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NUR305 (2017) > Week 4 > Flashcards

Week 4 Flashcards

1
Q

What does ALS stand for?

A

Advanced Life Support

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2
Q

What is the initial nursing care assessment of a pt with HF?

A
  • subjective and objective health hx
  • sleep and activity
  • Physical Exam
  • mental status
  • Respiratory assessment = lung sounds
  • cardiovascular assessment = heart sounds
  • Fluid status/signs of fluid overload = daily weight/input and output
  • assess response to medications
  • further medical investigations = CXR, ECG, bloods
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3
Q

What is the initial assessment for a pt presenting with acute CP or ACS symptoms?

A

Always assume cardiac till proven otherwise.

  • 12 lead ECG recorded and assessed within 10 minutes of presentation
  • receive caare based on the ACS assessment protocol
  • cardiac specific troponin =bloods
  • Aspirin (300mg stat unless contraindicated)
  • Oxygen therapy = only if below 93%
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4
Q

What are the 2 shockable rhythms?

A
  • Ventricular fibrillation

- ventricular tachycardiac

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5
Q

In ALS what do the 4H’s stand for when assessing reversible causes?

A
  • hypoxaemia
  • hypovolaemia
  • hyper/hypokalaemia
  • hypo/hyperthermia
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6
Q

In ALS what do the 4T’s stand for when assessing reversible causes?

A
  • tension pneumothorax
  • tamponade
  • toxins (poisons/drugs)
  • thromboembolic (coronary/pulmonary)
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7
Q

the 2 most prevalent and fatal disease affecting the heart are?

A
  • coronary heart disease

- heart failure

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8
Q

What does it mean if the ECG features a ST-segment elevation with tall T wave?

A

Myocardial infarction

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9
Q

what is the nursing management of ACS or MI pt’s?

A
  • need to reduce myocardial workload and maximise cardiac output
  • provision of treatment
  • careful monitoring to determine the effects of treatment and to detect complications
  • comfort and pain control
  • psychological support and education
  • discharge planning
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10
Q

cardiac rehabilitation is structured around 4 phases, with phase 1 beginning during admission. These include?

A
  • info regarding disease process
  • assessing the pt on understanding
  • discharge planning
  • early mobilisation
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11
Q

what is pericarditis?

A

inflammation of the visceral and parietal layers of the pericardium that covers the heart.

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12
Q

Management of HF post the acute phase is based on 3 principles. What are these?

A
  1. self-care management
  2. long-term lifestyle changes
  3. adherence to pharmacotherapy
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13
Q

Pt assessment for HF involves?

A
  • ECG
  • CXR = will show cardiomegaly and pulmonary problems
  • physical assessment
  • cardiovascular assessment = pulse rate, rhythm and strength; IPPA; BP lying and standing, checking peripherals
  • pulmonary assessment- chest ausculatation for inspiratory crepitations that do not clear with cough
  • FBC - checking for anaemia and thrombocytopenia
  • Urea
  • Urinalysis
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14
Q

What is heart failure?

A

The inability of the heart to pump sufficient blood to meet the needs of the tissues for oxygen and nutrients

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15
Q

How is heart failure catergoried?

A

Fluid overload and inadequate tissue perfusion

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16
Q

What are some of the symptoms of heart failure?

A
  • fatigue
  • weakness
  • oedema
  • nausea
  • polyuria
  • cough/wheeze
  • orthopnoea
  • ascites
17
Q

What are the nursing interventions of a pt with HF?

A
  • promoting activity tolerance= encourage mobility, spreading out activities, cardiac rehab programs
  • monitoring fluid volume= daily weighing, fluid restrictions, FBC, nutrition modifications (low sodium diet)
  • oxygen therapy
  • psychological support = decreasing stress
18
Q

A blood transfusion procedure consists of?

A
  • collecting equipment
  • performing pre-transfusion checks
  • IV access
  • performing all obs, prior, during and after
  • documentation
19
Q

Should a reaction occur what should you do?

A
  • immediately stop the transfusion and clamp the line
  • call Dr
  • monitor the pt’s condition
  • recheck pt’s ID with blood pack
  • keep the blood and the line so it can be tested
  • documentation
20
Q

List the possible adverse reactions that could occur during a blood transfusion

A
  • shivering
  • flushing
  • pain
  • SOB
  • decreased BP
  • anaphylaxis
  • rash/urticaria
  • haemaglobinuria
21
Q

List some ischaemic cardiovascular causes

A
  • Tachy-arrhythmia
  • stable angina
  • severe aortic stenosis
  • ACS
22
Q

List some non-ischaemic cardiovascular causes

A
  • PE
  • GI causes
  • pericarditis/myocarditis
  • aortic dissection
23
Q

List some medical management for HF

A
  • prevent exacerbation
  • reduce workload of the heart by reducing preload and afterload
  • reduce or eliminate contributing factors
24
Q

List the initial nursing interventions for a patient with ACS symptoms

A
  • ECG
  • Full blood test = checking cardiac troponin
  • O2 therapy if stats are below 93% or 88-92% for COPD pt
  • administration of Aspirin (300 mg) unless contraindicated

NUR305 (2017) (13 decks)

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