Cardiovascular Conditions pt. 3: Conditions & Management Flashcards
coronary atherosclerotic disease
plaques deposited on arterial walls
angina
transient arterial spasms vs exertional
stable vs unstable
MI
evolution of ischemia to infarction
agonal rhythm
irregular
<20 bpm
near death
multifocal VT
irregular rhythm and rate >150 bpm
AV blocks
rhythm disturbance where electrical conduction from atria to ventricles is partially or completely blocked
valvular heart disease
affects one or more of the 4 valves in the heart
- stenosis, regurgitation, prolapse
myocardial heart disease
affect heart muscle tissue
referred to as cardiomyopathy
pericardial heart disease
affects the pericardium
cardiac management
revascularization and reperfusion of myocardium ablation procedures cardioversion life vest valve replacement AVR cardiac transplant
what is thrombolytic therapy
acute management strategy for pts experiencing MI
percutaneous revascularization
balloon tipped catheter threaded into occluded artery
balloon is inflated to make artery patent once again
coronary artery bypass graft
CABG
vascular graft used to revascularize the myocardium when a coronary artery is occluded
median sternotomy is standard, sternal precautions!!
sternal precautions last how long
typically 8 wks but up to surgeon
risk factors for dehiscence
obesity COPD diabetes smoking PVD repeat thoracotomy female pendulous breasts
what AD can a sternal precaution pt use
walker but do not bear weight thru arms
ablation procedures
remove or isolate ectopic foci in order to reduce rhythm disturbance
with an ablation procedure what is required
the leg used for procedure must remain straight and immobile for 3-4 hrs
cardioversion
restore normal heart rhythm in tachycardia arrhythmic conditions
cardiac pacemaker implantation
provides pacer function to ensure regular rhythm
automatic implantable cardiac defibrillator
manages ventricular arrhythmia by defibrillating myocardium as needed to restore normal rhythm
PT considerations for cardioversion
closely monitor activity response with HR and BP - also know if device has rate modulation
cardiac pacemaker implantation, what is good to know about this device and why
not all devices have rate modulation, pt’s HR may not change with activity during PT
what is an example of an external defibrillator
life vest
high risk for cardiac arrest
ventricular assist device
used to unload right or left ventricle and support pulmonary/systemic circulation
rehab for ventricular AD
referral for initiating exercise for phase I-II cardiac rehab
precautions for ventricular AD
kno emergency procedures in case of battery failure, maintain patency of drive lines w external pump, monitor hemodynamics
complications for ventricular AD
thrombus formation, CVA, hemorrhage, line infections renal or hepatic insufficiency
stable angina
- predictable, episodic
- triggered by physical and/or psychological stressors
- occurs with constant fq. over time
- relieved by rest of nitroglycerin
unstable angina
- 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
what do you do if a pt has chest pain
- 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
