Cardiac Interventions & Hemodynamic Monitoring Flashcards
Assessment of aneurysm includes ______ extending to neck, shoulders, lower back, and abdomen. It also includes syncope, dyspnea, tachycardia, and cyanosis. Most patients are a______. For every cm above ______cm the risk of rupture increases exponentially.
PAIN
ASYMPTOMATIC
5.5CM
Treatment goal is to prevent enlargement or rupture. Need tight ______ control. Surgical resection or excision is done to replace with artificial graft to prevent further bulging/dissection.
BLOOD PRESSURE
Collaborative post-op interventions for AAA include VS, pulses distal to graft. Limit HOB elevation to ______ degrees so it doesn’t kink graft, strict I&O, assess incisional site for bleeding, SS infection, instruct to not ______ objects heavier than 15-20lb for 6-12 weeks. avoid ______ activities.
45
LIFT
STRENUOUS
Post-op interventions for a thoracic aneurysm are similar to abdominal except with the addition of monitoring ______ tube, r______ status, and encouraging to cough and DB while s_____ excision
CHEST
RESPIRATORY
SPLINTING
Post-op complications that can arise from aneurysm resection include leaks, dissection, bleeding, graft dislocation, emboli which creates the nursing Dx of Risk for i______ t______ p______ and Risk for I______.
INEFFECTIVE TISSUE PERFUSION
INFECTION
When noninvasive methods don’t work well to control life threatening arrhythmias other options may be an i______ c______ d______, a ______ or r______ c______ a______.
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD)
PACEMAKER
RADIOFREQUENCY CATHETER ABLATION
An ICD senses life threatening ______ arrhythmias. 0.25 seconds after sensing arrhythmia it sends a 25 joule shock to cardiac muscle. It can repeat if needed.
VENTRICULAR
Catheter ablation therapy uses r______ energy to burn or ablate areas of the conduction system. This is performed in cath lab and used for t_______ arrhythmias.
RADIOFREQUENCY
TACHYCARDIC
When pt is treated they are taken off any antiarrhythmic meds thus creating an arrhythmia in order to treat. Pt teaching required (produces anxiety)
_______ describes a group of heart muscle diseases that lead to a functional inability of the cardiac muscle to pump properly. Eventually transplant is an option. Newer treatment is the use of the LVAD (______) as a bridge or destination device.
CARDIOMYOPATHY
LEFT VENTRICULAR ASSIST DEVICE
An LVAD can be worn ______ term for those ______ or ______ for transplant. Survival rate is twice as high as those on medication alone.
LONG
WAITING
INELIGIBLE
An Intra Aortic Balloon Pump (IABP) is deflated during ______ and inflated during ______. During systole this decreases afterload, decreases cardiac work, decreases myocardial O2 consumption, increases CO. During diastole this augments diastolic pressure which increases coronary perfusion.
SYSTOLE
DIASTOLE
_______ is the amount of energy from pacemaker to cause depolarization.
CAPTURE
_______ is the minimal electrical impulse required to produce consistent cardiac depolarization.
THRESHOLD
______ is the minimum cardiac electricity needed to trigger the pacemaker.
SENSITIVITY
The pacemaker ______ is predetermined and is set on the device.
RATE
______ pacemakers are asynchronous, at a fixed rate, and painful.
EXTERNAL (TEMPORARY)
______ temporary pacemakers are set in asynchronous or demand modes, single chamber pacing, connected to wires that come out of the chest wall which are connected to control box.
INTERNAL
Internal ______ pacemakers can be asynchronous (fixed rate), demand (fires when out of a predetermined zone), dual chamber (one lead controls RA and other RV), or sensor driven (rate responsive - where it can sense the patient activity and adjust rate).
PERMANENT
Central Venous Pressure (CVP) gives information about ______.
PRELOAD
A Swan Ganz Catheter provides information from the left ventricle that gives ______ pressure.
PULMONARY
Nursing management for hemodynamic monitoring includes level, zero and calibrate system every ______. Take readings correctly (aligned and no air bubbles). Draw blood and flush line correctly. Change sterile dressings and IV solution and tubings per policy.
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