Cardiac Flashcards
Angina, HF, MI, CAD, pericarditis
Chronic stable angina occurs with…
Exertion, stress, or emotional upset
Can chronic stable angina be relieved? If so, how?
Rest or NG
Unstable angina occurs…
At rest or minimal exertion
Can unstable angina be relieved? If so, how?
May not be relieved w/ NG
Variant angina
Can occur at rest or during sleep
Variant angina interventions
SL NG or light exercise
S+S of right HF
Distended neck veins
Hepatomegaly
Ascites
Peripheral edema
Weight gain
S+S of left HF
Dyspnea, orthopnea, PND
Cough w/ pink, frothy sputum
Crackles, rales
Weakness and fatigue
Cold, clammy skin
Weight gain
Nursing interventions for acute HF
High Fowler position
Oxygen
Loop diuretics
Strict I+O
Meds for HF
Diuretics: reduce preload
BB: to reduce cardiac workload
ACE inhibitors: to reduce afterload (BP)
Digoxin: to increase cardiac contractility
Patho of MI
Sudden rupture of unstable plaque -> thrombus in coronary artery -> ischemia and cardiac cell death
S+S of MI
Chest pain
Anxiety
Feeling of impending doom
EKG changes: ST depression, ST elevation
Difference between ST depression and ST elevation
ST depression: partial thrombotic obstruction
ST elevation: total
Tx of MI
Aspirin
SL NG
Morphine
Oxygen
BB prescribed AFTER MI
Anticoagulants
Statin
PCI
t-PA
PCI
First-line tx
Involves: thrombus retrieval, angioplasty, coronary artery stent placement
Perform w/in 90 min
CABG
Rerouting myocardial blood flow around blocked coronary arteries
Nursing interventions of MI
Semi-Fowler position
Bed rest
Assess distal peripheral pulses and skin temp
Pericarditis causes
Autoimmune dz
Viral or idiopathic
Renal failure
Following MI
Patho of pericarditis
Fluid accumulation -> pericardial effusion -> cardiac tamponade
S+S of pericarditis
Pleuritic chest pain
Pericardial friction rub
Systemic symptoms
Interventions for pericarditis
Encourage to lean forward
Monitor for melena
Meds for pericarditis
Colchicine (anti-inflammatory)
NSAIDs
Signs of cardiac tamponade
Muffled heart sounds
Hypotension
Patho of CAD
Narrowing of coronary arteries due to buildup of hardened fat deposits (plaques)
Impaired blood supply to heart -> tissue ischemia and necrosis (MI)
Dx of CAD
EKG
Stress cardiac testing
Cardiac catheterization
Lipid levels
Meds for CAD
Antiplatelets
Nitrates
Cholesterol-lowering meds
BB
ACE inhibitors
CCB
Thrombolytic agents CI
Active bleeding
Recent trauma
Hx of hemorrhagic stroke
Recent surgery
Uncontrolled HTN
(BP > 180/110)
CABG teaching
Report any redness, swelling, warmth, or drainage from incisions
Wash incisions daily w/ soap and water in shower and gently pat them dry
Wear elastic compression hose on legs and elevate while sitting
For interventions following CABG
Cover w/ warming blanket, increasing room temp, using warmed IV fluids
Monitor BP via arterial line
Notify HCP > 100 mL/hr
Assess for pulsus paradoxus
Measure difference b/w Korotkoff sounds auscultated during expiration and throughout respiratory cycle
Place a blood pressure cuff on the patients arm and very very slowly deflate the cuff while listening for brachial pulsations
ICD insertion teaching
Refrain from lifting affected arm above shoulder until approved by HCP to prevent dislodgement of lead wire on endocardium
Cardiac cath includes what?
IV iodinated contrast
Cardiac cauterization teaching
Increase fluid intake: promote clearance of IV contrast
Keep leg straight for 4 hrs
Anticoagulants prescription
Complications of IV iodinated contrast (cardiac cath)
Allergic rxn
Lactic acidosis
Contrast-induced neuropathy
Endocarditis S+S
Stroke
Septic pulmonary emboli
Kidney infarction and hematuria
Splinter hemorrhage
Petechiae
Splenic infx
Pallor and ischemia = report
tPA CI
After 3.5-4.5 hr from onset of S+S
Recent major hx
Hemorrhagic stroke
Head trauma (recent)
Severe HTN (>185/110)
Coagulation disorders
Pt reports HA when taking NG…
Administer acetaminophen
S3 indicates
HF
