Cardio Flashcards
Infective Endocarditis: Patho
Vegetations growing on valves break off and embolism to various organs -> life threatening complications
Infective Endocarditis: Life threatening complications
Stroke, Spinal cord ischemia, Ischemia to extremities, Intestinal infarction, Splenic infarction
Ischemia to extremities meaning:
Pain, pallor, and cold foot or arm
Which is reported immediately?
Pain and Pallor in one foot
Chronic venous insufficiency: Patho
Valves in veins of lower extremities consistently fail to keep venous blood moving
What does CVI cause?
Chronic increased venous pressure; pushing fluid out of vascular space to surrounding tissues, tissue enzymes then break RBC down
Clinical finding for Chronic venous insufficiency
Brownish, hardened skin on lower extremities
Chronic venous insufficiency clinical manifestations
Brownish skin discoloration: chronic edema and inflammation; Tissue then harden appearing leathery, this skin prone to breakdown and ulcerations inside of the ankle
Emphasis of Discharge teaching for DVT
Minimize risk factors and promote blood flow and venous return and prevent reoccurrence
Teaching points for DVT education
Drink plenty of fluids: avoid caffeine and alcohol
Elevate legs when sitting and dorsiflex
Begin exercise program
Change position frequently
Stop Smoking
Avoid wearing restrictive clothes
Irregular waveforms of varying shapes/amplitudes
VFIB
EO: Potentially lethal dysrhythmia, irregular waveforms of varying shapes/amplitudes
VF
Dysrhythmia: Ventricle quivering with no effective contraction or cardiac output
VF
What does VF result in?
Unresponsive pulse less, apneic state
Treatment for VF
Rapid:
CPR
Defib
Drug Therapy
What drug therapies are used for VF?
Epinephrine
Vasopressin
Amiodarone
Discharge instructions for CABG
Hygiene
Medications
Activity Level
Sexual activity
Symptoms to report
CABG: Hygiene teaching
Shower instead of bath
No soaking or applying lotions to incisions
CABG: Activity level
No lifting objects >5lb
No driving for 4-6 weeks
CABG: Sexual activity
Resume able to walk 1 block or climb 2 flights of stairs w/o symptoms
CABG: Symptoms to report
Chest pain or SOB during rest
Signs of infection
Modify cardiac risk factors for CABG
No smoking, lose weight, maintain healthy diet, and increasing activity levels through exercises
Heart failure: Full Patho
Cardiac output reduced: unable to pump blood right
Leads to: Reduce perfusion to vital organs
Reduced perfusion leads to: Decreased renal blood flow
Decreased renal leads to: Renin-angiotensin system to compensate by increasing blood volume via increased water resorption
Final result of compensation: Fluid volume excess and dilutional hyponatremia
Heart Failure: Dilutional hyponatremia
Treated with:
Fluid restrict
Loop diuretics
ACE inhibitors
Heart Failure: Furosemide
Resolve hyponatremia by:
Promote free water excretion
Allow hemoconcentration and increased sodium
Pt with heart failure 8-hour urine output of 200 mL. What action should be first?
Auscultation of pts breath sounds
What does Urine output of <30 mL/hr indicate?
Low vascular volume: Dehydration or blood loss
Decreased Renal Perfusion: Low cardiac output
Intrinsic kidney injury
Urinary obstruction: Prostate or foley
Why would auscultation be necessary for client’s with heart failure, low urine output?
Decreased cardiac function and buildup of fluid:
Leads to need to assess lung sounds for crackles
S/S Failing pacemaker
Failure to capture with:
Bradycardia
Hypotension
Failure to capture in pacemaker
Pacer spikes without associated QRS
PRIORITY for Failed Pacemaker
Initiate transcutaneous pacing
Acute blood loss: Interventions
Improve perfusion to brain and vital organs
Acute blood loss: Priority
Lowering the head of the bed prior to other interventions
PAD: Description
Chronic atherosclerotic disease
Caused by buildup of plaque in arteries
What does PAD commonly affect?
Lower extremities: Leading to tissue necrosis
PAD: Management
Lower extremities below heart when sitting/lying (improves arterial blood flow)
Engage moderate exercise
Daily skin care
Stop smoking
Avoid tight clothes
Take meds as prescribed
Focuses of management
Improving blood flow and circulation to extremities via lifestyle changes and medications
Halter Monitor: Pt education
Diary of activities and symptoms
Do not bathe or shower
Engage in normal activities
Clinical manifestations of DVT:
Calf pain
Lower leg warmth, and redness
Unilateral leg edema
DVT occurs:
Commonly from decreased activity or mobility
DVT S/S
Unilateral edema
Calf Pain or TTP
Warmth
Erythema
Low-grade fever
Clients with … are at risk for life-threatening dysrhythmias (Heart block, V-tach, V-fib)
Myocardial Infarction
Myocardial Ischemia damages what? Causing what?
Cardiac muscle cells causing electrical irritability (PVC)
What increase the risk for dysrhythmias?
Electrolyte imbalances/ Hypokalemia
How does hypokalemia relate to Dysrhythmias?
Hyperpolarizes cardiac conduction pathways increasing risk for dysrhythmias
Medications administered for pts w/ NSR w/ PVC and lab values of Potassium 3.3 mEq/L
Potassium chloride IVPB once
A-fib discharge pt stable w/ meds (Digoxin). What education is needed before discharging?
Visit doctor to check drug levels
Report to HCP if nausea and vomiting
Tell HCP if HR below 60 BPM
NO need for increasing potassium intake
Troponin:
High specific cardiac marker for detection of MI
Difference from Troponin and CK MB
Troponin:Greater sensitivity and specificity for myocardial injury
Troponin serum levels increase…
4-6 hours after onset of MI
Troponin value indicative of cardiac muscle damage
0.7 ng/mL
Immediate focus
Highest priority for intervention with patients having chest pain
Elevated Troponin value: indicative of myocardial injury
Pt education for Mitral valve prolapse
Stay hydrated
Avoid caffeine and EOTH
Exercise regularly
Reduce stress
Take beta blockers (for palp and chest Px)
S/S of Mitral Valve Prolapse
Experiencing occasional palpitations, lightheadedness, and dizziness
