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Older Adults Pt 2 > 9.1 Cardiovascular Part 2 > Flashcards

9.1 Cardiovascular Part 2 Flashcards

1
Q

Valves of The Heart

A
  • Mitral and Tricuspid
    Located between atria and the ventricles
  • Aortic and Pulmonary
    Located between ventricles and major blood vessels leaving the heart
  • Maintain unidirectional flow of blood through the heart
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2
Q

Valvular Dysfunction

A

Results from

  • Congenital defects
  • Trauma
  • Ischemic damage
  • Degenerative changes
  • Inflammation
  • Radiation
  • When injured valve leaflets are healing, collagen deposits and scarring occurs which causes these leaflets to shorten and stiffen
  • Valvular disorders most commonly affect aortic and mitral valves.
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3
Q

Regurgitation

A
  • Also called incompetent, regurgitant and insufficient
  • Failure of valve to close which allows backflow of blood

Aortic Regurgitation - Allows backflow to left ventricle during diastole
Mitral Regurgitation - Affects backflow to left atrium during systole

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4
Q

Stenosis

A
  • Narrowing of valve orifice and failure of leaflets to open all the way, which results in blood failing to move forward as it should
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5
Q

Mitral Stenosis

A
  • Fibrous replacement of valvular tissue, stiffness, and fusion of valve leaflets
  • Valve becomes funnel shaped because of thickening
  • Usually caused by rheumatic heart disease, rheumatic fever, or congenital defects
  • Exertional dyspnea is the most common symptom
  • Can also cause palpations (atrial dysrhythmias), pulmonary congestion, post-nocturnal dyspnea (SOB during sleep), orthopnea (difficulty breathing when lying flat).
  • Rheumatic means caused by inflammation due to immune system
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6
Q

Mitral Regurgitation

A
  • Structural changes to valve leaflets, annules or chordae
  • Incomplete closure of leaflets causes backflow to left atrium during systole
  • Caused by Trauma, MI, Infective Endocarditis, and MVP (Mitral Valve Prolapse)
  • Signs and symptoms include enlarged left ventricle, hyperdynamic left ventricular impulse (shaking of pericardium), and pansystolic murmur (murmur heard from 1st to 2nd sound).
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7
Q

Mitral Valve Prolapse

A
  • Non-inflammatory disarray of valvular structure where leaflets and chordae are abnormally stretchy
  • Leaflets become enlarged and floppy and either prolapse or balloon back into left atrium during systole.
  • Caused by familial, infections, or connective tissue diseases.
  • It affects mostly tall thin women, can be asymptomatic but if symptoms do occur it can cause irregular heart beats, palpitations, and SOB.
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8
Q

Aortic Stenosis

A
  • Because there is increased resistance to ejection of blood from the left ventricle, it increases the work demand of the left ventricle which decreases blood into circulation
  • Causes include rheumatic fever and congenital valve disorders
  • S/S include syncope (fainting), angina, CHF, dyspnea, peripheral cyanosis
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9
Q

Aortic Regurgitation

A
  • Blood flows back into the left ventricle during diastole which results in increased left ventricular stroke volume
  • Caused by rheumatic fever, Infective Endocarditis (IE), and Trauma
  • Symptoms don’t occur until heart failure occurs which can cause exertional dyspnea, orthopnea, post-nocturnal dyspnea, chest pain, and syncope
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10
Q

Nursing Management of Valvular Heart Disorders

A
  • Monitor vital signs, heart failure, dysrhythmias
  • Assess for pain, dizziness, syncope
  • Monitor daily weights
  • Maintain rest and comfort for patient

EDUCATION

  • Sleep with HOB elevated to facilitate breathing
  • Balancing activity with rest periods
  • Monitor weight gain
  • Medication adherence
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11
Q

Commissurotomy

A
  • Remove calcium deposits and other scar tissue from the leaflets
  • Mitral valve stenosis is an open procedure or percutaneous balloon procedure
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12
Q

Balloon Valvuloplasty

A
  • Minimally invasive procedure where a balloon catheter is inserted through the femoral artery into the heart to widen the valve and improve blood flow
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13
Q

Annuloplasty

A
  • Tightens and reinforces the ring around a valve to support it
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14
Q

Leaflet repair

A
  • Minimally invasive robotic procedure that removes abnormal leaflet segments and edges of the leaflet are sewn back together
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15
Q

Chordoplasty

A
  • Remodels the chordae tendineae which is responsible for maintaining the position and tension of valve leaflets
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16
Q

Valve Replacement

A
  • Consideration must be made about the patients age, valve durability, medication options, and risks
  • High rate of long term success
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17
Q

Mechanical Replacement

A
  • Made of strong durable material that can last the remainder of a patients life
  • It is essential to prevent clot formation because they can cause malfunction of the valve or cause embolus
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18
Q

Tissue Replacement (Bioprosthetic Valve)

A
  • Created from animal valves that last 10-20 years
  • It is very likely it will need to be replaced later in life so younger people do not find it appealing
  • Do not require long term use of anticoagulation
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19
Q

Autografts

A
  • Ross-Yacoub Pulmonary Autograft
  • Aortic valve is replaced with a persons own pulmonary valve, and their pulmonary valve is replaced by a allograft from a corpse.
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20
Q

Homografts

A
  • Human donor valves are used
  • Usually used for patients with infective endocarditis
  • Can be expected to last 10-20 years
  • Most uncommon type
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21
Q

Nursing Management of Valvular Surgery

A
  • Hemodynamic stability (stable blood flow) and recovery from anesthesia
  • Assess cardiovascular, neurologic and respiratory systems
  • Heart sounds are assessed every 4 hours as well as heart failure monitoring and emboli
  • Patient education focuses on anticoagulation therapy, prevention of infective endocarditis, routine cardiology follow ups, and repeat ECG to assess valve functions
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22
Q

Cardiomyopathy

A
  • Disease of the heart muscles
  • “Acquired” comes secondary to another disease
  • “Inherited” comes from genetics
  • Cause is usually not known
  • Progressive disorder that impairs cardiac output and leads to HF, sudden death, or dysrhythmias.
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23
Q

Hypertrophic Heart Failure

A
  • Caused by excessive ventricular growth (hypertrophy)
  • Involvement of the ventricular septum is often disproportionate
  • Common disease of young adults
  • Unknown/genetic cause
  • Causes dyspnea
  • Elevation in left ventricular diastolic pressure causes impaired ventricular filling, and increased wall stiffness due to ventricular hypertrophy
  • Most common cause of sudden cardiac death in younger athletes
    MEDICATIONS
  • DO NOT USE DIURETICS DUE TO RISK OF DEHYDRATION
  • Beta blockers, calcium channel blockers, anticoagulants
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24
Q

Dilated Cardiomyopathy

A
  • Progressive cardiac hypertrophy and dilation with impaired systolic function (pumping ability of ventricles)
  • Decreased myocardial contractility
  • Caused by genetics, ischemic heart disease, infection, toxins, alcohol, chemotherapy, metal
  • S/S include heart failure, dyspnea, orthopnea, decreased exercise capacity
  • Systemic and mural thrombi can be seen in later stages
  • Death usually occurs from HF and dysrhytmias
  • This is the most common cause of needing a heart transplant
    MEDICATIONS
  • ACE inhibitors and Angiotensin 2 blockers if ACE does not work
  • Beta blockers
  • Diuretics
  • Digoxin
  • Anticoagulants
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25
Q

Restrictive Cardiomyopathy

A
  • Ventricular filling is affected because of rigidity of ventricular walls
  • Caused by infiltrative diseases like amyloidosis, fibrosis, sarcoidosis, metastatic tumors
  • Causes dyspnea, Paroxysmal Nocturnal Dyspnea (PND) - SOB after waking up, orthopnea, peripheral edema, fatigue, weakness
  • Cardiomegaly and dysrhythmias are often seen (death caused by RHF and dysrhythmias)
  • Treatment depends on the cause but medications same as DCM
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26
Q

Cardiomyopathy Assessment

A
  • Predisposing factors, family history
  • Chest pain
  • Diet including sodium and vitamins
  • VS, pulse pressure, weight gain/loss, PMI (point of maximal impulse), murmurs, s3 or s4 sounds, pulmonary auscultation for crackles, JVD, edema
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27
Q

Nursing Diagnosis for Cardiomyopathy

A
  • Decreased CO
  • Risk for ineffective cardiac, cerebral, peripheral, renal tissue perfusion
  • Impaired gas exchange
  • Activity intolerance
  • Anxiety
  • Powerlessness
  • Noncompliance with medications and diet therapies
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28
Q

Cardiomyopathy Issues

A
  • Heart failure
  • Ventricular dysrhythmias
  • Atrial dysrhythmias
  • Cardiac conduction defects
  • Pulmonary/cerebral embolism
  • Valvular Dysfunction
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29
Q

Goals for Cardiomyopathy patients

A
  • Maintenance of CO
  • Increased activity tolerance
  • Adherence to care program
  • Increased sense of power in decision making
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30
Q

Nursing Interventions for Cardiomyopathy

A
  • Improve CO by promoting rest with legs down, supplemental O2, low sodium, O2 therapy, and avoiding dehydration
  • Increase activity tolerance and gas exchange by balancing rest with activity and ensuring patient recognizes the need for rest
  • Decrease sense of powerlessness by assisting patient in identifying things they have lost (ability to play sports) and identifying things they still have control over
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31
Q

Dobutamine (Dubotrex)

A
  • Beta 1 adrenergic agonist with positive inotropic effects
  • Short term use for patients with decreased contractility due to HF
  • Cardiac Decompensation (Heart can no longer provide proper circulation)
  • Given as IV
  • Used for decompensated HF because it increases contractility which leads to larger stroke volume and increased cardiac output.
    ADVERSE EFFECTS
  • Hypertension, tachycardia, ventricular dysrhythmias
  • Increased HR in A-Fib patients
  • Sulfite hypersensitivity
    RARE ADVERSE EFFECTS
  • Hypokalemia and phlebitis
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32
Q

Digoxin

A
  • Narrow therapeutic index so dose must be monitored closely
  • Manages HF symptoms and treats A-Fib (flutter)
  • Positive inotrope, negative dromotropic (slows conduction), slows HR (negative chronotropic).
  • Ultimately increases CO and controls heart rhythm
    DO NOT USE IN PATIENTS WITH HEART BLOCK OR VENTRICULAR FIBRILATION
  • Toxicity (most common with hypokalemia) causes GI disturbances (n/v, diarrhea, abd pain)
  • Cardiotoxicity includes brady/tachy dysrhythmias and heart block
  • CNS toxicity includes drowsiness, fatigue, lethargy
  • Blurred vision, haloes, color disturbances and sarcoma
    ANTIDOTE - DIGIBIND (IV AFTER RECONSTITUTION)
  • Check apical pulse for a full minute before administering (hold dose if less than 60 bpm)
  • ASSESS DRUG BLOOD LEVELS BEFORE ADMINISTERING
    EDUCATION
  • Do not stop medication abruptly, take pulse before each dose, monitor weight gain
  • Report swelling in ankles/feet, SOB, or toxicity
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33
Q

Decompensated HF Medications

A
  • Inamrinone (Incor) - Enhances myocardial contractions and reduces preload and afterload
  • Milrinone (Primacor) - Positive inotrope and vasodilator (inodilator). Increases CO and cardiac mechanical efficiency
  • Both drugs are for short term treatment of HF who do not respond well to other medications
  • Slow IV bolus and IV infusion
34
Q

Infective Endocarditis (IE)

A
  • Develops in people with prosthetic heart valves or structural cardiac defects
  • Caused by IV drug abusers, catheters, prolonged IV therapy
  • Caused by bacteria that enters blood stream and settles in endocardial layers of heart (innermost layer)
  • Staphylococcus is the leading cause
35
Q

IE Causes

A
  • Mitral Valve Prolapse
  • Congenital Heart Disease
  • Prosthetic Heart Valves
36
Q

Risk Factors for IE

A
  • Neutropenia (low neutrophils)
  • Immunodeficiency
  • DM
  • Alcohol/Drugs
  • The only way to get IE is if you have damaged endocardial surfaces (valvular disease, prosthetic valves, congenital heart defects), and a poral of entry into circulatory system
  • IV drugs, IV therapy, and Catheters provide a portal of entry
37
Q

IE Pathophysiology

A
  • Formation of vegetative lesions (infectious organisms and debris) that stick onto valves
  • These lesions release bacteria into the blood stream
  • This causes valve regurgitation, development of ring abscesses, heart block, and valve perforation.
  • These vegetations can also become emboli which can get lodged into small vessels causing “splinter hemorrhages” and infarction of tissue.
38
Q

IE Manifestations

A

PRIMARY SYMPTOMS INCLUDE FEVER AND HEART MURMUR
- Fever
- Systemic Infection
- Murmur
- Emboli
- Small hemorrhages on skin, nail beds, mucous membranes
- Systemic Emboli can cause cough, dyspnea, abdominal/flank pain
RARE SYMPTOMS
- Olser Nodes (small painful nodes on fingers/toes)
- Janeway’s Lesions (Red/Purple painless macules on palms, fingers, soles, toes, hands)
- Roth Spots (hemorrhage with pale centers in eyes)

  • Blood culture is best way to diagnose
39
Q

Rheumatic Heart Disease (RHD)

A
  • Rheumatic Endocarditis
  • Happens secondary to streptococcal pharyngitis (which is why it is essential to treat strep as soon as possible)
  • Rheumatic Fever (immune-mediated, inflammatory disease caused by exaggerated response to strep)
  • RHD develops in 10% of people who have rheumatic fever
  • Can cause chronic valvular disorders and permanent cardiac dysfunction
40
Q

RHD Manifestations

A
  • Carditis (inflammation of heart)
  • Polyarthritis (in larger joints), Arthralgias (Joint pain)
  • Chorea (involuntary movement of face/limbs/muscular weakness/disturbances in speech/gait)
  • Erythema Marginatum (Pink, non pruritic lesions in trunk and extremities)
  • Subcutaneous nodules
  • Fever
  • Elevated C-reactive Protein (CRP)
  • Prolonger PR interval on ECG
41
Q

RHD Diagnosis

A
  • Elevated ESR (erythrocyte sedimentation rate)
  • WBC count
  • CRP (C-reactive protein)
  • Evidence of preceding strep
42
Q

Acute Pericarditis

A
  • Inflammation of pericardium usually cause by viral infection.
  • Classified by exudate (serous, fibrinous, purulent, hemorrhagic)
  • Inflammation causes capillary permeability which allow plasma protein to enter pericardial spaces which cause the formation of exudates
  • Manifestations include chest pain, which gets worse with breathing and lying down. Can also cause pericardial friction rub and ECG changes
  • Diagnosed with WBC, ESR, CRP
  • Can cause pericardial effusion and cardiac tamponade (fluid around heart)
  • Prevented with prophylactic antibiotics before certain procedures
  • Can be caused by dental visits (oral hygiene), IUD’s, catheters.
43
Q

Myocarditis

A
  • Inflammation of myocardium
  • Most commonly caused by viral infection
  • Severe cases can lead to HF, dysrhythmias, sudden death
  • Manifestations include chest pain, abnormal heart beat, SOB
  • Can cause cardiomyopathy and HF
44
Q

Vascular System

A

Right Side - Pumps blood through lungs to pulmonary circulation
Left Side - Pumps blood to the body

  • Supplies blood to needed tissues via blood flow, regulates blood pressure, capillary filtration, reabsorption, peripheral vascular regulation.

Problems in vascular system include pump failure, circulatory insufficiency to extremities, and alterations in blood/lymphatic vessels.

45
Q

Old People Considerations

A
  • Aging changes blood vessels that affect transport of oxygen/nutrients
  • These changes cause vessels to stiffen and increase peripheral vascular resistance/impaired blood flow/and increased left ventricular workload.
46
Q

Health History Assessment

A
  • Focus specifically on pain (especially in extremities)
47
Q

Intermittent Claudication

A
  • Pain from obstruction of arterial blood flow from muscle ischemia during exercise
  • Most commonly affects calves (thigh and butt are also affected)
  • Produced by exercise and relieved by stress
48
Q

Physical Assessment

A
  • Comprehensive assessment of pulses
  • Assessment of integumentary system (especially extremities)
  • Note skin color (pallor/cyanosis/rubor)
  • Temperature/moisture
  • Loss of hair, brittle nails, scaly skin, atrophy, ulcerations of wounds
49
Q

Ankle Brachial Index (ABI)

A
  • Important way to diagnose/evaluate peripheral vascular disease
  • Compares systolic BP of arms and legs to indicate severity of PAD
50
Q

Diagnostic

A
  • Doppler ultrasound
  • Ankle Brachial Test
  • Exercise testing
  • Duplex ultrasound
  • CT scanning
  • MRA
51
Q

Arteriosclerosis

A
  • Thickening of small arteries and arterioles

- Risks are same as Coronary Artery Disease

52
Q

Atherosclerosis

A
  • Accumulation of lipids, calcium, fibrous tissue on medium/large arteries
53
Q

Peripheral Artery Disease (PAD)

A
  • Blockage or narrowing of artery in lower extremities resulting in decrease blood flow
  • Hallmark symptom is intermittent claudication (with exercise and relieved with rest)
  • Pain associated with ischemia of distal extremities (persistent, aching, boring pain)
  • Pain is worse at night and may wake patient
  • Assess risk factors, s/s of arterial insufficiency, claudication & rest pain, weak/absent pulses, skin changes/breakdown
  • Major goals is to increase arterial blood supply with vasodilation, relief of pain, and maintenance of tissue integrity
  • Consult HCP for exercise routines, avoid leg crossing, elevate feet but not above heart level, avoid extreme temperatures, smoking cessation and stress reduction
54
Q

Medications for PAD

A
  • Pentoxifylline (Trental) - Anti-inflammatory vasodilator to treat poor circulation
  • Cilostazol (Pletal) - PDE3 inhibitor that allows greater walking distances for patients with intermittent claudication
  • Aspirin - For antiplatelet effect
  • Clopidogrel - Antiplatelet
  • Statins - Antihyperglycemics
55
Q

Surgery for PAD

A
  • Balloon angioplasty (opens vessels with balloon)
  • Stent graft (wire stents that reinforce weak spot in vessel)
  • Atherectomy (remove plaque)
56
Q

Surgery for PAD

A
  • Used when tissue necrosis and amputation is at risk

Carotid Endarterectomy - Remove plaque from carotid artery (improves circulation to brain)
Bypass Graft - Synthetic vein to bypass clot

57
Q

Nursing Care for Surgery

A
  • MAINTAIN CIRCULATION
  • Assess pulses, doppler, color/temperature, capillary refill, motor function of extremities
  • ABI (Ankle brachial index) monitored once every 8 hours for the first 24 hours, then once a day
  • If peripheral pulse disappears it may mean the graft has been occluded (immediate attention)
  • Complications include bleeding, hematoma, fluid imbalance, and infection
58
Q

Aneurysm

A
  • Dilation of a weak point in the wall of an artery (greatest concern when it happens with aorta)
59
Q

Characteristics of Arterial Aneurysm

A

False Aneurysm - Just a pulsating hematoma (clot and connective tissue are outside the arterial wall)
True Aneurysm - 1/2/3 layers of artery are involved
Fusiform Aneurysm - Symmetric, spindle shaped expansion of entire circumference of involved vessel
Saccular Aneurysm - Bulbous protrusion of 1 side of the arterial wall
Dissecting Aneurysm - Hematoma that splits the layers of arterial wall

60
Q

Thoracic Aneurysm Manifestations (TAA)

A
  • Asymptomatic
  • Pain maybe constant and boring
  • Dyspnea, cough, hoarseness, stridor, dysphagia
  • Weakness/loss of voice
    IMPENDING RUPTURE SIGNS
  • Back/abdominal pain or lower back pain
  • Drop in BP, hematocrit
  • Hematoma in scrotum, perineum, flank or penis from retroperitoneal rupture

Physical Findings

  • Dilation of superficial veins in chest, neck or arms
  • Edema of chest wall
  • Cyanosis
61
Q

Abdominal Aneurysm (AAA)

A
  • Asymptomatic
  • Sensation of abdominal heart beat (especially supine)
  • Abdominal mass or abdominal throbbing
  • Cyanosis and mottling of toes
  • Pulsatile mass and bruit on auscultation
62
Q

Diagnostic Test for Aneursym

A
  • Chest X-ray
  • Computed Tomography Angiography (CTA) - Preferred method
  • MRA (Magnetic Resonance Angiography)
  • TEE (Transesophageal Echocardiography) for thoracic aneurysm
63
Q

Medical Management of Aneurysm

A
  • Aortic Aneurysms are just monitored over time for changes in size/appearance
  • Ultrasounds, BP control, Antihypertensives (diuretics, BB, ACE inhibitors, ARB (Angiotensin receptor blockers), CCB)
  • Blood pressure control is vital to prevent rupture
64
Q

Surgery for Aneurysms

A
  • Removing weakened portion and suturing a bypass graft
65
Q

Complications of Aneurysm Repair Surgery

A
  • Bleeding/Hematoma
  • Graft leaks/migration
  • Infection or Graft Thrombosis
  • Delayed rupture
  • Distal Ischemia
  • Emboli which results in organ failure
66
Q

Nursing Management of Surgery

A
  • ABC’s
  • VS and Peripheral Pulses (Doppler) every 15 minutes
  • Monitor Pulmonary/Cardiovascular/Renal/Neurologic Status
  • Notify surgeon of persistent coughing, sneezing, vomiting, elevated systolic BP to prevent rupture
67
Q

Aortic Dissection

A
  • 3x more likely in men than women (occur between 50-70 y/o)
  • Common in patients with Marfan Syndrome (connective tissue disorder)
  • Caused by uncontrolled HTN, blunt chest trauma, cocaine
  • Tear or rupture of vessel wall, if the outer layer ruptures it can be fatal
  • Dissections of ascending aorta is the most fatal
68
Q

Aortic Dissection Manifestations

A
  • Severe persistent pain (tearing or ripping)
  • Pallor/Diaphoresis/Tachycardia/Differing BP from one arm to another
    NURSING MANAGEMENT
  • Immediate surgical intervention
69
Q

Raynaud’s Disease

A
  • Intermittent vaso-occlusion usually in fingertips or toes
  • Raynaud’s syndrome is secondary to another disease such as lupus or RA
  • Affects young women the most and can be triggered by cold or stress
    MANIFESTATIONS
  • Color change white (lack of blood flow), blue (lack of oxygen), numbness, tingling, burning
    MANAGEMENT
  • Protection from cold and other triggers
  • CCB can be used in severe cases (Nifedipine (Procardia)) for vasodilating effects
70
Q

Superficial Thrombophlebitis

A
  • Sudden vasoconstriction that results in color change, white lack of blood flow, blue lack of oxygen, red when blood returns.
  • Nursing Management includes protection from triggers like cold, avoiding injury to hands and feet, CCB (Nifedipine (Procardia)) for vasodilation
71
Q

Deep Vein Thrombosis

A
  • Clot in vein due to venous stasis, endothelial damage and hypercoagulation (Virchow’s triad)
  • May result in pulmonary embolism so for post-op patients it is important for early mobilization, compression socks, and anticoagulation
  • PREVENTION IS THE BEST MANAGEMENT such as frequent position changes, rotate ankles every 2 hours, anticoagulation such as heparin and warfarin
72
Q

Chronic Venous Insufficiency (CVI) and Venous Leg Ulcers

A
  • Valves of legs get damaged resulting in venous stasis
  • Increased pressure in the veins cause fluid to leak out and edema
  • RBC breakdown releasing hemosiderin which causes discoloration of lower legs and skin to become thickened, hardened, and dark around the ankles
  • Can be caused by DVT
  • Treated with anti-infective therapy, compression therapy, debridement of wounds
  • Can cause infection, gangrene and limb loss
  • Goals are to restore skin integrity, wound care, avoid trauma and heat sources
  • Leg ulcers can cause activity restriction, so improving mobility is a goal
  • Nutrition with zinc is important for anti-inflammation effects, enzyme and hormone support, wound healing (low zinc inhibits wound healing),
  • Foods high in zinc include meat, shellfish, legumes, seeds, nuts, dairy, eggs, whole grain
  • Outcomes include improved skin integrity, increased physical mobility, adequate nutrition
73
Q

CVI vs PAD

A

PAD
- Painful, Gangrene, Decreased pulses, No Edema, Ulcers more often in toes, very little drainage

CVI
- No pain, rarely gangrenous, pulses are fine, edema, ulcers in lower leg or ankles, drainage

74
Q

Varicose Veins

A
  • Veins become dilated from weakened walls that cant withstand pressure
  • Dilation prevents the valves from closing, allowing backup and pressure.
  • Management includes promoting venous return by changing positions, elevating legs above the heart, education on avoiding pressure in legs such as crossing legs, or knees high. Use Compression socks and weight loss can help
  • Prevention through mobilization, not wearing restrictive clothing, elevating legs, compression socks
  • Medical management includes litigation of veins (tied off) and removal of vein
  • Micro phlebectomy removal of veins
  • Thermal Ablation - seal the vein
  • Laser ablation - seal the vein
  • Sclerotherapy - Obliterating the vein with chemicals
75
Q

Cellulitis

A
  • Bacteria breeching the skin barriers and allowing it to release chemicals into subcutaneous tissue.
  • Usually caused by strep or staph
  • Localized swelling, fever, chills, redness, diaphoresis
  • Treated with antibiotics
    NURSING MANAGEMENT
  • Elevation of effected area, warm/moist packs to site every 2-4 hours
  • Education on foot/skin care and prevention
76
Q

Lymphatic Disorders

A
  • Affects the flow of lymph
    Primary disorders are genetic
    Secondary disorders are acquired obstruction

Lymphangitis - Inflammation of lymphatic channel
Lymphadenitis - Inflammation/Infection of Lymph Node
Lymphedema - Tissue swelling related to obstruction of lymph flow

77
Q

Aortic Valve Stenosis

A
  • Occurs in aortic valve (between left ventricle and aorta)
  • Obstructs blood flow across the valve
  • Caused by calcification of the aortic valve, which stiffens it and it cant open all the way
    SYMPTOMS
  • Can be asymptomatic
  • Causes chest pain, dizziness, fainting during exercise, congestive heart failure
  • Syncope, Angina, CHF, Dyspnea, Peripheral Cyanosis
78
Q

Mitral Valve Stenosis

A
  • Caused by infection like Rheumatic Fever.
  • Blood cannot move adequately to the left ventricle to be pumped to the rest of the body
  • Blood backs up from the left ventricle to the left atrium
  • Fluid backup into the lungs
    SYMPTOMS
  • SOB, Fatigue, Dizziness, Swollen feet/legs, Heart palpations
79
Q

Aortic Regurgitation

A
  • Valve between left ventricle to aorta
  • When the ventricle contracts, oxygenated blood is forced through the aorta to supply the body with blood
  • Symptoms do not occur until heart failure occurs
  • It can cause exertional dyspnea, orthopnea, post-nocturnal dyspnea, chest pain, and syncope
80
Q

Mitral Regurgitation

A
  • Located between left atrium and left ventricle
  • Backflow increases the amount of blood in the left atrium
  • This causes pressure in the veins from the lungs of the heart
    SYMPTOMS
  • ## Abnormal heart sounds, sensations of rapid heartbeat, SOB, fatigue, swollen feet or ankles.
81
Q

Myocardial Infarction

A
  • What is the hallmark symptom of MI
  • Elevated ST (ALAWYS ELEVATED ST)
  • What is a rapid test for MI
  • ECG
  • Troponin test is also rapid

Older Adults Pt 2 (17 decks)

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