cadiovascular Flashcards
which sided HF usually occurs first?
Left sided (and can trigger right)
What are manifestations of R sided HF?
peripheral edema, JVD, ascites, weight gain
What are manifestations of L sided HF?
fatigue, anxiety, PE, crackles, dyspnea
Risk factors for HF?
Hypertension, previous MI (biggest one), CAD, ischemic heart disease, male gender
Which disrhythmia is commonly associated with HF?
atrial fibrillation
Description of a fib on an ECG
no discernible p waves, rapid, irregular QRS complexes (ventricular response)
description of a fib (whats happening in the heart)
multiple areas in the atria elicit irregular electrical impulses some of which get through to the ventricle
What drug could be given to a HF pt who is experiencing a fib?
digoxin
Which diagnostic test is used to measure the pressure in the R atrium?
pulmonary artery catheterization
What is an echocardiography used to determine?
cardiac valvular defects, chamber enlargement, pericardial effusions
What is an ECG used to determine?
arrhythmias, underlying miocardial ischemia
Vagal stimulation (valsalva maneuver) amy cause what? (rhythm)
bradycardia
Possible HF nursing diagnoses?
- fluid volume excess (heart not pumping effectively and fluid builds up in tissues and lungs)
- impaired gas exchange (lung tissues become congested with fluid, less O2 available for exchange, resulting in decreased tissue oxygenation)
- decreased cardiac output
- activity intolerance
possible nursing interventions for HF?
- monitor weights
- degree of peripheral edema
- ECG
- VS
- oral and IV intake
- monitor labs (particularly potassium)
- monitor inr/ptt
- fall precautions
manifestations of pulmonary edema?
confusion, restlessness, frothy/productive/blood tinged cough, tachycardia, dyspnea, blue/cold skin, crackles in the lungs
foods high in potassium?
AVOCADOS, BANANAS, CANTALOUPES, RAISINS, SPINACH, fish, tomatoes, mushrooms, veal, beef, carrots
Which enzyme test is best post MI or unstable angina?
Triponin - it is specific to the heart. Creatinine kinase MB and myoglobin are good to test for if it has been a longer amount of time. they are also not specific to cardio.
Within the scope of an LPN?
- administering meds PO
- attaching cardiac monitor leads
- obtaining an ECG
- data/assessment collection (listening to lung sounds and assessing peripheral edema for stable pt’s)
- observing a previously taught action for accuracy
- wound care
- reinforcing previously taught material
- foley insertion
- IV insertions ONLY IF TRAINED AND ONLY IN SOME STATES!
- SQ administrations/infusions
Not in the cope of an LPN?
- administering high alert meds (anticoagulants, narcotics)
- administering meds to unstable pt
- obtaining pt history
- reviewing meds with pt
- planning activity levels
- planning for client care or teaching
- IV insertion (unless properly trained or in some states)
- Pt education
What is the cough that is sometimes seen in pt’s taking ACE inhibitors caused by?
caused by a build-up of bradykinin
goal of hypertension meds
reduced pt BP to < 140/90
What is altaplase?
What is the time limit for administering it?
Thrombolytic
6 hours
MONA order
Oxygen
Aspirin
Nitroglycerin
Morphine
coronary arteriography?
Biggest risk?
diagnostic cathlab procedure
Risk: bleeding (you would see an elevated HR)
