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cv Flashcards

1
Q

diagnostic tests for peripheral arterial disease

A

ankle-brachial index

doppler ultrasound

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2
Q

pharmacological therapy for peripheral arterial disease

A 
ace inhibitors 
antiplatelet therapy (ASA, clopidogrel)
pentoxifylline treats intermittent claudication
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3
Q

nursing interventions for peripheral arterial disease

A 
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
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4
Q

diagnostic criteria for metabolic syndrome

A 
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
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5
Q

nursing management for metabolic syndrome

A 
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

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6
Q

types of cardiomyopathy

A

dilated
hypertrophic
restrictive

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7
Q

dilated cardiomyopathy

A

ventricular dilation, atrial enlargement

  • ETOH,cocaine, genetic, HTN, CAD, valve disease, pregnancy, myocarditis, Muscular dystrophy
  • Common type
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8
Q

hypertrophic cardiomyopathy

A

thickening of the heart’s walls

-genetic, aortic stenosis, HTN

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9
Q

restrictive cardiomyopathy

A
  • This condition restricts heart from stretching properly, and limits the amount of blood that fills the heart’s chambers.
  • rare
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10
Q

diagnostics for cardiomyopathy

A 
Echocardiogram (Doppler)
Chest x-ray
ECG
Serum B-type natriuretic peptide (BNP)
History and physical- presence of heart failure
Cardiac catheterization
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11
Q

aims of treatment in dilated cardiomyopathy

A 
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
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12
Q

aims of treatment in hypertrophic cardiomyopathy

A

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)

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13
Q

nursing interventions for hypertrophic cardiomyopathy

A 
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
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14
Q

aims of treatment in restrictive cardiomyopathy

A

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

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15
Q

pericarditis

A

Inflammation of the pericardial sac

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16
Q

when does pain increase with pericarditis

A

with deep inspiration and when lying supine

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17
Q

complications of pericarditis

A

pericardial effusion and cardiac tamponade

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18
Q

diagnosis of pericarditis

A

diffuse ST segment elevations

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19
Q

nursing interventions for pericarditis

A

pain and anxiety management
anti-inflammatory meds
PPIs

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20
Q

nursing management for preoperative care

A

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

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21
Q

nursing management for intraoperative care

A

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

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22
Q

general anesthesia

A

IV induction, inhalation agents, and adjuncts(cholinergic, anti-cholinergics, Neuromuscular paralyzing agents, opioids, benzodiazepines, and antiemetic’s)

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23
Q

local anesthesia

A

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)

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24
Q

procedural sedation

A

monitored and controlled setting

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25
Q

emergency events in the operating room

A 
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
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26
Q

nursing management post operative care

A 
Thorough report received from PACU:
Breathing pattern and oxygenation
Hemodynamics
Fluid Balance
Level of Consciousness
Pain control
Post-op nausea and vomiting
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27
Q

acute pacemaker disorder

A

External electrical therapy:
Transcutaneous
Mediastinal pacing leads implanted post open-heart surgery

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28
Q

possible complications and malfunctions of acute pacemakers

A 
Failure to capture
Undersensing
Oversensing
Loss of pacing
Change in QRS shape
Diaphramatic twitching, hiccups, chest wall twitching
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29
Q

chronic pacemaker disorder

A

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.

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30
Q

possible complications and malfunctions of chronic pacemakers s

A 
Possible complications and malfunction:
Failure to capture
Undersensing
Oversensing
Loss of pacing
Change in QRS shape
Hemorrhage
Infection
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31
Q

pacemaker codes

A 
1 = chambers paced (o = none, a = atrium, v = ventricle, d = dual)
2 = chambers sensed (o = none, a = atrium, v = ventricle, d = dual)
3 = response to sensing (o = none, i = inhibited, t = triggered, d = dual)
4 = rate adaptive (o = none, r = rate adaptive)
32
Q

pacemaker therapy indication

A

Indicated for conduction disturbances that are symptomatic.
Usually for slower-than normal impulse formation.
Can be used to control some tachydysrhythmias.
Some patients requiring ablation therapy may require a permanent pacemaker.

33
Q

what may be used to treat advanced heart failure

A

Biventricular pacing or Cardiac Resynchronization Therapy(CRT) may be used to treat advanced heart failure.

34
Q

what does CRT allow for

A

CRT allows for synchrony of ventricular contraction, and manipulation of heart rate as needed.
Indications include: decreased LV ejection fraction, widened QRS, left bundle branch block(LBBB), and NYHA classification. (Saxon & DeMarco, 2014)
Addition of Implantable cardioverter-defibrillator (ICD) with patients that have a persistent NYHA functional Class II or IIII with optimized therapy and an EF <35%

35
Q

pediatric considerations for pacemaker therapy

A

Underlying congenital cardiac defect may precipitate the dysrhythmia.
Sometimes, after a structural heart defect is repaired an AV block may occur temporarily.
Parents and the child(depending on the age) should be taught how to take a pulse for a full minute.
CPR instruction is suggested for parents, as a measure to create psychological well-being.

36
Q

patient teaching considerations for pacemaker therapy immediately post-op

A 
Ice the incision site of the generator.
Limit movement of the arm on the side of the generator placement while healing.
Signs and symptoms of infection
Assess for hematoma formation
General wound care
37
Q

ongoing patient education for pacemaker therapy

A

Teach patient and caregivers to self assess a pulse
Signs and symptoms of pacemaker malfunction
Discuss appropriate physical activities, but recognize the limitation of participation in contact sports.
Use of a medical identification card with pertinent pacemaker information.

38
Q

patient teaching electromagnetic interference considerations for pacemaker therapy

A

Electromagnetic interference considerations:
Avoid large magnetic fields, such as MRI, large motors, arc welding, electrical substations.
When going through security gates, inform the officer prior and provide the documentation of your pacemaker, and request a physical search.

39
Q

recommended infection reduction strategies for pacemaker insertion

A

electrical shaving of hair at device insertion site close to procedure time
skin preparation with chlorhexidine 2% in 70% isopropyl alcohol
iv antibiotic administration that both covers pertinent organisms and has been completed prior to skin incision (30-60 min)
rigorous hemostasis to prevent device pocket hematoma

40
Q

disadvantages of pacemaker therapy

A 
Risk of systemic infection
 Vein thrombosis / stenosis
 Lead fracture
 Risks of endovascular extraction
 No pacing, no ATP
 No advanced diagnostics
 80J
 Big generator
41
Q

medications for heart failure and coronary artery disease

A 
dobutamine hydrochloride 
dopamine 
norepinephrine 
milrinone
angiotensin receptor-neprilysin inhibitor (ANRI) sacubitril/valsartan 
IF inhibitor (ivabradine)
digoxin (cardiac glycoside)
42
Q

dobutamine hydrochloride

A

Mechanism of Action:
Positive inotrope (increases contractility) without affecting HR
Availability: IV route
½ life: 2 min
Indications: short term management (48 hrs) of HF from heart disease or surgical procedures
Interactions: use with nitroprusside for synergistic effect
Contraindications: hypersensitivity to dobutamine or bisulfites
Adverse Effects: CNS-headache Resp-SOB CV-HTN, increased HR, PVC’s, angina pectoris, arrhythmias, hypotension, palpitations GI—N & V
Assessment/ Teaching: consult physician for vital sign parameters.
Monitor BP, HR, CO, CVP urinary output. Report arrythmias. Assess peripheral pulses and notify physician if mottling occurs.

43
Q

dopamine

A

Mechanism of Action:
Small doses stimulate dopaminergic receptors, producing renal vasodilation. Larger does (2-10mcg/kg/min) stimulate dopaminergic and B1 adrenergic receptors—cardiac stimulation and renal dilation
Doses larger than 10 mcg/kg/min may cause renal constriction
Indications: Low dose- increases renal perfusion
Shock unresponsive to fluids—increases BP, CO and urine output
Availability: IV route
½ life: 2 min
Contraindications: tachyarrhythmias, pheochromocytoma, hypersensitivity to bisulfites. Use cautiously in hypovolemia, MI. Efficacy not established in pregnancy
Interactions: MAO inhibitors, some antidepressants may cause hypertension
Phenytoin may cause hypotension and bradycardia
General anesthetics may cause arrhythmias
Adverse Effects: CNS: headache Resp: dyspnea CV: arrhythmias, hypotension, angina, ECG changes, palpitations GI: N& V Derm: piloerection Local: irritation at IV site
Assessment/ Teaching: Consult physician for vital sign parameters.
Monitor BP, HR, pulse pressure, CO, CVP urinary output. Report arrhythmias.
Assess peripheral pulses and notify physician if mottling occurs.
If hypotension continues a more potent vasoconstrictor (norepi) may be administered

44
Q

norepinephrine

A

Mechanism of Action: Vasopressor
Indications:
Produces vasoconstriction and myocardial stimulation; severe hypotension and shock
Availability: IV route
½ life: unknown
Contraindications: vascular, mesenteric or peripheral thrombosis.
Hypersensitivity to bisulfates
Decreased uterine blood flow
Interactions: MAO inhibitors, methyldopa, doxapram, or tricyclic antidepressants may result in severe hypotension
Adverse Effects: CNS-anxiety, dizziness, headache, insomnia, restlessness, tremor, weakness Resp—dyspnea CV-arrhythmias, bradycardia, CP, hypertension
GU: decreased urine output, renal failure Endo: hyperglycemia Metabolic acidosis
Assessment/ Teaching: Consult physician for vital sign parameters.
Monitor arterial pulses, ECG, CO, CVP, urinary output. Report arrhythmias and U/0 <30 ml/hr.
Assess peripheral pulses and notify physician if mottling occurs.

45
Q

milrinone

A 
Mechanism of Action: ionotropic
Indications: short term treatment of HR unresponsive to conventional therapy with digoxin, diuretics and vasodilators
Availability: IV route
½ life: 2.3 hrs
Contraindications: hypersensitivity, severe aortic or pulmonic vavular heart disease, hypertrophic subaortic stenosis
Interactions: None significant
Adverse Effects:
CNS-headache, tremor CV-ventricular arrhythmias, angina pectoris, CP, hypotension, supraventricular arrhythmias GI- increased liver enzymes Hypokalemia and thrombocytopenia
Assessment/ Teaching:
Monitor BP and HR
Monitor I/O and daily weight
Continuous ECG: monitor for arrhythmias
Monitor electrolytes
Monitor platelets
46
Q

Angiotensin receptor-neprilysin inhibitor (ARNi) Sacubitril/ valsartan

A

Mechanism of Action: vasodilator, antihypertensive
Sacubitril: inhibits the enzyme neprilysin. It degrades natriuretic peptides, bradykinin, and adrenomedullin –thus increasing levels of these peptides, causing vasodilation and decreased extracellular fluid via sodium excretion
Valsartan: blocks vasoconstriction and aldosterone-production effecting angiotensin II at receptor sites
Indications: to decrease mortality and hospitalization in NYHA class II-IV with decreased EF
Interactions: NSAIDS and selective Cox-2 inhibitors may increase risk renal dysfunction
May increase lithium levels
Contraindications: hypersensitivity, angioedema in ACE inhibitors or ARBs
Delay for 36 hrs after last dose of ACE inhibitors for washout period
Concurrent use with aliskiren in pts with diabetes or moderate to severe renal impairment
Severe hepatic impairment
May cause death of fetus
May not be effective in Black pts
Adverse Effects: CNS-dizziness Resp-cough CV-hypotension Hyperkalemia Angioedema
Assessment/ Teaching: BP (orthostatic), pulse. Monitor daily weight. Monitor renal function, potassium levels, hemoglobin and HCT

47
Q

IF inhibitor (ivabradine)

A

Mechanism of Action: inhibits the cardiac pacemaker If current by acting on the hyperpolarization-active cyclic nucleoside-gated channel blocker.
Decreases HR without effecting contractility or ventricular repolarization.

Indications: heart failure (decreases mortality and hospitalization)

Contraindications: acutely decompensated HR, sick sinus syndrome, sinoatrial block or 3o heart block, severe hepatic impairment, pacemaker dependent, pregnancy

Adverse Effects: phosphenes CV-afib, bradycardia, HB, hypertension, sinus arrest
Interactions:
CYP3A4 inhibitors (azole antifungals, macrolide anti-infectives, HIV protease inhibitors and nefazodone is contraindicated.
Moderate CYP3A4 inhibitors (diltiazem and verapamil) should be avoided
CYP3A4 inducers (barbiturates, phenytoin and rifampicin) should be avoided
Bradycardia risk with concurrent use of negative chronotropes (amiodarone, b-blockers, digoxin)
Avoid St. John Wort
Avoid grapefruit juice
Assessment/ Teaching:
Monitor HR
Avoid grapefruit juice
May be teratogenic—use appropriate contraception

48
Q

digoxin (cardiac glycoside)

A

Mechanism of Action:
Positive ionotropic medication
Control ventricular response by controlling the refractory period—reduces HR
Vagal tone: increases diastolic filling
Indications: HF, Afib and Aflutter
Contraindications: known drug allergy. 2nd or 3rd O HB, afib, vtach or vfib, heart failure (diastolic dysfunction), subaortic stenosis, kidney dysfunction. May still be prescribed by cardiologist
Interactions: Low K+ or Mag levels may increase toxicity
Amiodarone, quinidine sulfate, and verapamil hydrochloride may increase digoxin levels by 50%
Adverse Effects:
CV: bradycardia, tachy, hypotension
CNS: headache, fatigue, confusion, convulsions
Occular: blurred vision, halo vision
GI: anorexia, N & V, diarrhea
Narrow therapeutic window. Normal levels 0.5-0.9ng/ml
Dig toxicity: ↓ in kidney function
Treatment of toxicity: withhold the next dose or digoxin immune Fab
Dosing: usual oral maintenance dose: 0.125-0.5mg/daycareful of decimal points*
Assessment: Medication typically held if apical HR for 1 minute < 60 bpm
lab monitoring—when initiating the med and toxicity suspected

49
Q

coronary artery bypass graft surgery (CABG)

A

Indication: Multi-vessel coronary artery disease. Complex coronary artery lesions that can not be treated with angioplasty, or post failed PCI.
May be done in conjunction with Cardiopulmonary Bypass(CPB), or Off-Pump Coronary Artery Bypass(OPCAB)

50
Q

valve replacement surgery

A

Open Heart:
Indication: Complex structural considerations
Minimally invasive:
Transcatherter Aortic Valve Implantation TAVI
Indication: aortic stenosis patient’s who are not a candidate for open heart surgery.

51
Q

cardiopulmonary bypass surgery (CPB)

A

This procedure allows for the mechanical circulation and oxygenation of blood while bypassing the heart and lungs.
The patient receives heparin to prevent clotting and thrombus formation in the bypass circuit.
Once disconnected from CPB protamine sulfate is administered to the patient to reverse the effects of heparin.
During CPB hypothermia is maintained at 28-320C.

52
Q

collaborative problems/potential problems post-op open heart surgery

A

Cardiac complications: Heart Failure, MI, stunned myocardium, dysrhythmias, cardiac tamponade, cardiac arrest
Pulmonary complications: Pulmonary edema, pulmonary emboli, pleural effusions, pneumothorax or hemothorax, respiratory failure, acute respiratory distress syndrome(ARDS)
Hemorrhage/Coagulopathy
Neurological Complications: Embolic or hemorrhagic stroke
Renal Failure
Electrolyte imbalance
Hepatic Failure
Infection/Sepsis

53
Q

priority nursing interventions post-op open heart surgery

A 
Restoring Cardiac Output
Promoting Adequate Gas Exchange
Maintaining Fluid and Electrolyte Balance
Minimizing Sensory Perception Imbalance
Relieving Pain
Maintaining Adequate Tissue Perfusion
Maintaining Normal Body Temperature
Promoting Home and Community Based Care
54
Q

nursing implications: prosthetic valves

A

ASSESS FOR:

  • Dyspnea
  • Hemoptysis
  • Angina
  • Fatigue, generalized weakness
  • Fever
  • Abnormal heart sounds
  • Signs of fluid overload (edema, crackles, JVP)
  • Teaching: cardiac risk factors, meds, caution with dental procedures, INR monitoring
55
Q

home care: prosthetic valves

A

Management and prevention of heart failure, dysrhythmias, endocarditis and emboli
Patient teaching re cardiac risk factors (i.e. smoking, hypertension)
INR monitoring with anticoagulation
Caution with dental procedures

56
Q

common causes of heart failure

A 
chronic = cad, htn, rheumatic heart disease, congenital heart disease, ventricular septal defect, pulmonary disease, cardiomyopathy, anemia, bacterial endocarditis, valvular disorders
acute = acute mi, dysrhythmia, pulmonary embolism, thyrotoxicosis, hypertensive crisis, myocarditis, bacterial endocarditis, rupture of papillary muscle
57
Q

clinical manifestations of right sided heart failure

A 
Fatigue
Dependent edema
Rt upper quadrant pain
Anorexia and GI bloating
Nausea
Weight gain
Increased HR
Ascites
Anascara
JVD
Hepatomegaly
Rt-sided pleural effusion
58
Q

clinical manifestations of left sided heart failure

A 
Fatigue
Dyspnea
Orthopnea
Dry, hacking cough
Pulmonary edema
Nocturia
Paroxysmal nocturnal dyspnea
Cheyne-stokes resp
Pulsus alternans
Crackels
S3 and S4
59
Q

class 1 heart failure patient symptoms

A

No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea (shortness of breath).

60
Q

class 2 heart failure patient symptoms

A

Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea (shortness of breath).

61
Q

class 3 heart failure patient symptoms

A

Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, or dyspnea.

62
Q

class 4 heart failure patient symptoms

A

Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases.

63
Q

collaborative care interventions for end stage heart failure

A

Goal: relieve patient symptoms, improve functional status and quality of life, and extend survival.
Medical management is based on the type, severity, and cause of HF.
Specific objectives of medical management include:
Eliminate or reduce any etiologic contributory factors, especially those that may be reversible
Reduce the workload on the heart by reducing afterload and preload.
Optimize all therapeutic regimes.
Prevent exacerbations of HF

64
Q

chronic heart failure drug therapy

A 
ACE inhibitors
ARB
ARNIs
aldosterone antagonists 
omega 3 
phosphodiesterase inhibitors
digoxin 
nitrates
65
Q

contraindicated medications for heart failure

A

NSAIDS

decongestants

66
Q

priority nursing interventions for end stage heart failure

A

Promoting Activity Tolerance
NYHA class III: 30-45 min. of physical activity 3-5 times a week
Participation in a Cardiac rehabilitation program
Managing Fluid Volume
Timing for administration of diuretics
Controlling Anxiety
Sympathetic response increases cardiac workload
Minimizing Powerlessness
Assess for factors that contribute
Promoting Home and Community-based Care
Patient and Family teaching

67
Q

heart failure collaborative management priorities

A 
decreasing intravascular volume 
decreasing venous return 
decreasing afterload
improving gas exchange and oxygenation 
improving cardiac function 
reducing anxiety
68
Q

overall goals for chronic heart failure

A

Decrease in symptoms (e.g., shortness of breath, fatigue)
Decrease in peripheral edema
Increase in exercise tolerance
Compliance with the medical regimen
No complications related to HF
Patient/caregiver teaching: medications, diet, and exercise regimens
Exercise training (e.g., cardiac rehabilitation) improves symptoms but is often under prescribed.
Home nursing care may be required for follow-up and to monitor patient’s response to treatment
Conserve energy
Sodium restriction (<2g/day)
Fluid restriction (1.5-2 L/day OR as per MD orders)
Monitor weight daily (gain of >2 kg over a 2-day period: call health care provider)

69
Q

ventricular assist devices (VADs)

A

Destination therapy (in US only)
Bridge to transplant
HeartWare (Abbott) & Heart Mate3 (Medtronic)
HeartWare uses continuous centrifugal flow
Blood pulled into pump from LV and continuously delivered to ascending aorta
Uses magnetic levitation technology
Patients must be anticoagulated to prevent clot formation (INR 2.5-3.5

70
Q

LVAD potential complications

A 
Clots/ stroke
Life threatening
May require urgent implantation of new device or increase priority on transplant list
Bleeding
anticoagulation
Infection
Drive line site
Device malfunction
Right sided heart failure
Arrhythmias
Kidney failure
71
Q

LVAD interdisciplinary team

A 
VAD surgeon (cardiac surgeon with additional specialties)
VAD cardiologist
Intensivist physician (during ICU stay)
Perfusionist
VAD/transplant nurse clinician
RN
Physiotherapists
Pharmacists
Social workers
Dieticians
Echocardiogram technologists
72
Q

LVAD nursing care

A 
Assessments
MAP
Dressing
Drive line & insertion site
Pump speed, flow, power
Daily Weights
Intake & Output 
Mobilization & physio
Education (patient & support system)
VAD system
Alarms
Power system
Dressing changes
Showers
Anticoagulation (Coumadin)

CAUTION: Chest Compressions

73
Q

heart transplant post-op care

A

Includes a constant balance of the risk of rejection with the risk of infection.
Patients have a complex regime of diet, medications, activity, follow-up laboratory studies, biopsies of the transplanted heart, and clinic visits

74
Q

heart transplant common immunosuppressant therapy

A

cyclosporine(Neoral) or tacrolimus(Prograf) or azathioprine or mycophenolate mofetil(Cellcept), and corticosteroids(prednisolone).
Immunosuppressive induction therapy with a MAB begins in the operating room. This buys time for the kidneys to recover from the insult of surgery prior to the addition of other immunosuppressants.
Greatly decreases the body’s rejection of foreign proteins.
Patient’s specifically taking cyclosporine or tacrolimus are at risk for development of secondary hypertension.

75
Q

post transplant collaborative problems/ potential complications

A

Accelerated atherosclerosis of coronary arteries
Hypertension
Osteoporosis
Post-transplantation lymphoproliferative disease and cancer of skin and lips are most common.
Medication Regime side effects: weight gain, obesity, diabetes, dyslipidemias, hypotension, renal failure, and central nervous, respiratory, and gastrointestinal disturbances

76
Q

priority nursing interventions with heart transplant

A

Increase activity tolerance
Denervated heart
Enhance coping management
Encourage patient compliance with post-op regime
Establish ongoing follow-up of overall well being

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