Cardiac Management

Question 1

What is the immediate post op care for cardiac management?

Answer 1

• History
• Physical exam and assessment
• Labs and tests
• Warming
• Bleeding- surgical bleeding, treatment of medical bleeding and transfusion of red blood cells
• Hemodynamic management- hypotension and low cardiac output, inotropes and vasopressors
• Tamponade
• Mechanical assist devices- intra aortic balloon pump

Question 2

What are the pharmacological interventions of cardiac management?

Answer 2

• Diuretics used to relieve symptoms of dyspnoea and oedema
• Life expectancy
• Angiotensin converting enzyme inhibitors (ACE inhibitors)
• ACE inhibitors become first line therapy with beta blockers
• ACE inhibitors are contraindicated in patients with aortic stenosis and careful monitoring during titration is essential
• Aldosterone antagonists licensed for heart failure are an option for second line treatment
• aspirin is often part of heart failure patients poly pharmacy especially with a history of heart failure
• Anticoagulants are prescribed for heart failure patients with AF
• Vasodilators
• Digoxin is often used in patients with systolic dysfunction

Question 3

What are the nursing interventions for cardiac management?

Answer 3

• Education- nature of condition, medication and management plan
• lifestyle advice- smoking, alcohol consumption, dietary advice, weight management, immunisation, contraception
• Exercise where appropriate
• Device therapy- cardiac defrillator and biventricular pacemaker
• palliative care