17, 18 Flashcards
volume of blood that the heart pumps out per minute
stroke volume
stroke volume determined by three things
preload
afterload
contractility
the volume of blood returned to the right side of the heart
preload
the force that the heart has to overcome to eject blood into systemic circulation (think pressure)
afterload
preload, afterload and contractility all influence the cardiac output how
by affecting the stroke volume
% of blood that is ejected from the left ventricle during systole
normal %
ejection fraction
50-70%
what kinds of problems can occur with decreased ejection fraction; what would decrease ejection fraction
can cause a backup of blood into the pulmonary vessels
tissue perfusion diminishes
heart failure
problems with too much blood in ejection fraction
increase pressure in the pulmonary vessels can cause pulmonary edema
largest veins in the body; where do they empty blood
superior and inferior vena cave
right atrium
three layers of artery wall tissue
outer: tunica adventitia: ct
middle: tunica media: smooth muscle
inner: tunica intima: endothelial cells
the force that the blood exerts against the walls of the aorta and its branches
blood pressure
blood pressure greatest during what
ventricular contraction / systole, when blood is ejected into the aorta
if blood volume decreases, kidneys secrete what
renin enzyme into the blood
renin acts on certain proteins to produce
angiotensin 1
angiotensin I is converted to angiotensin II by
angiotensin-converting enzyme from lungs
angiotensin II acts directly on what
what is the outcome
What does angiotensin II stimulate
what does this cause
blood vessels
causing constriction and raising blood pressure
adrenal gland to release aldosterone
causing sodium and water retention by the renal tubules- increasing blood volume- increasing bp elevation and improved cardiac output
sympathetic nervous system’s role in regulating vessel diameter (releases what)
prompts release of norepinephrine and epinephrine that cause vasoconstriction
cardiovascular age-related changes:
what happens to the actual heart and the contractility; resulting in what
becomes stiffer and contractile ability decreases, resulting in decreased stroke volume
cardiovascular age-related changes:
coronary arteries, cardiac valves
ca: become tortuous and dilated, areas of calcification
cv: thicken, murmurs are common
cardiovascular age-related changes:
SA node
aorta
SA: loses about 40% of its pacemaker cells over time, predisposing to cardia dysrhythmia or SA node failure
aorta: stiffer, contributing to increase in bp due to left ventricle pumping against greater pressure
Cardiovascular disease:
includes what kind of issues
congenital or acquired, heart failure, stroke, hypertension, dysrhythmias, infection and inflammation, DM, metabolic syndrome, obesity, sedentary lifestyle, and stress
Cardiovascular disease:
causes
coarctation ( narrowing of the aorta)
arteriosclerosis (thickening and loss of elasticity)
atherosclerosis (buildup of plaque)
aneurysms
stenosis (inflammation of the valve structure causing narrowing)
insufficiency (incomplete closure) of heart valves
hypertrophy (thickening of myocardial muscle)
hypertension
pulmonary hypertension
valve problems
ischemia
infarct
endocarditis (inflammation within the lining and valves)
pericarditis ((inflammation of the surrounding sac)
Cardiovascular disease:
modifiable risk factors
obesity
high cholesterol
hypertension
diabetes
smoking
sedentary lifestyle
excessive stress
excessive alcohol
drug use
common diagnostic tests & purpose:
electrocardiography
holter monitor
loop recorder
exercise ECG stress test
chemical stress test
e: record impulses of the heart to determine rate, rhythm, site of pacemaker, and presence of injury at rest
h: correlates normal daily activity with electrical function of heart to determine whether activity causes abnormalities
l: continuously records ECG to determine if an arrhythmia is the cause of symptom (syncope, palpitations, or dizziness)
e: records electrical activity of the heart during exercise; insufficient blood flow and oxygen can be identified by the abnormal waveforms they produce
c: used for those who cannot exercise for an ECG stress test
common diagnostic tests & purpose:
echocardiography
stress echocardiogram
venous ultrasoud of the legs
impedance plethysmography
nuclear imaging
e: evaluate size, shape, and position of structures and movement within heart
test of choice for valve problems
can evaluate blood flow through the heart and determine ejection fraction
s: detects differences in left ventricular wall motion before and after exercise
v: assesses occlusion or thrombosis in a vein
i: estimates blood flow in a limb based on electrical resistance present before and after inflating a pneumatic cuff placed around the limb
detects deep vein thrombosis
n: evaluates blood flow in various parts of the heart
determines areas of infarction
common diagnostic tests & purpose:
multiple-gated acquisition (MUGA) scan
computed tomography (CT) scan
CT angiography
magnetic resonance imaging (MRI)
magnetic resonance angiography
(MRA)
position emission tomography
m: determines area and extent of myocardial infarction
assesses left ventricular function
c: determines size and condition of aortic aneurysm
coronary vessels may be imaged
m:evaluates cardia tissue, integrity, detects aneurysms, determines ejection fraction, and determines patency of proximal coronary arteries
p: evaluates myocardial perfusion
common diagnostic tests & purpose:
transesophagel echocardiogram (TEE)
angiogram (venogram)
arteriogram
cardiac catheterization
electrophysiology studies
hemodynamic monitoring
t: provides images of the wall
thickness, heart valve structure and function, atrial septum, and presence of clots, and can calculate ejection fraction
a: identifies thrombi within the venous system
rarely used because noninvasive images provide adequate information
art: visualizes arterial anatomy and vascular disease in carotid, vertebral, aorta, renal, coronary, and peripheral arteries
c: assesses size and patency of coronary arteries and presence of collateral circulation
identifies pressure gradients for the aortic and mitral valves
assesses pumping action of the left side of the heart by measuring the ejection fraction of the left ventricle
e: measure and record electrical activity from within the heart to determine the area of origin of the dysrhythmia and the effectiveness of the antidysrhythmic drug for the particular dysrhythmia
h: determines pressure, flow, and oxygenation within the right side of the heart and pulmonary vessels
diagnosing a vascular problem: history, physical examination, and what kind of tests
-CBC
-urinalysis
-blood lipid and cholesterol assessment (including HDL and LDL)
-sequential multiple analyzer (SMA, metabolic panel) screening liver and kidney function, electrolytes, blood glucose
-doppler flow studies
-angiography
-nuclear medicine scans
diseases that elevate blood pressure
hyperthyroidism
cushing syndrome
pheochromocytoma
nephrosclerosis
renal arterial stenosis
ankle-brachial index
-evaluate arterial status in the lower extremities
-reg bp cuff is placed above the malleolus, another cuff placed above brachial artery
a doppler probe used to check the systolic endpoint at the dorsalis pedis and the
posterior tibial sites
-bp measured
-ABI calculated by dividing the systolic ankle by the systolic brachial
-normal: 1 or more
-intermittent claudication
Physical assessment for CVD
abnormal or extra heart sounds
crackles in lungs
pink frothy sputum (indicating pulmonary edema)
chest pain (if present, further assess using PQRST)
bluish cast to skin
pallor or diaphoresis
clubbing of fingers
pitting edema of feet, ankles, or sacral area
distended jugular veins
to detect bruits (a whooshing or purring sound made either when blood passes through a area of an artery that has ben patially obstructed OR when blood is flowing rapidly) listen with the bell over
lightly over the carotid arteries, abdominal aorta and femoral arteries
characteristics of skin chroniclly malnourished because of blood supply
smooth, shiny, and thin, little or no hair, nails are thick and yellow
common problems of patients with cardiovascular disorders
fatigue and dyspnea
edema
pain
altered tissue perfusion
impaired tissue integrity
crieteria used to determine whether a cardia patient is tolerating an activity
-heart rate does not rise more than 20 bpm over the baseline rate
-systolic bp does not drop
-there is no complaint of chest pain, dyspnea, or severe fatigue
-no abnormal heart rate or rhythm
elastic stockings are not used for pt’s with
arterial disorders
amount of cardiac output depends on:
heart rate
venous return (amount of blood returning to the heart)
strength of contraction
resistance to the ejection of blood (pressure in the arterial system)
common diagnostic tests & purpose:
multiple-gated acquisition (MUGA) scan
computed tomography (CT) scan
CT angiography
magnetic resonance imaging (MRI)
magnetic resonance angiography
(MRA)
position emission tomography
m: determines area and extent of myocardial infarction
assesses left ventricular function
c: determines size and condition of aortic aneurysm
coronary vessels may be imaged
m:evaluates cardia tissue, integrity, detects aneurysms, determines ejection fraction, and determines patency of proximal coronary arteries
p: evaluates myocardial perfusion
early warning signs of heart disease in women
chest pain
pain in neck and jaw
upper back pain
pain in upper abdomen
nausea
fatigue
shortness of breath
general weakness
changes in skin color (grayish skin)
sweating
metabolic syndrome components
-elevated waist circumference: men >40 inches, women >35 inches
-elevated triglycerides >150mg/dL
-reduced high-density lipoprotein cholesterol: men <40mg/dL, women <50mg/dL
-elevated blood pressure at or above 130/85mm Hg
-elevated fasting glucose indicating insulin resistance; glucose 100mg/dL
cardiac enzyme test
myoglobin
troponin
creatinine phosphokinase (CPK)
AST
creatinine kinase (CK-MB)
LDH
-myoglobin: initial rise <2hrs, peak 6-9hrs, back to norm 1day
-troponin: initial rise <4hrs, peak 14-24hrs, back to norm 3-5 days
-creatinine phosphokinase (CPK)
-AST: initial rise after CPK, peak 48hrs, back to norm 4-5 days
-creatinine kinase (CK-MB): initial rise 3-6hrs, peak 12-24hrs, back to norm 2-3 days
-LDH: initial rise 24-48hrs, peak 2-3 days, back to norm 5-10 days
scale for grading pulse quality
0: absent
+1: weak, thready
+2: light volume
+3: normal volume
+4: full, bounding
common problems of pt’s with cardiovascular disorders
-fatigue and dyspnea
-fluid overload: weight gain of 2-3lbs or more in 2-3 days or less - signs of hypokalemia
-pain: anginal pain or palpitations
-altered tissue perfusion: warm environment
-impaired tissue integrity
how is hypertension classified
primary (no other factors, genes, environment, insulin, glucose, and lipoprotein abnormalities related to metabolic syndrome)
secondary (renal, vascular, and endocrine disorders, stress, excessive alcohol, sickle cell disease, arteriosclerosis, coarctation of the aorta, eclampsia of preg, neurologic disorders, NSAID use, amphetamine use, alcohol taken with MAOIs, smoking, female hormone therapy)
pathophysiology of hypertension
when bp increases, the heart works harder to pump blood to perfuse the body- this is ideal for fight or flight but the heart can not keep this up in a constant state, ending with complications due to hypertension
-smaller diameter of blood vessles
-increase in volume or viscosity of fluid in the blood
-stress can stimulate the sympathetic nervous system
-excess renin secreted by the kidneys
complications of hypertension
-signs may only appear in late stages
-kidneys: renal ischemia and nephrosclerosis
-brain: arteriosclerosis and microaneurysm
-aorta: aortic aneurysm
-eyes: retinal damage
-heart: left ventricular hypertrophy and reduced cardiac output
-pts may complain of: dizziness, headache, blurred vision, blackouts, irritability, angina, dyspnea, or fatigue
hypertension:
treatment goals
reduction of high bp
long-term control to decrease the risk of stroke, heart attack, loss of vision, and kidney disease
hypertension:
treatment for mild, moderate, and severe
-mild: stop smoking, lose weight, sodium restriction, alcohol restriction, exercise, low-fat diet, stress control, diuretic or antihypertensive medication
-moderate: all of the above, with other medications added
-severe: above and more than two drugs, increasing dose as needed to achieve the desired bp level, unless side effects occur
how to differentiate between venous and arterial insufficiency during a physical assessment
v:
-pulse: strong and symmetric, may be difficult to palpate if edema is present
-skin: mottling with brown pigmentation at ankles, veins may be visible, legs or feet bluish when dependent, dermatitis, warm at ankle
-edema: present, particularly around ankle and foot
-ulceration: at bones of ankle
-necrosis and gangrene: unlikely
-pain: aching, cramping, particularly when dependent, may have nocturnal cramps
-nails: normal
-hair: normal
a:
-pulse: diminished, weak, or absent
-skin: pallor, dependent rubor; thin, dry, shiny, cool, maybe cellulitis
-edema: absent or mild
-ulceration: on toes or at pressure points of feet
-necrosis and gangrene: likely
-pain: intermittent claudication when walking, sharp, stabbing, gnawing, lessens when at rest
-nails: thick, brittle (normal in older adults)
-hair: hair loss distal to area of occlusion (hair loss normal in older adults)
-pulse: strong and symmetric, may be difficult to palpate if edema is present
-skin: mottling with brown pigmentation at ankles, veins may be visible, legs or feet bluish when dependent, dermatitis, warm at ankle
-edema: present, particularly around ankle and foot
-ulceration: at bones of ankle
-necrosis and gangrene: unlikely
-pain: aching, cramping, particularly when dependent, may have nocturnal cramps
-nails: normal
-hair: normal
s/s of arterial or venous disease
venous
-pulse: diminished, weak, or absent
-skin: pallor, dependent rubor; thin, dry, shiny, cool
-edema: absent or mild
-ulceration: on toes or at pressure points of feet
-necrosis and gangrene: likely
-pain: intermittent claudication when walking, sharp, stabbing, gnawing, lessens when at rest
-nails: thick, brittle (normal in older adults)
-hair: hair loss distal to area of occlusion (hair loss normal in older adults)
s/s of arterial or venous disease
arterial
complications of uncontrolled hypertension
-can cause damage to arteries, making them less elastic, placing an increased workload on the heart that could cause an MI, left ventricular hypertrophy, aortic aneurysm, and congestive heart failure
-small vessel damage to the brain disrupts circulation and may lead to dementia, transient ischemic attacks (TIAs), and ischemic strokes
-may cause an already weakened area in a blood vessel to rupture, may cause an intracranial bleed (hemorrhagic stroke)
-may cause damage to small vessels of the kidneys and may lead to kidney failure
-damages arteries of the eye, causing the formation of clots or occurrence of hemorrhage that may lead to blurred vision or blindness
how do antihypertensive drugs work
-reduce bp by decreasing blood volume, cardiac output, or peripheral resistance
-reverse or block conditions causing elevated blood pressure
-diuretics address fluid volume
-most blockers work by stopping a progression of a process resulting in vasoconstriction
assess pt’s taking an antihypertensive for:
dizziness
confusion
syncope
restlessness
drowsiness
hypertensive emergency, s/s, why
vs
hypertensive urgency, s/s, why
e:
-life-threatening, bp rises higher than 180/120, indication of target organ damage
s/s:
-severe headache, blurred vision, seizures, nausea, and change in loc
why:
-pt has most likely stopped taking their antihypertensive medication, or it may be secondary to another disease process.
-pt would be placed in ICU and treated with IV emergency drugs: IV sodium nitroprusside (Nipride), nicardipine (Cardene IV), nitroglycerin, or labetalol (Normodyne) to lower bp
-a reduction of bp to 160/100 is desired over the first 2 hours
-bp is monitored every 5 -15 min
-medication is adjusted to reduce pressure slowly to prevent renal, cerebral, or coronary ischemia
u:
occurs when bp rises to 180/110, but there are no signs or symptoms of target organ damage
-pt observed in ED and treated with oral medication
why monitor potassium levels in ACE inhibitors
it suppresses the release aldosterone, increasing potassium retention
what to monitor when pt is taking clonidine, why
liver function, may cause liver damage in some pt’s
what to monitor when pt is taking hydralazine, why
renal function, may cause renal impairment
pt’s may experience this after abruptly quitting antihypertensives
rebound hypertension
notify prescriber if a persistent dry cough develops after starting on this
ACE inhibitor
stress:
stimulates-
actions of the body-
causing-
increasing-
sympathetic nervous system
heart rate increases
cardiac contractility increases
vasoconstriction increases
increases peripheral vascular resistance
increases cardiac output
bp
renin released by kidneys:
stimulates-
actions of the body-
causing-
increasing-
angiotensinogen-angiotensin I- angiotnesin II
arteriole constriction
aldosterone secretion
increasing peripheral resistance
retention of sodium and water
increasing blood volume
bp
hypertension:
older adult considerations
-stiffening of arteries
-baroreceptors become less sensitive
-lack of elasticity of the vessels and decrease sensitivity = risk for orthostatic hypotension
arteriosclerosis:
definition
etiology
d:
hardening of the arteries, causing blood flow to slow
e:
-thickening of the artery walls that progresses to hardening as calcium deposits form
-DM speed development
-hypertension is a major factor
-occurs with aging
atherosclerosis:
definition
etiology
d:
artery narrowing due to lipids
e:
-lipids are deposited within the vessel walls and -combine with cells, fibrin, and cell debris to form plaques
-DM speed development
where is atheromatous plaque with thrombi primarily formed
larger arteries: aorta, femoral, carotid, and coronary arteries
s/s of embolus or thrombus occlusion: 6 p’s
pain
pulselessness
poikilothermia
pallor
paresthesias
paralysis
arterial embolus commonly caused by
thrombus formed in the heart by atrial fibrillation
treatment of PAD
goal
g: increase blood flow through peripheral arteries and decreasing risk of clot formation
reg exercise
stop smoking
antiplatelet agent and platelet inhibitors
percutaneous transluminal angioplasty
femoropopliteal bypass
aspirin and clopidogrel (plavix)
aneurysm:
etiology
pathophysiology
e:
outpouching of the wall of an artery resulting from a structural defect in the layers of the arterial wall
p:
-can occur along any artery
-once developed, it continues to grow larger and may rupture
-usually result of plaque formation, genetic predisposition, or hypertension
-occur in areas weakened by trauma or surgical procedures
aneurysm:
s/s
treatment
s:
-no obvious symptoms
-abdominal aortic aneurysm may report back pain or a feeling of pressure and may have a visible pulsation of the abdomen
-aortic aneurysm in the thoracic area may cause substernal or tracheal pressure and difficulty with breathing
t:
surgery
focus- lower bp and treat the pain
carotid artery disease:
s/s
treatment
s:
-carotid bruit, confusion, transient vision loss, fainting, extremity weakness
t:
-carotid endarterectomy or carotid artery angioplasty
major nursing care goals for pt’s with PAD
-maintaining arterial blood flow to the lower extremities
-protecting tissues from further injury from pressure and constriction of blood flow
-preventing wound infections
thromboangiitis obliterans Buerger disease:
etiology and pathophysiology
s/s
diagnosis
treatment
nursing management
e and p:
-a primary condition not caused by atherosclerosis but involves inflammation and thickening of small and medium-sized arteries
-condition may be primary disorders or caused by other diseases
s:
-occlusion of the hands and feet usually noted first
-numbness and tingling of the toes or fingers in cold weather
-pain in the feet, and intermittent claudication that progressively becomes more severe, pain is intense
-ulcerations and gangrene may occur
d:
made through pt history, symptoms, and angiography
t:
cessation of smoking
exercise
n:
-pt teaching and reinforcement of the need to stop smoking
-assessment of the extremities for skin impairment is essential
-pain management is needed due to the ischemic pain
Raynaud disease and Raynaud phenomenon
etiology and pathophysiology
s/s
diagnosis and treatment
nursing management
e and p:
-characterized by spasms of the arteries of the upper and lower extremities
-can be a primary disorder or may occur secondary to another disease (lupus, RA, scleroderma)
-phenomenon occurs on only one side of the body
s/s:
-affected body part changes color
-when spasm stops, typically there is burning pain and throbbing
d and t:
-evaluation of pt symptoms
-labs: antinuclear antibody (ANA) to determine the presence of autoimmune disorders
-stress control, avoidance of exposure to cold, and smoking cessation
-calcium channel blockers
-synthetic prostaglandin iloprost (Ventavis)
n:
-teach pt to protect extremities and prevent injury
-teach pt to avoid cold temps when possible, manage stress and stop smoking
-caffeine intake should be limited
superficial thrombophlebitis
causes
s/s
treatment
c:
-vessel trauma, venous stasis (or turbulence), and abnormal coagulability
-in pt’s receiving IV therapy may caused by chemical or mechanical irritation of the vessel (if not identified and treated, bacteremia may occur, resulting in septic thrombolitis)
s:
-redness and tenderness along the course of the vein accompanied by swelling
- labs: for hypercoagulability and to check inflammation status, WBC will help id infection
-ultrasound demonstrating thickened, inflamed, and noncompressable veins confirms diagnosis
t:
depends on severity (IV: remove and change locations, severe IV: elevate and add heat)
primarily symptomatic
analgesics
elastic support hose
deep vein thrombosis:
etiology and pathophysiology
s/s
treatment
e:
-prolonged surgeries, orthopedic surgeries, spinal cord damage and paralysis, and chronic failure all contribute to venous stasis
-immobility with the legs dependent in car or airplane travel for extended periods also promotes venous stasis
-trauma or external pressure or internal pressure from hypertension may damage the endothelium
-smoking, female hormone replacement, estrogen-based contraceptives, corticosteroids, and various blood disorders are contributing factors to blood hypercoagulability
-DM, lung disease, blood disorders, PVD, sepsis, or cancer
s:
pain, swelling, redness, edema
t:
-IV heparin
-low-molecular-weight heparin (LMWH), like enoxaparin (Lovenox)
-oral anticoagulation
-thrombolytic therapy
-compression stockings
-vena cava filter
s/s of pulmonary embolism in pt’s with known DVT
how to know if treatment is working
dyspnea
hemoptysis (bloody sputum)
tachypnea
tachycardia
chest pain
decreased O2 stat
a feeling of impending doom
cyanosis
possibly coughing and altered mental status
t:
decreased swelling, redness, and pain
when is thrombolytic therapy used
used to dissolve thrombus if vessel obstruction is severe
pt’s at risk for DVT:
each shift assesses for s/s including
-observation of the extremity for asymmetric size
-areas of warmth and redness over a vein
-calf pain/tenderness
-pitting edema of the affected extremity
-measurement of calf circumference
-body temp >100.4
-pulse of affected extremity
varicose veins:
what is it
etiology and pathophysiology
s/s
treatment
w:
enlarged and tortuous veins that are distorted in shape by accumulations of pooled blood
e and p:
absence of or damage to the valves in the veins
s:
chronically swollen legs; thick, brownish skin around the ankles; and itchy, scaly skin
t:
knee-high elastic support stockings and elevation of the legs whenever possible
venous stasis ulcer:
who is most at risk for this
treatment
w:
diabetic pt’s with venous insufficiency due to compromised circulation in extremities and a slow rate of healing
t:
-leg elevation, a moist dressing, and compression
-dressing to be used depends on the condition of the ulcer and the amount of exudate produced
noncompliance with medical regimen for hypertension can result in
MI
what is the most common cause of PVD
athrosclorosis
the best treatment for arterial insufficiency is
exercise
hypertension and this are long-term factors in the development of aneurysm
athrosclorosis
pt’s bp is 200/100 and is having symptoms of blurred vision and seizures and change in LOC, diagnosis is
hypertensive crisis
the etiology of Raynaud’s disease is an exaggerated response to _ and _
cold, and stress
treatment of carotid stenosis includes
stints
thrombophlebitis is the development of a _ and _ of a vein
inflammation and thrombus
treatment of varicose veins are _, _ and _
exercise, elevation and support hose
pt with PAD has been scheduled for this procedure
femoral bypass
which diagnostic test provides the most detailed information regarding heart function
cardiac catheterization
when preparing pt for cardiac catheterization assess:
assess renal function
assess allergy status, especially related to iodine
which effect on bp occurs when peripheral vascular resistance rises
increases
blood pressure determined by _ x _
cardiac output x peripheral vascular resistance
systolic bp of _ to _ classified as stage 1 hypertension
140 - 159
systolic bp of _ to _ classified as prehypertensive
130-139
systolic bp of >_ classified as stage 2 hypertension
160
which prescribed antihypertensive med would prompt the nurse to monitor serum glucose levels for a pt who is diabetic
Atenolol - beta blocker
target reading for controlling bp
120/80
what symptoms might a hypotensive pt who is taking antihypertensive meds exhibit
dizziness
restlessness
what is the drug for hypertensive emergency
sodium nitroprusside
smoking is directly linked to what disease progression
Buerger disease
thromoangiitis obliterans
medication classes used to control hypertension
loop diuretic
calcium channel blocker
direct-acting vasodilator
angiotensin-converting enzyme inhibitor
calcium channel blockers are like _ for your heart
valium
negative inotropic, chronotropic, dromotropic
like _ for your heart; what do they do to the heart; called what
valium; they calm the heart down; cardiac depressants
positive inotropic, chronotropic, dromotropic do what for the heart; called what
speed up the heart; cardiac stimulant
what do the negatives treat?
A AA AAA
side effects:
H & H
Antihypertensives: relax the heart and decreases bp
AntiAnginal drugs: relaxes heart, using less O2, decreases O2 demand
AntiAtrialArrythmia: treats atrial flutter, atrial difibliration, supraventricular tachycardia
Headache: vasodilation in the brain
Hypotension: lowers too much
names of calcium channel blockers:
anything ending in -depine (dip-ine in the calcium channel blockers) & verapamil and cardizem-
which is continuous IV drip; hold if systolic is under _
Cardizem; 100
medication prescribed to correct multiple premature ventricular contractions (PVCs)
lidocaine is used to treat atrial and ventricular dysrhythmias by slowing the sodium channel. prolonging the time of depolarization and increasing the refractory period
which alteration in cardiac rhythm is the most serious type of arrhythmia
ventricular fibrillation;
-medical emergency that will result in death if left untreated
-ventricles are quivering with disorganized electrical and mechanical activity
use of what is related to the development of HF
toxins: cocaine, excessive alcohol, certain chemo drugs, NSAIDs, and thiazolidinediones used for DM
infection
anemia
myocarditis
dilation from blood backup behind diseased valves
damage from MI
cardiomyopathy
poor prognosis; disease of the heart muscle
a short-term treatment of heart failure that allows the heart to rest after a MI or open-heart surgery
intra-aortic balloon pump
digitalis toxicity s/s
yellow-green halos around lights
nausea
diarrhea
confusion
v fib results in:
no cardiac output
requires cpr and defibrillation to correct
tests to rule out MI
troponin I
ECG
CPK
CK_MB
Myoglobin
if ischemia is prolonged and not quickly reversed, acute coronary syndrome (ACS) occurs, what does ACS include:
-unstable angina
-non-ST-elevation myocardial infarction (NSTEMI)
-ST-elevation myocardial infarction (STEMI)
what is the drug of choice for pt with acute myocardial infarction
morphine
temporary pacemaker maybe used to treat what
cardiac dysrhythmia, persistent bradycardia
sign indicates pt who is recovering from MI may be developing pericarditis
friction rub on auscultation and chest pain that worsens with movement
temporary pacemaker may be inserted to treat which cardiac dysrhythmia for a pt who has experienced a myocardial infarction
persistent bradycardia
ACE inhibitors (-prils) prevent:
vasoconstriction
loops (furosemide, bumetanide) remove:
excess fluid, waste k+
potassium sparing:
triamterene, amiloride
thiazides (hydrochlorothiazide metolasone) remove:
excess fluid, waste k+
angiotensin-receptor blockers (losartan, valsartan, irbesartan) produce and remove:
produce vasodilation, excrete salt and water
beta-blockers function
reduce bp, slow heart rate
calcium channel blockers function
vasodilation, reduce hr
digitalis increases:
cardiac contractility
