Cardiac Tx

Question 1

oxygen administration, pharmacology therapy, cardioversion/defibrillation; primary focus is to relieve ischemia

Answer 1

non invasive interventions

Question 2

Pt is not coding- HAS A PULSE, is having some difficulty, can’t breathe, HR too fast, BP too low—need to slow HR- electric shock to slow it down- less energy than normal defibrillator

Answer 2

synchronized cardioversion

Question 3

rhythms that require cardioversion

Answer 3

Afib with rapid ventricular response (170 bpm) esp if symptomatic- resets cycle

Question 4

Usually elective procedure, can be emergency; versed is used

Answer 4

cardioversion consent; conscious sedation

Question 5

chance of going back to previous rhythm; need to watch: airway, clot formation, rhythm, achy pain

Answer 5

cardioversion post procedure

Question 6

NOT synchronized; vfib- emergency

Answer 6

defibrillation

Question 7

AICD- chronic long periods of Vtac, or rhythms that compromise
Pacemakers
Percutaneous Transluminal Coronary Interventions –angioplasty

Answer 7

Invasive procedures

Question 8

detects life-threatening changes in the cardiac rhythm

Single, dual or biventricular chambered

Answer 8

AICD: Automatic internal cardiac defibrillator

Question 9

pulse generator used to provide an electrical stimulus to the heart.- can do override pacing if tachy- to outpace it and slow it down

Answer 9

Pacemaker

Question 10

bradycardia, SA node problems, tachy or atrial arhthmias

Answer 10

pacemaker indications

Question 11

bleeding- quickclot dressing; generators need to be replaced q10 yrs

Answer 11

pacemaker post procedure complications

Question 12

catheter ablation, Percutaneous Transluminal Coronary Interventions,

Answer 12

temporary pacemakers

Question 13

Destroys, removes, or isolates using heat to pass through tissue

Answer 13

catheter ablation

Question 14

SVT, Afib, and/or aflutter

Answer 14

indications for catheter ablation

Question 15

started on anti-coagulants

Answer 15

post procedure catheter ablation

Question 16

restores blood flow; most common temp pacemaker

Answer 16

PTCI: Percutaneous Transluminal Coronary Interventions

Question 17

chronic stable angina, unstable angina, acute MI, stemi code

Answer 17

indications for PTCI

Question 18

up to 50% occulusion of coronary vessel- complication- plaque breaks off- stroke

Answer 18

balloon angioplasty

Question 19

body response- body wants to attack, most pts with no health insurance receive this

Answer 19

bare metal stenting

Question 20

coating on stent that prevents WBC and thrombin from sticking

Answer 20

drug eluting stenting

Question 21

Informed consent
 	Assess for allergies- dye is used- friendlier on kidneys but can still cause problems- will look at pts creatinine 
 	Offer educational videos (CVT)
 	Perform complete assessment 
 	Assess for CP
 	Baseline VS
 	Check allergies 
 	Peripheral pulses- very often- will mark an X on pulse before 
 	Administer medications
–	Valium (on call to Cath Lab)
–	Benadryl (on call to Cath Lab)
–	BP and cardiac medications

Answer 21

pre procedure nursing interventions for PTCI

Question 22

Monitor VS & cardiac rhythm as ordered
Observe appropriate activity orders ( flat or up to 30 degrees if closure device) according to access site
Assess cath site –hematoma, bleeding, bruising & pulses per protocol
Maintain any IV infusions such as Nitroglycerin, Angiomax and/or Integrillin
PO Plavix, Effient, or Brilinta
Continue IVF to flush contrast
Encourage PO fluids
Monitor for arrythmias

Answer 22

post procedure nursing care for PTCI

Question 23

Bleeding and hematomas
 	Anaphylactic contrast reactions
 	Pseudoaneurysms 
 	Embolization 
 	Vessel dissection
 	Restenosis 
 	Dysrhythmias

Answer 23

potential complications for PTCI

Question 24

normal 0-100, over 100 technically in HF (fluid overload),

Answer 24

BNP

Question 25

Prep for CABG- coronary artery bypass graft

Answer 25

EKG
 Chest X-RAY
 Labs
 T&C for blood
 Some will require PFT’s (pulmonary function tests)

Question 26

Vital Signs
Closely monitor I & O
Monitor CT output- bc they are kept “dry”
Monitor H&H and electrolytes
IVF, Blood and Albumin common- volume expanders
IV Dopamine, Dobutamine, Nitroglycerin, & Nipride
Monitor for arrhythmias

Answer 26

Care of post CABG

Question 27

cool to 92 degrees right before heart stops, arctic sun-dec myocardial o2 demand and saves brain- warm back up 24-36 hours afterwards

Answer 27

protocols for MI

Question 28

Hypothermia, Acute Pain, Decreased Cardiac Output, Ineffective Airway clearance, Disturbed Thought Processes, Risk for Infection

Answer 28

Common CABG Nursing Dx

Question 29

Hypovolemia 
 	Hypotension and/or hypertension
 	Hypothermia
 	Arrythmias 
 	Infection

Answer 29

CABG complications

Question 30

Medications
 	Teaching 
 	Cardiac rehab- 3 levels
 	Diet
 	Activity
 	Incisional care
 	Follow up appts

Answer 30

Discharge of the CABG pt

Question 31

– Usually begins while still in the hospital. Supervised walking in the halls.

Answer 31

Phase 1 cardiac rehab

Question 32

– Early outpatient phase of cardiac rehabilitation

– 2-6 weeks after released from hospital

Answer 32

Phase 2 cardiac rehab

Question 33

– Improve functional capacity and endurance
– Provide education of lifestyle changes
– Reduce fear and anxiety
– Assist in making optimal and social adjustments

Answer 33

Goals for Phase 2 cardiac rehab

Question 34

– 6 weeks

Answer 34

Phase 3 cardiac rehab

Question 35

– Provide an ongoing exercise program
– Offer support necessary to make lifestyle changes
– Achieve the desired goal, such as independent lifestyle or return to work
– Prevent progression of heart disease

Answer 35

Goals for Phase 3 cardiac rehab