless
LETHAL ARRHYTHMIA
57
v tach intervention
defibrillation: pulseless, unconscious, unstable
cardioversion: awake, some kind of heart beat, BP
- timed with R wave
LETHAL ARRHYTHMIA
58
Torsades or V fib presentation
- pulseless
- lifeless
- pale
- cyanotic (no circulating blood volume)
59
Torsades or V fib treatment
- defibrillation STAT
- epinephrine
- mg (Torsades specific: diminish electrical excitability)
60
asystole presentation
pulseless
61
asystole interventions
- CPR
- epinephrine (increase vascular tone)
- atropine (minimuze vagus nerve on systolic rhythm)
NO SHOCKING. no beats.
