Cardio Exam 1 Study Guide Flashcards
List diet considerations/examples for the pt with HTN
DASH (Dietary Approaches to Stopping HTN)
Low sodium, high potassium, high calcium diet proven to lower BP and cholesterol.
Limit alcohol intake.
apricots, bananas, tomatoes, potatoes, low fat dairy for calcium.
Define stable angina and unstable angina. What causes angina? How might the pt present? Goals of therapy/treatment? Pt education
Stable angina - exertional angina. occurs with exercise or emotional stress and is relived by rest of nitroglycerin (nitrostat)
Unstable angina - pre-infarction angina. occurs with exercise or emotional stress, but it increased in occurrence, severity, and duration over time.
Will present with anxiety, feeling of impending doom. Chest pain (substernal or precordial). Nausea and dizziness.
Nursing considerations for angio/cardiac catheterization (pre, infra, and post procedure)
Pre - client must understand the procedure prior to signing the informed consent. Ensure client remains NPO 8 hours prior to procedure. Determine the the client and family understand the procedure. Identify and report iodine/shellfish allergy (contrast media)
Infra – Remind patient that they will be awake and sedated during procedure. A local anesthetic is used. The client will feel warmth and flushed when the dye is inserted.
Post – Check vitals every 15 minutes’ x 4, every 30 x 2, every hour x 4, then every 4 hours. Monitor groin at the same intervals for bleeding hematoma formation, CMST. Maintain bed rest in supine positon with extremity strait for the prescribed time. Administer antiplatelet or thrombolytic agents to prevent clot formation and restenosis. Also anxiolytics (Ativan), and analgesics as needed for pain. Monitor urine output.
List causes of an MI
The main cause of an MI is when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle and heart muscle dies. The blood clot that causes the heart attack usually forms at the site of rupture of an atherosclerotic, cholesterol plaque on the inner wall of coronary artery.
S/S of an MI and reasons for symptoms
risks: male gender postmenopausal women tobacco use hyperlipidemia diabetes hyperthyroidism stress
What are cardiac enzymes and why are they used?
These tests can measure blood levels of the enzyme creatine phosphokinase (CPK), also called creatine kinase (CK), and a more specific form of this enzyme called CK-MB.
Additionally, cardiac enzyme tests can be used to check blood levels of the proteins myoglobin and troponin.
What is creatine kinase? Why is it important?
An elevated level of creatine kinase is seen in heart attacks, when the heart muscle is damaged, or in conditions that produce damage to the skeletal muscles or brain.
S/S (early and late) of HF (differentiate between L and R sided). How do we monitor the pt with Heart Failure?
Left sided failure: dyspnea, orthopnea, SOB, fatigue, displaced apical pulse, S3 heart sound (gallop), pulmonary congestion, frothy sputum, altered mental status, organ failure.
Right sided failure: jugular vein distention, ascending dependent edema, abdominal distention, fatigue, nausea and anorexia, polyuria at rest, liver enlargement, weight gain.
Monitor daily weight and I&O, SOB, vitals.
Correct use of the defibrillator (when and how to use), proper pad placement.
An automated external defibrillator is used on a person who is having sudden cardiac arrest and may save the person’s life. Two pads are placed on the body. One on the right of the sternum below the clabicle (2nd and 3rd intercostal space. The other paddle left (4th or 5th intercostal space mid axillary line.
Describe each part of the PQRST of the ECG and be able to label each letter on a rhythm strip
The P wave, QRS complex and the T wave represent electrical activity in the heart on an electrocardiogram. The ECG Learning Center explains that the P wave represents the depolarization of the right and left atria. The QRS complex follows the P wave and depicts the activation of the right and left ventricles. Practical Clinical Skills reveals that the T wave indicates repolarization of the ventricles.
Describe how to apply and perform an ECG. Pt education while doing an EKG
atient must lie still while nurse places 12 leads on the body.
What is cardiac tamponade? What are the findings?
Compression of the heart caused by fluid collecting in the sac surrounding the heart. Findings include pain in the chest, low blood pressure, fainting, lightheadedness, fast heart rate, SOB, faint heart sounds, swelling in extremities, wheezing.
Who is at risk for HTN?
Those who have a BMI of more than 30, have diabetes, caffeine and alcohol drinkers, smokers, people who are severely stressed out, people who don’t work out at least 3 times a week.
List the classifications for HTN (pre, stage 1, stage 2)! Must know values.
Pre – systolic BP 120 to 139. Diastolic 80 to 89.
Stage 1 – Systolic 140 to 159. Diastolic 90 to 99.
Stage 2 – Systolic greater than or equal to 160. Diastolic greater than or equal to 100
Describe a low cholesterol diet, give examples.
Eliminate fatty parts of meat, dairy, processed meat, deep fried foods, and egg yolks can drop cholesterol.
