Cardiac Disorders Flashcards
Echocardiogram nursing implications
TEE:
- NPO 8 hours prior (little bit of water w meds)
- Sedation is given so needs ride home
Cardiac catheterization & angiography nursing implications
- Maintain pt on flat bedrest for 2-6 hrs to prevent stress on insertion
- Observe catheter site for bleed or hematoma
- Assess renal function, H&H, coagulation
Echocardiogram purpose
- Heart size
- Pump function
- Blood-volume status
- Valvular integrity & function
Cardiac catheterization purpose
- Cardiac filling pressures
- Cardiac output
- Valvular function
Mechanism: x-ray procedure where catheter enters vein/artery
Cardiac angiography purpose
Done w cardiac catheterization
- Inspect coronary artery for blockage and need for revascularization (CABG or PCI)
Difference between ischemia and infarction
Ischemia: lack of O2 d/t occlusion
Infarction: prolonged period of lack of O2 which causes cellular death (irreversible)
Stable angina
- Fixed plaque
- Predictable
- Exacerbated w exercise, alleviated w rest/meds
Unstable angina
- Occlusive thrombus (blockage)
- Medical emergency
- 1st phase of acute coronary syndrome
- Precursor to MI
Prinzmetal angina
- Not due to obstruction; abnormal spasms of arteries + atherosclerosis usually present
- Spasms occlude vessels
- Occur between 12am - 8 am
Stable angina management
- Nitroglycerin
- Other meds that reduce risk factors like DM, HTN, HD
Unstable angina management
- MOAN/MONA: morphine, oxygen, nitroglycerin, aspirin (blood thinner)
- Other meds: CCB, BB, anticoagulants
Prinzmetal angina management
- Statins (lipitor)
- ACE inhibitors
- BB
Nitroglycerin administration
- No more than 3 doses taken 5 minutes apart
- Call 911 if pain (angina) persists after
- Preferred route: sublingual, IV (fast absorption)
Nitroglycerin MOA
Vasodilates arteries and veins
- Converted into NO (vasodilator)
Prevents and treats angina in CAD
Cardiac catheterization risks
Dysrhythmia, Premature Ventricular Contractions (extra systolic beats), bleeding, infection, perforation
CAD pt teaching
- When to call 911
- Lifestyle management: cardiac rehab
- Medication regimen
- *Bleeding precautions
CAD lifestyle management / prevention
- *Cardiac rehab
- Diet
- Exercise
- Smoking cessation
- Alc cessation
- Depression/anxiety assessment
HF major risk factors (common)
- CAD
- HTN
- *Diabetes
- *Metabolic syndrome
- *Smoking
- High sodium intake
HF major risk factors (other)
- Valvular dysfunction
- *Cardiomyopathies
- Infections & inflamm HD (pericarditis/endocarditis)
- *Dysrhythmias
- *Cardiotoxic substances (alc, illicit drugs, chemo)
What do HF diagnostic testing tell us
- BNP: released when muscle overstretched d/t HF
- Echocardiogram: show dilated L heart muscle w reduced ejection fraction
HF diagnostic tests
- Chest x-ray
- *Echocardiogram
- ECG
- Multigated acquisition scan
Lab tests
- *BNP
- CBC
- Serum electrolytes
- Urinanalysis
- Lipid profile
HF pt teaching
- *Daily weight (to check fluid retention)
- Cardiac rehab
- Med management
- Limit sodium intake
- Exercise as tolerated
HF nursing action
- Fluid and sodium restriction
- Administer meds: ACEi, diuretics, ARBs, BB, inotropic agents
- Maintain adequate O2: administer O2, elevate head of bead, provide a fan
CAD nursing action
- Administer O2 (+ meds)
- Obtain EKG
After PCI:
- Appropriate cardiac catheterization care
- Report & treat chest pain ASAP
- Administer coagulants
- Maintain fluids/bedrest
EKG identify
- Dysrhythmia
- New/old heart damage
- Electrolyte abnormalities
- Cardiac hypertrophy (HTN causes heart to work harder)
