Cardiovascular Conditions pt. 3: Conditions & Management

Question 1

coronary atherosclerotic disease

Answer 1

plaques deposited on arterial walls

Question 2

angina

Answer 2

transient arterial spasms vs exertional

stable vs unstable

Question 3

MI

Answer 3

evolution of ischemia to infarction

Question 4

agonal rhythm

Answer 4

irregular
<20 bpm
near death

Question 5

multifocal VT

Answer 5

irregular rhythm and rate >150 bpm

Question 6

AV blocks

Answer 6

rhythm disturbance where electrical conduction from atria to ventricles is partially or completely blocked

Question 7

valvular heart disease

Answer 7

affects one or more of the 4 valves in the heart

- stenosis, regurgitation, prolapse

Question 8

myocardial heart disease

Answer 8

affect heart muscle tissue

referred to as cardiomyopathy

Question 9

pericardial heart disease

Answer 9

affects the pericardium

Question 10

cardiac management

Answer 10

revascularization and reperfusion of myocardium
ablation procedures
cardioversion
life vest
valve replacement
AVR
cardiac transplant

Question 11

what is thrombolytic therapy

Answer 11

acute management strategy for pts experiencing MI

Question 12

percutaneous revascularization

Answer 12

balloon tipped catheter threaded into occluded artery

balloon is inflated to make artery patent once again

Question 13

coronary artery bypass graft

Answer 13

CABG
vascular graft used to revascularize the myocardium when a coronary artery is occluded
median sternotomy is standard, sternal precautions!!

Question 14

sternal precautions last how long

Answer 14

typically 8 wks but up to surgeon

Question 15

risk factors for dehiscence

Answer 15

obesity 
COPD
diabetes
smoking
PVD
repeat thoracotomy 
female
pendulous breasts

Question 16

what AD can a sternal precaution pt use

Answer 16

walker but do not bear weight thru arms

Question 17

ablation procedures

Answer 17

remove or isolate ectopic foci in order to reduce rhythm disturbance

Question 18

with an ablation procedure what is required

Answer 18

the leg used for procedure must remain straight and immobile for 3-4 hrs

Question 19

cardioversion

Answer 19

restore normal heart rhythm in tachycardia arrhythmic conditions

Question 20

cardiac pacemaker implantation

Answer 20

provides pacer function to ensure regular rhythm

Question 21

automatic implantable cardiac defibrillator

Answer 21

manages ventricular arrhythmia by defibrillating myocardium as needed to restore normal rhythm

Question 22

PT considerations for cardioversion

Answer 22

closely monitor activity response with HR and BP - also know if device has rate modulation

Question 23

cardiac pacemaker implantation, what is good to know about this device and why

Answer 23

not all devices have rate modulation, pt’s HR may not change with activity during PT

Question 24

what is an example of an external defibrillator

Answer 24

life vest

high risk for cardiac arrest

Question 25

ventricular assist device

Answer 25

used to unload right or left ventricle and support pulmonary/systemic circulation

Question 26

rehab for ventricular AD

Answer 26

referral for initiating exercise for phase I-II cardiac rehab

Question 27

precautions for ventricular AD

Answer 27

kno emergency procedures in case of battery failure, maintain patency of drive lines w external pump, monitor hemodynamics

Question 28

complications for ventricular AD

Answer 28

thrombus formation, CVA, hemorrhage, line infections renal or hepatic insufficiency

Question 29

stable angina

Answer 29

- predictable, episodic - triggered by physical and/or psychological stressors - occurs with constant fq. over time - relieved by rest of nitroglycerin

Question 30

unstable angina

Answer 30

- new onset - occurring at rest of minimal exertion - progressive in nature with increased fq. of episode - refractory to previously effective medicine - more likely lead to MI

Question 31

what do you do if a pt has chest pain

Answer 31

- stop activity let them rest - monitor vitals - angina rating scale - determine what the pain is - take nitroglycerin if prescribed - educate pt's on the difference btw the chest pains