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Undeleted > Chronic Cardiac (adults) > Flashcards

Chronic Cardiac (adults) Flashcards

0
Q

diastolic heart failure

A

ventricle cannot relax and fill

EF > 40%
Often > 60%

Appear (CO down but still pumping all blood out)

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1
Q

systolic heart failure

A

inability of the ventricle to contract

EF < 40%

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2
Q

causes of left-sided heart failure

A
  • htn
  • valve disease
  • coronary disease
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3
Q

left-sided heart failure interventions

A
  • body positioning
  • breathing
  • education (fluids, safety, compliance)
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4
Q

left-sided heart formerly known as…

A

CHF

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5
Q

cor pulmonale

A

right-sided heart failure caused by pulmonary disease

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6
Q

right-sided heart failure

A
  • coronary disease
  • left-sided failure
  • pulmonary hypertension (not necessarily extension of systemic)
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7
Q

left-sided heart failure nursing implications

A

ALWAYS SAFETY

  • afterload management
  • activity intolerance
  • airway clearance
  • fluid management
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8
Q

right-sided heart failure nursing implications

A

ALWAYS SAFETY

  • nutrition
  • infection
  • ventilation
  • comfort
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9
Q

evaluation of heart failure: blood work

A
  • organ function
  • BNP
  • anemias
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10
Q

evaluation of heart failure: diagnostics

A
  • EKG
  • echocardiogram
  • chest x-ray
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11
Q

Class I heart failure

A
  • patients with cardiac disease but without resulting limitations of physical activity
  • ordinary physical activity does not cause undue fatigue, palpitation, dyspnea, or a anginal pain
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13
Q

Class II heart failure

A
  • patients with cardiac disease resulting in sight limitation of physical activity
  • they are comfortable at rest
  • ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain
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14
Q

Class III heart failure

A
  • patients with cardiac disease resulting in marked limitation of physical activity
  • comfortable at rest
  • less than ordinary physical activity causes fatigue, palpitation, dyspnea, or anginal pain
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15
Q

Class IV heart failure

A
  • patients with cardiac disease resulting in inability to carry on any physical activity without discomfort
  • symptoms of cardiac insufficiency or of the anginal syndrome may be present, even at rest
  • if any physical activity is undertaken, discomfort is increased
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16
Q

medical therapies for heart failure (x3)

A
  • cardiac resynchronization therapy
  • ventricular assist device
  • myocardia reduction surgery
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17
Q

myocardial reduction surgery why & how

A
  • indicated for altering ventricular size
  • alcohol ablation
  • surgical resection of LV and/or septum
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18
Q

mitral stenosis is…

A
  • fibrotic or calcified valve
  • can’t open
  • incomplete filling
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19
Q

mitral stenosis common cause

A

rheumatic fever

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20
Q

mitral regurgitation

A
  • fibrotic or calcified valve
  • can’t close
  • backflow of blood
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21
Q

mitral regurgitation common cause

A

endocarditis

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22
Q

mitral prolapse is…

A
  • valve is enlarged
  • leaflets don’t come together well
  • more common in younger
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23
Q

aortic stenosis is…

A
  • “wear and tear” of aortic valve
  • fibrotic or calcified valve
  • obstructs outflow
  • huge afterload increase can cause obstructive shock
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24
Q

aortic regurgitation why/how/result

A
  • valvular leaflets can’t come together
  • fibrosis or calcification
  • LV dilation
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25
Q

aortic regurgitation common cause

A

endocarditis

congenital

26
Q

non-invasive valve repair (x2)

A
  • balloon valvuloplasty

- mitral clip

27
Q

transcatheter aortic valve replacement is…

A
  • for high risk clients
  • non-emergent
  • medically stable
28
Q

nursings implications for valve replacement

A
  • drug therapy (anticoag, afterload reducer)
  • plan activities
  • surgical site
  • client education
  • assess for: vital sign trends, mental status, chest pain, edema, syncope, cyanosis, dyspnea
29
Q

arteriosclerosis

A

hardening of the arterial wal

30
Q

atherosclerosis

A 
plaque formation
risks!!
- intimal layer damage
- hyperglycemia
- hyperlipidemia
- hypercholesterolemia
- hypertension
31
Q

hypertension: normal

A

SBP < 120

DBP < 80

32
Q

pre-hypertension

A

SBP 120-139
OR
DBP 80-89

33
Q

Stage 1 hypertension

A

SBP 140-159
OR
DBP 90-99

34
Q

Stage 2 hypertension

A

SBP > 160

DBP > 100

35
Q

arterial baroreceptors

A

carotid sinus receptors (internal) - stim by sinus nerve to nerve IX
aortic arch receptors - stim by vague nerve X

36
Q

RAAS problems (x2)

A

renal artery stenosis

renal disease

37
Q

causes of RAAS problems

A
  • hyperthyroidism
  • hyperaldosteronism
  • Cushing’s Syndrome
  • pheochromocytoma
38
Q

peripheral artery disease stages (I-IV)

A

I - asymptomatic
II - claudication
III - rest pain
IV - necrosis/gangrene

39
Q

claudication

A

too little blood flow after exercise

40
Q

PAD assessment findings

A
  • decreased capillary refill
  • decreased pulses (palpable, doppler)
  • cool/pale skin
41
Q

PAD non-surgical interventions

A
  • warmth (not hot!!)
  • minimize exposure
  • minimize vasoconstriction (pharm and non)
42
Q

PAD surgical interventions

A
  • angioplasty
  • stent
  • atherectomy
  • revascularization (vascular bypass)
43
Q

arterial aneurysm is…

A
  • can occur in any artery

- weakening of vascular wall (aorta, cerebral arteries)

44
Q

aneurysm presentations (x4)

A
  • pulsatile mass
  • aching, “gnawing” pain
  • “tearing” (possible radiation)
  • bruit
45
Q

aneurysm non-surgical management

A

monitor
bp management
stress management

46
Q

aneurysm surgical management

A

endograft
clipping
coiling

47
Q

aneurysm post-procedure care

A
  • bleeding/infection
  • neuromuscular function
  • graft/vessel occlusion (heart, brain, abdominal cavity, spinal cord, limb)
  • client education
48
Q

peripheral venous disease

A
  • venous thromboembolism (DVT, phlebitis, thrombophlebitis)
49
Q

PVD non-surgical interventions

A
  • pharmacologic (antiplatelet, anticoag, thrombolytic)
  • elevate extremity
  • SCDs
50
Q

PVD surgical interventions

A
  • thromboectomy

- inferior vena cava filter

51
Q

PVD nursing implications

A
  • prevention
  • improve venous return
  • DON’T RUB
  • hydration
  • remove causative factors
  • warm compresses
  • pharm management

BOOM BOOM!

52
Q

sinus bradycardia presentation

A
  • dizzy
  • nausea
  • diaphoretic

some people have normally low HR (athletes, elderly) but can be related to lower CO and very symptomatic esp. 60-70

53
Q

sinus tachycardia presentation

A
  • dizzy
  • fluttering in chest
  • heart pounding

HR up, heart has less time to fill. elderly: decreased ability to compensate = severe presentation

54
Q

a fib and a flutter presentation

A
  • fluttering in chest
  • heart racing
  • chest pain

no benefit from atrial kick, so decrease in CO -> fatigue and chest pain

55
Q

atrial kick

A

when atria contracts, it adds 25% more blood to ventricle than via passive filling

56
Q

v tach presentation

A
  • syncopal
  • chest pain
  • palpitations
  • dizziness
  • pulseless

LETHAL ARRHYTHMIA

57
Q

v tach intervention

A

defibrillation: pulseless, unconscious, unstable
cardioversion: awake, some kind of heart beat, BP
- timed with R wave

LETHAL ARRHYTHMIA

58
Q

Torsades or V fib presentation

A
  • pulseless
  • lifeless
  • pale
  • cyanotic (no circulating blood volume)
59
Q

Torsades or V fib treatment

A
  • defibrillation STAT
  • epinephrine
  • mg (Torsades specific: diminish electrical excitability)
60
Q

asystole presentation

A

pulseless

61
Q

asystole interventions

A
  • CPR
  • epinephrine (increase vascular tone)
  • atropine (minimuze vagus nerve on systolic rhythm)

NO SHOCKING. no beats.

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