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Med Surg > Chapter 26 Cardiovascular > Flashcards

Chapter 26 Cardiovascular Flashcards

1
Q

Preload (2)

A
  • degree of stretch of cardiac muscle fibers at end of diastole
  • force needed for the heart to actually beat
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2
Q

After load (2)

A
  • resistance to ejection of blood from ventricle

- how much force needed to force the blood out of the heart

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3
Q

Client Preparation before Undergoing Cardiac Catherization (5)

A
  • obtain written consent
  • ensure preprocedure labs are drawn as prescribed (BUN and creatinine- these assess kidney function for excretion contrast); client will receive heparin during procedure (aPTT, PT, or INR)
  • contraindication: SHELL FISH ALLERGY
  • Metformin must be stopped 48 hours before and after procedure
  • explain the pt will be awake and may experience flutter feeling
  • *NPO after midnight
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4
Q

Postprocedure Nursing Care after Undergoing Cardiac Catherization (6)

A
  • maintain “flat” bed rest for 4-6 hours (risk for hematoma to the site)
  • maintain pressure dressing at insertion site
  • monitor BP (drop in BP indicates bleeding), HR (tachycardia indicates bleeding), color and temp of extremeties, assess for signs of bleeding at site
  • if bleeding occurs, apply manual pressure
  • increase fluid intake (contrast dye secreted through the kidneys)
  • monitor I & O’s
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5
Q

Chronic Stable Angina Pectoris

A
  • temp imbalance between the coronary aretery’s ability to supply oxygen and the cardiac muscles’s demand for oxygen
  • ischemia (lack of oxygen to the tissue) limited in duration and does not cause permanent damage to the myocardial tissue
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6
Q

Three Types of Angina

A
  1. Stable
  2. Unstable
  3. Variant
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7
Q

Stable Angina (2)

A
  • relieved by rest or nitro

- can be caused by stress or exercise

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8
Q

Unstable Angina

A

-preinfaractiojn (pt sitting watching tv and all of a sudden has chest pains)

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9
Q

Variant Angina

A

-directly related to a coronary artery spasm

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10
Q

Characteristics of Angina (4)

A
  • precipitated by exertion or stress
  • relieved by rest or nitroglycerin
  • symptoms last less than 15 minutes
  • NOT associated with nausea, epigastric distress, dyspnea, anxiety, diaphoresis (these are more MI symptoms)
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11
Q

Nursing Care of Patients with Chest Pain (4)

A
  • EKG monitoring (usually within 10 minutes of complaint of chest pain)
  • vital signs (oxygen saturation should be about 95%)
  • may need to call RRT (rapid response team)
  • medications (aspirin-may have pt chew to have a quicker response to the body and nitrates)
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12
Q

Nitroglycerin (4)

A
  • 1st thing we assess are ABC’s (airway, breathing and circulation)
  • medication of choice in treating angina pain
  • vasodilator: causes hypotension and splitting headache
  • decreased preload and afterload causes a decrease in O2 demand in the heart
  • tablets are sensitive to light
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13
Q

Symptoms of Women with Impending MI (4)

A
  • jaw pain
  • neck pain
  • back pain
  • increased anxiety
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14
Q

Angio Plasty

A
  • more in-depth cardiac catherization
  • inflating a balloon to dilate the arterial lumen (stent)
  • helping to perfuse the heart
  • complications: plaque against walls of blood vessel can cause both stoke and pulmonary embolism potential; plaque can become dislodged
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15
Q

Coronary Stent

-nursing consideration for pre and post-procedure

A
  • Pre-procedure: NPO after midnight, allergy assessment to iodine
  • Post-Procedure: monitor vital signs, distal pulses, bed rest, heparin
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16
Q

Coronary Artery Bypass Graft (CABG) (5)

A
  • there is a major type of blockage, a stint is not going to work, and basically the obstructive area needs to be bypassed
  • restores myocardial tissue perfusion
  • most common form of cardiac surgery
  • graft taken from leg (saphenous vein)
  • patient will be in critical care
17
Q

CABG Post-Op Considerations (8)

A
  • infection
  • mechanical ventilation
  • vital signs
  • chest tubes
  • fluid and electrolyte embalance (want potassium level around 3.5 mEq/L)
  • hypotension (can collapse the vein graft)
  • hypertension (can explode the vein graft)
  • incentive spirometry- help bring sections up and expand the lungs
18
Q

Heart Failure (2)

A
  • heart is unable to pump sufficient blood to the meet the needs of the tissues for oxygen and nutrients
  • characterized by fluid overload or inadequate tissue perfusion
  • myocardial disease in which there is a problem with the contraction of the heart (systolic failure) or filling of the heart (diastolic failure)
19
Q

Right-sided heart failure

-clinical manifestations

A

RV cannot eject enough blood and the blood backs up in the venous system

20
Q

Left-sided heart failure

-clinical manifestations

A

LV cannot pump blood effectively to the systemic circulation; pulmonary venous pressures increase and result in pulmonary congestion

21
Q

Symptoms of Right Sided Heart Failure (7)

A

“Every Dog Always Watches Digging In Africa”

  • Enlarged liver & spleen
  • Distended jugular veins
  • Anorexia & complaints of GI distress
  • Weight gain
  • Dependent edema
  • Increase peripheral venous pressure
  • Ascites (accumulation of fluid in the peritoneal cavity)
22
Q

Symptoms of Left Sided Heart Failure (7)

A

“Eating Rice That Contains Carrots Offends Pigs”

  • External dyspnea (due to sputum)
  • Restlessness
  • Tachycardia & tachypnea
  • Cyanosis
  • Confusion
  • Orthopnea
  • Pulmonary congestion
23
Q

Laboratory and Diagnostic Testing for Heart Failure (4)

A
  • Human B-type natriuretic peptides:levels indicate the degree of severity
  • Utrasound: function of the heart, ejection fraction measurement
  • Chest X-Ray
  • Electrocardiogram
24
Q

Nursing Interventions for Patients with Heart Failure (5)

A
  • daily weights
  • SOB (oxygen and maximize ventilation)
  • vital signs
  • bed rest (energy conservation)
  • dietary restrictions (avoid sodium)
25
Q

Medications used for Heart Failure (5)

A
  • ACE Inhibitors
  • Beta Blockers
  • Calcium Channel Blockers
  • Diuretics
  • Inotropic Agents
26
Q

Activity Intolerance for Patients with Heart Failure (7)

A
  • bed rest for acute exacerbations
  • encourage regular physical activity (30-45 mins/day)
  • pacing of activites
  • wait 2 hours after eating for physical activity
  • avoid activities in extreme hot, cold, or humid weather
  • modify activities to conserve energy
  • positioning (elevate HOB to facilitate breathing and rest; support of arms)

Med Surg (5 decks)

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