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Complex Care > Week 6 THURS > Flashcards

Week 6 THURS Flashcards

Adult Cardiac

1
Q

What equipment should you call to get for someone who is slumped on the floor?

A

AED

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2
Q

What medication is the drug of choice for sinus bradycardia?

A

Atropine

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3
Q

Pt reports fatigue, shoulder blade discomfort, and SOB. What can the nurse suspect off of theses symptoms?

A

Myocardial infarction

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4
Q

Pt has angina pectoris, what does the nurse include for managing this condition?

A
  • balance rest w/ activity
  • stop smoking
  • carry nitro at all times
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5
Q

A pt is receiving nitroglycerin, what statement indicates therapeutic effect?

A

“My chest pain is decreasing”

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6
Q

The nurse knows a pt is having an MI after what lab result?

A

elevated troponin level

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7
Q

What assessment findings indicate possible bleeding or recurrent dissection?

A

Low BP and high HR
- BP: 82/40 and HR: 125bpm

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8
Q

Cardiac marker diagnostic labs

A
  • CK
  • troponin
  • CRP> inflammation marker
  • BNP> heart failure marker
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9
Q

Noninvasive cardiac diagnostic procedures

A
  • ECG
  • chest x-ray
  • echocardiogram
  • stress testing
  • CT
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10
Q

Invasive diagnostic procedures

A

Transesphageal echocardiogram(TEE)
- ultrasound down throat
Cardiac Cath
- balloon and stent

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11
Q

What does an echo show? and what is projected ejection fraction supposed to be?

A
  • blood flow in the heart
  • above 60% E.F.
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12
Q

Narrowing of an opening

A

Stenosis

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13
Q

What does stenosis cause?

A
  • creates partail obstruction which increases pressure and decreases forward blood flow and back up occurs
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14
Q

the narrowing of the mitral valve orifice that obstructs blood flow from the left atrium into the left ventricle

A

Mitral valve stenosis

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15
Q

What is mitral valve stenosis predominantly caused by?

A
  • rheumatic fever> complication of untreated strep or scarlet fever
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16
Q

The more severe mitral valve stenosis get what decreases?

A
  • cardiac output decreases
  • causing hypertrophy of the valve
  • causes dyspnea on exercition
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17
Q

What is an urgent concern of mitral stenosis

A
  • sudden increase in heart rate
  • decreased cardiac output
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18
Q

Atrial enlargement increases the risk for……

A

Atrial fibulation

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19
Q

A condition in which aortic valve is narrowed and blood flow obstructed from LV into aorta during systole

A

Aortic valve stenosis

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20
Q

Clinical manifestations of aortic stenosis

A
  • syncope
  • angina
  • dyspnea
  • orthopnea
  • paroxysmal noctural dyspnea
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21
Q

insufficient or incompetent valves that do not close completely and allows blood through he valve and backs up into where the blood just left

A

regurgitant

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22
Q

blood regurgitates back into the atrium vs being ejected through the aortic valve, decreasing forward cardiac output

A

mitral regurgitation

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23
Q

Blood flows back into the LV from the aorta during diastole leading to diminished cardiac output and LV pressure and volume increases
- Leads to left ventricular hypertrophy

A

Aortic valve regurgitation

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24
Q

Mitral cusps bulge up into the left atrium during ventricular systole
- floppy valve

A

valvular prolapse

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25
Microbial infection, begins to damage endothelium of a valve
Infective endocarditis
26
groups at risk for infective endocarditis
- preexisting heart disease - iv drug users - children> rheumatic fever or CHD - elderly - HIV - cardiac surgical pts - hemodialysis
27
How do you treat Infective endocarditis
- timely and agressive administration of antibiotics - possible valve replacement\ - prophylaxis antibiotics
28
How to manage valvular disorders
- sodium restriction - lifestyle changes - monitor with yearly echocardiograms - prophylactic antibiotics
29
T or F with a mechanical valve replacement pts need to be on a long term anti- coagulation
True! - makes platelets less sticky and doesn't stick to valve
30
An abnormal localized dilation of an artery that results from a weakened arterial wall
Aortic Aneurysm
31
nursing priorities for pts with valvular diseases include
- assess/ maintain cardiac output - manage side effects - prevent complications - provide pt education - administer pharmocogic therapies
32
Where can aneurysms be located?
Can be located all along the aorta, from the ascending thoracic aorta through the trunk of the abdominal aorta
33
What is the most common location for an aneurysm?
- abdomen!
34
T or F aneurysms are usually a complication of long-standing atherosclerosis
True!! - build-up of plaque leads to obstruction and backup of blood causing an aneurysm
35
risk factors for aneurysms
- HTN - smoking - age - male gender - hyperlipidemia - hx of PAD
36
Clinical manifestations of aneurysms
- often asymptomatic or cause only minimal symptoms - back/ flank pain, epigastric discomfort, altered bowel elimation
37
primary diagnostic for aneurysms
Diagnostic imaging is the primary tool for diagnosing aortic aneurysms
38
interventions for aneurysms
- open surgical repair> high risk - endovascular Aortic Repair> less invasive, more patients qualify
39
T or F with an aortic rupture there is a slow onset of severe symptoms
FALSE - there is rapid onset - shock goes through he body very fast!
40
Heart tissue is not getting enough perfusion (heart itself)
Acute coronary syncdrome
41
What does Acute coronary syndrome encompass
- unstable angina - NSTEMI - STEMI
42
What lab test is the big indicator of an MI
troponin
43
Post op considerations for pts after a valve replacement
- check pulses - I and O - s/s infection - assess physical health - monitor vs
44
inital collaborative management for Acute coronary syndrome
- relieve chest pain - reduce myocardial oxygen demand - ECG obtained - aspirin administered - nitro given - morphine give - education to pt and family
45
MONA
- morphine - oxygen - nitroglycerin - aspirin
46
sustained ischemia, causing irreversible myocardial cell death
Myocardial Infarction
47
clinical manifestations of MI
- chest pain lasting longer than 20 min - crushing/ gripping pain - chest heaviness and doom feeling - jaw pain, shoulder, epigastric pain, fatigue, nausea, worsening sob
48
Complications of MI
- dysrhythmias - premature contractions - life threatening> death - HF - cardiogenic shock - ventricular aneurysm - pericarditis
49
Nursing considerations when giving morphine and nitro
- decreased oxygen sats - low blood pressure - low pulse - severe headaches - too many vasodilators can cause issues too! - ask about viagra/ other vasodilators
50
Anticoag medications to help with Acute coronary syndrome> MI/ angina
- heparin - aspirin - plavix
51
Do all pts qualify for thrombolytic therapy?
NO - only used in pts experiencing acute STEMI - contradicted in pts w/ active bleeds and potential aneurysm
52
1 goal intervention to restore perfusion
- reperfuse the heart asap
53
nursing care for pre-procedure (PCI)
- perform baseline assessment - medication administration - patient and family education - pre op care - assess allergies> iodine!! Seafood!!
54
post op nursing care for PCI
- moniotr VS frequently - ECG - assess access site for pain, swelling, bleeding - bruising may be present> mark circumference - bloodwork - pt should remain flat and no ambulation for 4-6hrs
55
what is the #1 nursing care post-procedure for PCI
- monitor and stop bleeding!
56
CABG is what?
coronary artery bypass graph - takes vein from leg and put in in heart and bypasses a block
57
early pharmaceutical treatment for post MI, PCI, CABG
- beta blockers - Antiplates> aspirin, plavix - ACE inhibitors> prils - ARBs> artan's - Calcium channel blockers - digoxin
58
client education for beta blockers
- check pulses daily - teach pts how to check pulse - < 60 hold med - know when to call provider; light-headedness, increasing fatigue, impotence, low pulse, low bp
59
Stop taking antiplatelets if pt is experiencing...
- frequent nosebleeds that won't stop - rash - gi upset - bleeding - abdominal pain - blood in stool
60
ACE inhibitors are used especially in pts who ....
- recovering from STEMI - Heart Failure - EF < 40% - HTN
61
What is a major side effect of ACE inhibitors?
- angioedema - maculopapular rash
62
ARBs do what
block the binding of angiotensin II to muscles on blood vessels
63
Avoid antiarrhythmics (calcium channel blockers) in pts w/
- Heart failure - hypotension - sinus node dysfunction
64
What medication is Positive inotropes strengthen the hearts contractions, so it can pump more blood w/ fewer heartbeats
Digoxin - strengthen the force of the heartbeat, so every heartbeat counts
65
Digoxin toxicity s/s
- usually get when first taking this medication - confusion - irregular pulse - less appetite - n/v/diarrhea - fast heartbeat - vision changes
66
right side of heart holds what blood??
deoxygenated
67
left side of heart holds what blood??
oxygenated
68
Left side of heart pumps oxygenated blood where?
throughout the body!

Complex Care (26 decks)

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