Cardiac Alternations Flashcards
What is an abdominal aortic aneurysm?
An abdominal aortic aneurysm occurs when a lower part of the body’s main artery, called the aorta, becomes weakened and bulges. An abdominal aortic aneurysm is an enlarged area in the lower part of the body’s main artery, called the aorta
patient teaching+follow up info post cardiac cauterization?
No bending or lifting for 2 – 6 weeks
Careful with cleaning (they can have a shower - we don’t want direct soap or water scrubed into the site, not longer than 10min, water can run down) - can shower if there is no drainage coming out
What will beta-blockers do?
Beta Blockers: We give this because it can help control their HR, this is helpful because it can lower the HR to lower O2 demands – higher the oulse rate the more O2 demands we have
Why do we need to be catious with administering beta-blocker?(what can they cause)
Be cautious whenever using beta blockers as they can very quickly cause a dangerous drop in heart rate
What kind of symptoms do women often have with an MI?
-Women are often atypical and sometimes don’t present the same way men would (feeling unwell sleep disturbances are some of the most common symptoms)
Post procedure cardiac cath lab nursing interventions?
Post-procedure:
-Pull out catheter
-Monitor for signs of bleeding (putting pressure on the site of insertion)
-We could have a vaovgoresponse from putting pressure on the site and disrupting blood flow
Why do we give Aspirin?
Asprin: Give an antiplate medication to prevent the clot from getting bigger (they stop the platelets from sticking together) – we administer SL and get them to CHEW IT - we want quick absorption (do not swallow it!!)
Pre procedure cardiac cath lab nursing interventions?
Pre-procedure:
-Before the patient goes into surgery, we will:
-Give profloatic antibiotics
-Consent
-Med history (what have they already taken/that morning) -
-Vitals (height and weight)
-Baseline ECG (have this right before they go so we are able to compare)
-Goals of Care
-Allergy!!! ( this is important due to the dye)
S+S of venous peripheral vasc disease?
S+S if it is venous: we will notice skin colour changes, sloughing, swleein , edema, wet – we have pain and can be relieved when we put our feet up, aching pain –pain releved when we lift/rest the leg up – vericos vains
Why is there SOB+Diaphoresis with an MI?
Due to activation of the SNS?
What is peripheral vasc disease?
Peripheral Vascular Disease (PVD), also known as Peripheral Arterial Disease (PAD), is a common circulatory problem in which narrowed arteries reduce blood flow to the limbs. When you develop peripheral vascular disease, your extremities — usually your legs — don’t receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain when walking (claudication).
PVD is typically caused by atherosclerosis, a condition where plaque builds up in the arterial walls and reduces the flow of blood.
What happens/is going on with an MI?
With an MI the unstable plaque ruptures (plaques are filled with lipids) when this happens this causes a narrowing of the blood vessels which causes perminant damage to the heart muscle it’s self
What kind of pateints might have issues with properly noticing symptoms of an MI?Why?
Those with diabetes due to a decrese in sensation
Complications of an open AAA Repair?
Complications (open):
-Infection
-Hypovolemia from bleeding
-Kidney damage (from clamping off blood flow)
-Will have staples
Why don’t we see ST elevation on an ECG with an NSTEMI?
-We don’t see ST elevation here because there is repolarization here (there is still electricity going through here)
What is unstable angina?
Unstable angia is plaque with stability
S+S of MI?
Anxiety
Chrushing chest pain
left arm pain(med)
Arm,back,jaw pain(women)
Diaphoresis
Nausea
SOB
Management of Heart/pump failure?(Non-pharmacolgic therapy)
O2: Number one thing we are going to make sure that our patient is on (not an order if a patient has chest pain the first thing we have to do is put them on O2)
Pacemaker/ICD (Implanted cardiac defibulator): We have somone on a pacemaker because we have an insufficant heart that is not pumping the way that it needs to be
ECMO: This I still circulating blood through the heart, this is taking over the beating of the heart and oxygenation (will have this in surgery)
VAD: LVAD (think of greys) – this is physically pumping for the heart – it is taking oxygenation blood and pumping it through the aortia – this is done for patients that are waiting for a heart transpant – the ventricle is no longer working – they can last days on it (depends on the person for how long they will have) – it is pumping the blood into the aortia
Heart Transplant: You getting a new heart
When do we tell patients to come back to the hospital following an AAA repair?
Tell the patient to come back to the hospital if:
-Wound dehyse occurs
-Stretching, swelling, redness around wound (infection) – fatigue, fever, redness, swelling
Nursing care post angiogram?
Nursing care: Patient can’t sit up and bend for a couple of hours
How do we diagnose PVD?
Diagnosis of PVD begins with a physical examination, during which a doctor will look for signs of poor circulation. The Ankle-Brachial Index (ABI) — a comparative blood pressure reading in your ankle and arm — is a common test used to diagnose PVD. Further assessments may include Doppler and ultrasound imaging, Magnetic Resonance Angiography (MRA), and angiography.
Why do we give nitrates?
Nitrate: Vasodiolater – we want to administer this to increase blood flow back to the heart (widen the pathway so we can get more blood to the hear) – we need to monitor for hypotension – evaluate BP and pulse rate administration – we can administer this through spray, SL, or via IV (move to IV if we are not getting the response we need for SL) – We give every 5 min for up to 3 doses (follow MD order)
