(7) Cardiovascular System 2 Flashcards
What are the types of heart disease?
- heart failure
- coronary heart disease
- valve disease
- aneurysm
- cardiac arrhythmis
- cardiomyopathy
- pericarditis
What is the most common heart disease?
coronary artery disease
Whats the difference between stable and unstable angina?
- stable is predictable
What are the acute coronary syndromes?
- STEMI
- NSTEMI
What is coronary heart disease?
- major blood vessels supplying the heart are narrowed
- The reduced blood flow can cause chest pain and shortness of breath
What is a myocardial infarction?
blockage of one of the arteries surrounding the heart
What interventions can be used if someone has a blockage or an MI?
Percutaneous coronary intervention (PCI)
How does a PCI work?
- usually up through femoral artery
- inflates once reaches blockage
- stent left there and keeps artery open
What is a coronary artery bypass graft?
surgical procedure to treat coronary artery disease, the buildup of plaques in the arteries of the heart (MI)
What is said to patients about lifting objects following a coronary artery bypass?
not too lift or push anything heavier than a kettle for a few weeks
What patients would have considerable more risk of inadequate healing following a coronary artery bypass graft?
- obesity
- diabetes
Where is the graft taken from for a coronary artery bypass graft?
- radial artery
- saphenous vein
Why choose a CABG over a PCI?
- CABG less invasive
- depends on disease burden
What are complications post CABG (8)?
- atrial fibrillation
- high bp
- resp conditions (atelectasis of left lung)
- bleeding
- pericardial effusion
- neuro complications
- sternal wound
- graft wound
Why put someone on high flow oxygen?
- heated humidification (secretion clearance)
- fast vs slow
Day 1 intervention post CABG x2?
- check notes & vitals
- look out for if they’re on Noradren
- check with nurse
- sit out on edge of bed (keeping an eye BP, MAP & O2)
- check leg strength before standing him
- transfer him to a chair
- go through ACBT
- depending on how he gets on may take for a walk
Day 3 intervention post CABG x2?
- walking/moving him 200-300m
- room air?
- discharge planning (stairs, cardiac rehab)
- educate importance of moving (secretions, recovery)
Discharge post CABG x2?
- smoking cessation
- benefits quitting smoking
- progressing exercise plan (generally on flat surface)
- breathlessness
- expectations on cardiac rehab
What are the most common arrythmias?
- Atrial (fibrillation, flutter)
- Ventricular (tachycardia, fibrillation)
What are some interventions for atrial arrhythmias?
- medication
- cardioversion
- ablation
- maze procedure
What are ventricular arrhythmias?
- more serious, can lead to cardiac arrest
What are interventions for ventricular arrhythmias?
- treatment with ICD
- mini defibrillator
How does bradycardias occur?
- Aging
- post MI
- congenital
- post heart surgery
- underactive thyroid
- electrolyte imbalance
- Inflammatory disease
- Medication
What is important for bradycardias?
- avoid repetitive overarm activity
- pacemakers
What are interventions for tachycardias?
- beta blockers
- lifestyle modifications
What are the four valves of the heart?
- pulmonary
- tricuspid
- mitral
- aortic
What are two valve diseases?
- stenosis (back pressure to chambers)
- regurgitation (blood isn’t effectively emptied)
Day 1 intervention post aortic valve replacement (AVR)?
- speak nurse about pain management before physio
- sit on edge of bed?
- check BP (pump ankles or squeeze glutes)
- try stand her
- march on spot, get her out t o chair?
- Wean O2?
- Go over her chest clearance
- if able could walk her
Day 3 intervention post aortic valve replacement (AVR)?
- airway clearance
- start O2 if saturation low
- monitor vitals
- progress with mobility
Discharge post aortic valve replacement (AVR)?
- smoking cessation
- benefits quitting smoking
- progressing exercise plan (generally on flat surface)
- breathlessness
- expectations on cardiac rehab
What are the cardiomyopathies?
- dilated
- restrictive
- hypertrophic
Heart Transplants
- average 16 per year
- fitness for transplant essential
- denervated heart
- rejection (regular biopsies)
- immunosuppression
- risk for malignancy
Day 1 intervention post cardiac transplant for advanced dilated cardiomyopathy?
- quick resp Ax
- usually no secretions
- not doing a whole lot
Day 3 intervention post cardiac transplant for advanced dilated cardiomyopathy?
- try mobilise (best thing post cardiac surgery)
- sit over edge of bed
- try stand him
- if stable, try get to chair
- try wean O2
Day 7 intervention post cardiac transplant for advanced dilated cardiomyopathy?
- exercise program (walking)
- education
What are the two types of Vascular disease?
- Arterial (carotid, reynauds, renal, peripheral)
- Venous (varicose veins, thoracic outlet syndrome, chronic venous insufficiency)
What is prevention methods for vascular disease?
- endarterectomy
- bypass
- angioplasty
- stenting
Day 1 intervention post left fem-pop bypass?
- pain relief
- mobilise (risk DVT)
- may need walking aid
- need blood flow
Day 3 intervention post left fem-pop bypass?
- progress one crutch
- discharge planning
- smoking cessation
- lifestyle changes
- exercise education
What is secondary prevention for vascular disease?
- lifestyle management & risk factor modification
- cardiac rehab
