Cardiac Flashcards
Two treatments for Symptomatic bradycardia
Transcutaneous pacing
Atropine
Priority treatment for v-fib and pulseless v-tach
Defibrillation
Treatment for symptomatic tachycardia
Cardioversion
When should we start CPR
No pulse
How do we know if our patients have adequate oxygen: Nursing assessment
Do the pupils react to light
Amiodarone can help with these heart rhythms
PVCs
A-fib
A-flutter
V-tach
Organ typically damaged during CPR
Liver
Interval of time a person can survive without oxygen
4-6 minutes
How does clonidine work
Drops blood pressure
Common side effects of clonidine
Impotence
Dry mouth
Visual disturbances
What HR should we hold the beta blocker
< 50
Formula for CO
SV x HR
Decreased CO, ____ Tissue perfusion
Decreased
(3) Directly influences CO
HR
BP
Contractions
Findings of LOW CO
Decreased LOC
Sweaty skin
Diminished pulses
Bradycardia
Wet lung sounds
Decreased urinary output
Abnormal Heart rhythms that can lead to death
Asystole
Pulseless v-tach
V-fib
Stroke Volume
Blood is pumped from L. Ventricle/minute
Positive Homan sign is an indicator for:
DVT
Positive Homan sign
Pain in the calf upon flexing the knee and arching or cramping upon dorsiflexion of the foot.
Arteries
Carry blood from the heart
Veins
Carry blood to the heart
Arterial disorders =
Oxygenation
Hallmark sign of any arterial disorder
Claudication
Claudication
Pain caused by too little blood flow during exercise
Elevate ____
Veins
Dangle ____
Arteries
Findings of PAD
Shiny leg
Hairless extremity
Pale and Cold extremity
Diminished pulse
Numbness and pain at rest
Cardiac Tamponade
Fluid on the heart
Findings of tamponade
Decrease BP
Increased CVP
Muffled sounds
JVD
Classic sign of tamponade
Muffled sounds
Increased CVP
Narrow pulse
Treatment for tamponade
Pericardiocentesis
Pericardiocentesis
Fluid is taken from the pericardium
pulmonary Embolism
Fluid in the lungs
When does PE normally occur
night time
We pull fluids from our legs while we are supine
People who typically get a PE
Anyone with too much fluid
Kidney and heart failure patients
Very old patients
Very young patients
Findings of PE
HYPOXIA
a productive cough
Priority nursing intervention for PE
Oxygen
Typical med prescribed to treat PE
Lasix
Nitroglycerine
Vasodilator
Typical med prescribed for chest pain
Nitroglycerine
Nesiritide
IV vasodilator
Nesiritide can affect this lab value
BNP
Turn off infusion at least two hours PRIOR to BNP lab draw
Position to relieve PE
Up Right
Purpose of a pacemaker
Keep heart rate above bradycardia
Demand pacer
Kicks in when the HR drops below 60
Fixed rate pacer
Predetermined rate to kick in
Complication of pacemaker
Dislodged electrodes
After the pacemaker is placed in a client, what should we instruct them to do with their arms
Immobolize it
Do not raise it over a certain point
Exercises we can do with our patient after a pacer is placed
Passive range motions
Loss of capture
Do not see the p wave or QRS interval after pacer spike
Failure to sense
No pacer spike with P wave or QRS interval
How often should someone with a pacer check their pulse
Daily
Should be avoided with anyone who has a pacemaker
MRIs
Cell phones
5 heart disorders that put you at risk for failure
HTN
MI
Cardiomyopathy
Heart disease
Endocarditis
Left-sided heart failure
Blood backed up into the lungs
Right-sided heart failure
Systemic heart failure
Findings of Left-sided heart failure
SOB
A productive cough
Congestion
SOB laying down (Orthopnea)
Restlessness
Bloody sputum
Findings of right-sided heart failure
Edema
Large ORGANS
JVD
Bounding pulse
Ascites
Weight gain
Systolic heart failure
No contraction
Diastolic heart failure
No fill in ventricles
Lab used to identify heart failure
BNP
Normal BNP Level
< 100
A diagnostic test to identify HF
Echocardiogram
Echocardiogram
Looks at the ejection fracture of the heart
Normal ejection fracture
.55-.7
HF medication regiment
Ace inhibitor and ARBs
A medication commonly used for HF
Ace inhibitors
How do ace inhibitors work
Causes vessels to widen to decrease blood pressure
How do ARBs work
Same principle as an ace inhibitor. Widen blood vessels to decrease blood pressure
Example ARB
Losartan
Inhibited by ARBs and Ace inhibitors
Aldosterone - Helps us keep fluids and sodium
We always retain this electrolyte with ace inhibitors
Potassium
Drug regiment for HF patients being D/C
Beta-blocker and diuretic
Digoxin
Inotropic - makes the heart beat stronger
used to fix AFIB and HF
The expected outcome of digoxin
Better cardiac output
Finding of digoxin toxicity
VISUAL ISSUES
Irregular HB
Check prior to giving digoxin
Apical pulse
The cause of digoxin toxicity
Low potassium + Digoxin
Lab to check prior to given digoxin
Potassium
When should we administer diuretics
Early in the day
NEVER AT NIGHT TIME
Diet modification for HF
Low sodium
Decrease fluids
The best position for someone with heart failure
High fowlers
Cardiac rehab interventions to prevent heart failure (4)
No straining ( Docusate)
No Valsalva
No smoking
When can our client start having sex again
if they can walk around the block or a set of stairs without pain
The safest time for a client with HF to have sex
in the mornings
Best exercise for a client with HF
Walking
Findings of Hf
2-3 pound weight gain
LLE edema
SOB
Angioplasty
The balloon used to widen a blocked vessel
Stent
Tube used to widen a vessel
Complication of angioplasty
Heart Attack
Response to MI during angioplasty
Prepare for surgery
Complication post angioplasty
Angina
Medication typically prescribed after a stent is placed
Antiplatelt meds
Considered antiplatelets
Aspirin
Plavix
Abciximab
CABG
Open heart surgery
The expected outcome of a CABG
Occlusion went from the left main artery
Left main coronary artery occlusion =
death
