cardiovascular Flashcards
mediastinal CT
complications?
obstruction can cause fluid buildup in the pericardium causing a cardiac tamponade
CABG: post op
washing incision?
normal findings?
do not?
report?
where does the vein come from?
sign of hemorrhage?
MICABG- what is the difference?
- What to do:
- Wash incision/shower daily with soap/water and pat dry
- wear ted hose
- elevate legs when sitting
- Normal:
- Itching
- numbness and tingling around the incisions (for several weeks)
- Do NOT:
- Take tub baths= risk of infection
- Report:
- redness
- swelling
- drainage
- incision has opened
- graft harvested from great saphenous vein so brusing is expected
- hemorrhage= 100mL/hr or more of drainage into CT (PRIORITY)
- MICABG: more painful most op but shorter recovery time
when can a client resume sex w an MI?
If a client can walk 1 block or climb 2 flights of stairs w/o symptoms they can resume sex
It is safe to resume sex 7-10 days after an uncomplicated MI
troponin levels
when do they inc?
peak?
return to BL?
increase 4-6 hrs after onset
peak 10-24hrs
return to BL in 10-14 days
what is a holter monitor?
how long do you keep it on?
dos and do nots?
- Records ECG rhythm for 24-48 hrs
- Keep a diary of activities and symptoms, engage in normal activities
- do not bathe or shower during test period
Thrombotic thrombocytopenic purpura (TTP)
priority assessment?
safety measures?
any change in LOC
use electric razors, no NSAIDs (use acetaminophen instead)
Coronary arteriogram (angiogram)
eating/drinking?
post op positioning?
discharged?
XR or visualization
NPO 6-12 hours prior
lie flat for several hrs post op
discharged the same day
abdominal aortic aneurysm (AAA)
preop: what do you want to pay attention to?
signs of embolization or graft occlusion|?
what can prolonged hypotension lead to?
what is an Endovascular abdominal aortic aneurysm and what should you monitor for?
normal post op sx?
signs of graft leakage?
- Preop:
- pay attention to peripheral pulses, renal, and neuro status
- Mark dorsalis pedis and posterior tibial pulses
- embolization or graft occlusion:
- dec or absent pulse w cool, pale, mottled or painful extremity
- prolonged hypotension can lead to graft thrombosis
- Endovascular abdominal aortic aneurysm:
- do not require an abdominal incision
- monitor puncture sites for bleeding
- Post op:
- abd tenderness, nonrigid soft abd
- NG tube green bile drainage
- signs of graft leakage
- hypotension, tachycardia, inc abdominal girth, groin, back or pelvic pain, ecchymosis of scrotum/penis/groin/perineum, weak/absent peripheral pulses (pulses can be absent for 4-12 hrs after), dec H&H
rheumatic fever
what is it and what is it caused by?
symptoms?
tx?
- Inflammatory disease of the heart
- occurs 2-3 weeks after streptococcal pharyngitis (strep throat)
- sx: arthritis, carditis, SQ nodules, fever, arthralgias, inc ESR/c-reactive protein, prolonged PR interval
- Tx: penicillin
chronic venous insufficiency
Sx?
tx?
- sx:
- venous stasis
- leg ulcers/dermatitis
- edema
- warm thick skin
- brown pigmentation
- varicose veins
- tx
- elevate legs
- ambulate
- DVT prophylaxis (anti embolism stockings, SCD, SQ heparin)
R vs L sided HF causes and sx?
teaching?
interventions?
- Right (rest of body):
- causes: pulm HTN, MI
- sx: JVD, pitting edema, hepatomegaly, splenomegaly, ascites, inc abdominal girth, dilutional hyponatremia, inc CVP
- Left (lungs):
- causes: systemic HTN, MI
- sx: fatigue, SOB/dyspnea, orthopnea, pulm edema (fine crackles), cardiomegaly (displaced PMI, S3), dec CO= hypotension
- Teaching/interventions:
- daily weights
- dec Na (do not take NSAIDs, cause Na retention)
- fluid restriction
- take pulse for 1 minute if taking dig or BB
- walking w/ rest periods
- avoid extreme heat/cold
- meds: diuretics, ACEI, digoxin
- intra aortic balloon pump, AI defribrillator
cardiac tamponade?
sx?
tx procedure and position?
what can it be caused by?
- pericardial effusion buildup
- MEDICAL EMERGENCY
- sx: SOB, Narrowed PP (SBP-DBP), muffled/distant heart sounds, JVD, hypotension, pulsus parodoxus, chest pain, tachypnea, tachycardia
- tx: emergent pericardiocentesis
- supine
- can be caused by pericarditis
endocarditis/pericarditis/valvulitis?
acute pericarditis: what do we see in the EKG leads?
sx?
interventions?-meds? position?
- inflammation of heart layers
- STEMI in ALL leads (MI is only ONE lead)
- sx: inc WBC, fever, pain, dec =hypotension, pericardial friction rub
- interventions: IV abx, NSAIDs, aspirin, colchicine, sit up and lean foward to dec pain
carotid endarectomy?
monitor for?
- Removes plaque from carotid artery to improve cerebral perfusion
- Monitor for signs of altered neuro status ( risk for stroke)
- FAST
compartment syndrome
6Ps of CS
where should you place extremity?
volkamm contracture?
- Signs of CS (6 Ps):
- pain (unrelieved by repositioning or analgesics)
- pallor
- pulselessness
- paranesthesia
- poikilothermia (coolness)
- paralysis
- Place extremity at heart level
- volkamm contracture: Occurs as a result of CS associated with distal humerus fractures
- Restricting arterial blood flow
- wrist contractures and inability to extend fingers
- Medical emergency
