Cardiac Flashcards

Question

Cardiac Rehab

Answer 1

``` Stop smoking low fat, low salt, low cholesterol no iso workout no valsava no straining Sex resume 10 days , safe morning exercise walking ``` ``` Teach for HF symptoms Weight gain Ankle Edema SOB Confusion ```

Answer 2

Results from heart problems usually leading by hypertension

Answer 3

``` Left- moving backward into lungs left=lungs pulmonary congestion dyspnea cough tinged sputum restlessness tachy s-3 orthopnea noc. dyspnea ``` ``` RHF Goes back in to venous system Distended neck edema enlarged organs weight gain ascites ```

Answer 4

BNP , ventricular volume and pressure increases , can be positive when CXR shows nothing. Turn off nesiritide can give false high. CXR will be enlarged Echocardiogram , to see pump and ejection of heart / ECG, Swan Cath

Answer 5

Ace inhibitors *DOC Supress Angiotensin 1 from 2 > Arterial dilation and increase stroke volume. S/E - Nagging cough Arbs Block 2 , decrease arterial resistance and BP Beta First line therapy to ace relax , decrease bp, afterload, workload. Both ace and arbs block aldosterone - we lose sodium and water and retain potassium! Digoxin (0.5-2) for sinus rythm in combo with Ace, arbs, beta, diuretics contraction stronger, hr slower, co up, kidney perfusion up.

Answer 6

ACE and beta to decrease workload and vasoconstriction, keeping blood work forward

Answer 7

Diurese is good, digoxin works when CO is up. Toxicity is anorexia, vomitting, nausea. arrhythmia and vision changes. Before administering check apical pulse electrolytes - as hypokal with dig = toxicity Diuretics , MIDE/NIDE, THIAZIDE To decrease preload, give in morning

Answer 8

IV inotropes : milrinone Vasodilators nitroprusside,nitro Low sodium diet to decrease preload, salt subs, elevate HOB, Report gain of 2-3 lbs. Fluid Retention - think heart problems Report recurring signs of heart failure.

Answer 9

SA node is your natural pacemaker, that makes the heart contract below 60, pacemakers will be used when showing symptomatic bradi. make be temp or permanent. Set rate, fix rate is at a set rate constantly, never decrease. worry if it drops below set rate

Answer 10

Monitor incision common complication is electrode displacement. immbolize arm, active passive range to prevent frozen shoulder do not pass shoulder height

Answer 11

No contraction and stimulus - loss of capture Inappropriate firing - failure to sense This means: no programmed correctly dislodged battery depleted look at decreased rate

Answer 12

Check pulse daily Id Card avoid electromagnetic fields avoid MRI

Answer 13

Those receiving IV fluids young and old those with heart or kidney disease Patho Fluid is unable to go forward, going to lungs Occurring at night ``` s/s sudden onset breathless anxious hypoxia pink froth ``` ``` Txt High flow oxygen titrate above 90% Nitro Nesiritide Morphine Butanide furosemide - Diuretics ```

Answer 14

Diuretics - Furosemide 40 mg IV push 1-2 minutes watch for hypotention and ototoxicity Bumetanide , iv push, 1-2 min Nitro - Decrease afterload increases CO moving blood forward Morphine 2mg IV push Nesiritide - IV short term no more than 28hrs, turn off 2 hrs before drawing BNP levels

Answer 15

Upright legs down prevents ppling increases CO

Answer 16

Check lung sounds, avoid FVE

Answer 17

Blood, fluid, exudate leaking into pericardial sac compressing heart ``` S/S CVP up Decreased CO Bp drop *hallmark signs Muffled or distant heart sounds neck distended Narrowed pulse pressure from baseline ``` Txt: surgery remove fluid from heart pericardiocentesis

Answer 18

Atherosclerosis everywhere, acute version can cause occlusion reporting of numbness and pain, cold, 5P's Lower extremities more symptomatic intermittent claudication * hallmark sign, decreased peripheral pulses, skin/ nail changes, hairless pain at rest is severe obstruction Txt: Elevating would increase pain - harder to pump Treated with angioplasty or endarcarterectomy

Answer 19

Veins carry deoxygenated blood inflammation and chronic ulcers Developing into DVT