Cardiovascular Disorders Flashcards
Nursing Diagnoses Related to Cardivascular Disorders
Activity Intolerance Anxiety Decreased cardiac output Ineffective coronary tissue perfusion Fluid volume excess Impaired gas exchange Knowledge, deficient Pain
Decreased Cardiac Output is Related to…
Altered heart rate or rhythm
Altered stroke volume
Altered preload (decreased venous return)
Altered afterload (increased systemic venous return, increased BP)
Altered contractility
Risk Factors for Ineffective Tissue Perfusion
Hypertension, hyperlipidemia, coronary artery spasm, diabetes mellitus, cardiac surgery
Autonomic Nervous System
Controls the heart rate
Sympathetic/Parasympathetic Nervous System
Stimulates norepinephrine to increase heart rate
Baroreceptors
Pressure receptors located in the aortic arch, carotid sinuses
Have special nerve endings to detect changes in arterial blood pressure
Stretch Receptors
Found in the vena cava, respond to pressure changes
Antidiuretic Hormone (Vasopressin)
Influences blood pressure by regulating vascular volume
Keeps blood pressure high by retaining water
Renin
Vasoconstrictor to increase blood pressure
Aldosterone
Promotes water and sodium retention to increase blood pressure
S1
First heart sound, closing of the AV valves
S2
Second heart sound, closing of the semilunar valves
S3
Normal if under 30 years old, caused by decreased ventricular compliance
S4
Ventricular resistance to filling, caused by injury
Cardiac Catheterization and Angiography
Helps to visualize the heart’s chambers, valves, great vessels, and coronary arteries
Measures pressures inside of the heart
Uses contrast iodine
Nursing Interventions for Pre-Op Cardiac Catheterization and Angiography
Education, teach about “warm” feeling of iodine, screen for iodine allergy, keep NPO, get consent, observe recent vital signs, know the coags, review the lab work (CBC, BMP, potassium level), mark pedal pulses
Nursing Interventions for Post-Op Cardiac Catheterization and Angiography
Get vital signs every 15 minutes, assess circulation-sensation-movement of extremity accessed, assess pressure dressing, position on their back, encourage fluids
Complications of Cardiac Catheterization and Angiography
Diabetic patients taking Glucophage have increased risk of kidney damage with the contrast dye
Hemorrhage
Reocclusion
Echocardiography
Ultrasound directed at the heart
Helps to get information about the CO, EF, and valves
Cardiac Output = HR x SV (EF is the same)
Normal Cardiac Output for Left Ventricle
60-65%
Cardiac Output with Moderate Heart Failure
40-60%
Cardiac Output for Moderate to Severe Heart Failure
20-40%
Cardiac Output with Severe Heart Failure
< 20%
Electrophysiology
Stimulation of the heart with equipment to cause lethal rhythms in order to locate accessory pathways and cauterize them
Electron Beam Computer Tomography is used for accurate location of calcium in the heart
Stress Tests
Monitoring cardiac function under stress (treadmill, exercise bike)
With or without echo or nuclear imaging (Thallium)
If unable to exercise –> give drugs to mimic exercise (Dipyridamole [Persantine], Adenosine [Adenocard])
Nursing Interventions for Stress Tests
Keep NPO, hold beta blockers (decrease heart rate), prepare patients for long tests
Electrocardiography
ECG/EKG
Typically 12 leads
Measures heart rhythms
Holter Monitor: wear for 48 hours, press button if you have chest pain or dizziness
P Wave
Depolarization of the atria
QRS Complex
Depolarization of the ventricles
T Wave
Repolarization of the ventricles
Cardiac Monitoring
Have patient notify if they experience chest pain, SOB, palpitations
Check surrounding skin, make sure there is a tight seal, change pads
Communicate with person watching telemetry monitor
Never remove the telemetry monitor just do the patient can shower
Red Blood Cell Values
Men: 4.5-6.2 million cells/microliter
Women: 4.0-5.5 million cells/microliter
Polycythemia: result of chronic hypoxemia, increased red blood cells
White Blood Cell Values
5-10 cells/mm3
Differential: neutrophils, bands, eosinophils, basophils, lymphocytes, monocytes
“Shift to the Left” = increased immature neutrophils
Platelet Values
150,000-400,000 cells/mm3
Hemoglobin/Hematocrit Values
Male: 14-18 g/dL and 42-52%
Female: 12-16 g/dL and 37-47%
Erythrocyte Sedimentation Rate
Inflammatory condition indicator
Sodium Values
135-145 mEq/L
Potassium Values
3.5-5.1 mEq/L