cardio Flashcards
conduction system of the heart
SA node is primary pacemaker (60-100 BPM) (right atrium)
AV node is secondary (40-60) (right atrium)
Purkinje fibers are tertiary (20-40)
Conduction system of the heart events
Diastole- heart muscles relax and fill with blood
Artial systole- the last phase of diastole where the ventricular filling is completed
ventricular systole- period of contraction of the ventricles that occurs through the fist and second heart sounds
A Fib most common dysrythmia
Paroxysmal or persistent
most common dysrythmia
prevalence increases with age
usually occurs in patients with underlying heart disease
can also occur with other diseases
increases risk of stroke
a fib treatment
drugs to control ventricular rate and or convert to sinus
amiodarone
electrical cardioversion
anticoag therapy
radiofrequency ablation
maze procedure with cyroablation
a fib s&s
irregular heartbeat
heart palpitations (raid, fluttering, pounding)
lightheadedness
extreme fatigue
SOB
chest pain
EKG will have small hills leading to QRS wave
a fib INR
2-3
Angina
characterized by episodes or paroxysmal pain or pressure in the anterior chest caused by insufficient coronary blood flow
physical excertion or emotional stress increases myocardial oxygen demand and the coronary vessels are unable to supply sufficient blood flow to meet the oxygen demand
angina clinical manifestations
reversible ischemia
tightness, choking, heavy sensation
frequently retrosternal and may radiate to the neck, jaw, shoulder, back, or arms (usually left)
anxiety accompanies the pain
dyspnea, SOB, dizziness, NV
stable angina resolved with rest or nitroglycerin
unstable angina has increased frequency nd severity and is not relieved by nitro and requires attention
angina nursing implications
symptoms and activities that cause attacks
risk factors, lifestyle, health promotion activities
patient and family knowledge
adherence to the plan of care
treat angina
reduce anxiety
educate patients about self care
continuing care
advise patients to keep nitro on them at all times
maintain normal BP and glucose levels
angina nursing interventions
patient is to stop all activity and sit or rest in bed
assess while performing other necessary interventions
includes vital signs, observation for resp distress, pain assessment
ECG is assessed in hospital
administer meds as ordered or by protocol, usually NTG, reassess pain and administer NTG up to 3 doses
administer oxygen 2 L per minute by nasal cannula
MI treatment
MONA morphine oxygen nitrates aspirin
VOMIT vitals oxygen monitor IV access time to decide
MI lab findings
biomarkers: cardiac enzyme, troponin, creatine kinase, myoglomin
ST elevation continuously
MI S&S
may differ in men and women
men: chest discomfort or pain, upper body pain, stomach pain, sweating, SB, anxiety, lightheadness, NV
women: abdominal discomfort, neck jae dhoulder and upper back discomfort, stomach pain, NV, SOB, sweating and fatigue
MI emergency procedutes
percutaneous transluminal coronary angioplasty
coronary artery stent
coronary bypass graft CABG
cardiac surgery
CABG nursing care
assessment of patient
reduce fear and anxiety
monitor and manage potential complications
provide patient education
maintain cardiac output
promote adequate gas exchange
maintain fluid and electrolyte balance
minimize sensory perception imbalance
maintain body temperature
watch for signs of bleeding
Q4 Hgb Hct levels
promote health and community based care
administer blood if ordered
hypertrophic heart failure
increase in muscle mass and cardiac wall thickness
initally effective
over time leads to poor contractility, increased oxygen needs, poor coronary artery ciruclation, risk for ventricular dysrythmias
dilated heart failure
enlargement of chambers of the heart when pressure in the left ventricle is elecated
initially effective
eventually inadequate and CO decreases
Cardiac tamponade nursing actions
restriction of heart function due to fluid, decrease CO and venous return
provide O2
bed rest with legs elevted
2 large bore IVs
give medications as ordered
have fluids available for resuscitation
ECG monitoring
ENsure chest x ray and echo are done
have pericardioentesis tray ready
endocarditis treatment
a course of antibiotics through IV
pencillin or ampicillin with gentamicin
