Exam 3 part 3 Flashcards
Main threat of DVT
pulmonary embolism
treating DVT
TPA: dissolve the clot with tissue plasminogen activator (thromoblytic agent)
preventing DVT
- anticoagulants/blood thinners
- Pneumatic compression devices on for prolonged bed rest so blood doesn’t pool in the extremities
etiology DVT
Stasis of blood
- Bed rest
- Immobility
- CHF
Increased blood coagulation
- Dehydration
- Pregnancy
- Genetic factors
Vessel wall injury
- Indwelling venous catheters
- Surgery
- Trauma/infection
s/s DVT
- inflammation pain, swelling, deep muscle tenderness
- Elevated WBC count, fever
acute coronary syndrome
A spectrum of acute ischemic heart disease ranging from unstable ischemia to acute MI based on the presence of ECG changes
characteristics of acute coronary syndrome
ECG changes
- ST-segment elevation
- Serum cardiac markers
- Proteins released from necrotic heart cells
–Myoglobin, creatine kinase, troponin
types of acute coronary syndrome
Unstable angina (heart cells are not dying), non-ST segment elevation MI (no q waves), ST segment elevation MI (q waves)
s/s acute coronary syndrome
chest pain or pressure, shortness of breath, sweating, nausea, and pain radiating to the back, neck, jaw, or arms.
Stable plaque
thick fibrous cap, less likely to rupture
Unstable plaque
thin fibrous cap, likely to rupture and cause clot or embolism
Chronic stable angina
fixed coronary obstruction
- Imbalance between blood flow and metabolic demand
- Pain when the heart’s oxygen demand increases. occurs during:
– Physical exertion
– Emotional stress
** relieved by nitroglycerin - dilates coronary vessels
Unstable angina
- unexpected chest pain
- usually occurs while resting
- reduced blood flow to the heart muscle because the coronary arteries are narrowed by fatty buildups
- increased intensity and duration - MI
Variant/vasospastic angina
- Pain when coronary arteries spasm
- Occurs at rest or with minimal activity
Silent myocardial ischemia
- Myocardial ischemia without pain
- Factors associated are same as those responsible for angina
main cause of death associated with an MI
cardiac arrhythmias
complications of an MI
- Heart failure
- Cardiogenic shock
- Pericarditis
- Thromboemboli
- Rupture of the heart
- Ventricular aneurysms
Hypertrophic cardiomyopathy
- Defects in contractile proteins make cells too weak.
- Cells hypertrophy to do the same amount of work as normal cells.
- Need more oxygen and perform less efficiently, so the person is prone to heart failure and may suffer sudden death during exertion.
most common cause of sudden cardiac death (athletes) - Genetic - heart cells don’t have enough actin and myosin - each heart cell is working harder, it
hypertrophies - heart enlarges
–Enlargement of septum and left ventricle wall
dilated cardiomyopathy
progressive cardiac dilation - the heart is enlarged 2-3x normal.
- Easy for blood to get into chambers but hard for it to leave
- Heart loses contractile function - walls are thin like a stretched balloon
All - 4 chambers involved, thinning walls
dilated cardiomyopathy s/s
dyspnea, orthopnea, exercise intolerance
dilated cardiomyopathy treatment
relieving symptoms of heart failure
- Beta blockers, diuretics, ACE inhibitors
- Heart transplant
Restricted cardiomyopathy
Restricted cardiac filling - heart is “stiff” so it can’t fill properly
- can’t get blood into the heart because it is not expanding when blood is entering
Restricted cardiomyopathy s/s
- Dyspnea
- PND
- Orthopnea
- Peripheral edema
- Neck vein distension
Post partum cardiomyopathy
- Dilated cardiomyopathy that occurs in the last month of pregnancy or within 5 months after delivery
- Half of the women recover with no loss of cardiac function
- Heart weakens after childbirth, chance is higher after each child
pathophysiology of an MI
- complete obstruction of coronary artery infarction
- area affected becomes necrotic death of myocardium replaced by fibrous tissue
How is an MI diagnosed
Blood work including raised levels of troponin (also myoglobin and creatine-kinase)
s/s of MI
Chest pain: radiating to left arm/neck
- Severe, crushing, constrictive OR like heartburn
Sympathetic nervous system response
- GI distress, nausea, vomiting
- Tachycardia and vasoconstriction (pallor)
- Anxiety, restlessness, feeling of impending doom
Hypotension and shock
- Dizziness, weakness in the arms and legs
- Women may also experience - SOB, nausea and vomiting, back and jaw pain
In what type of patient do you see ST wave elevation, ST wave depression?
- Elevation - MI
- Depression - ischemia
30) What does non-ST wave elevation MI and ST wave elevation MI have in common?
Necrosis of heart cells, release of cardiac markers (myoglobin, CK, troponin)
signs and symptoms of an anaphylaxis reaction
- general, sudden vasodilation resulting in a rapid drop in blood pressure
- edema of the mucosa
- constriction of the bronchioles occurs obstructing airflow.
- hives
- Itching
- skin erythema
- Vomiting
- Abdominal cramping
anaphylaxis treatment
epinephrine: stabilizes the cardiovascular system; Causes vasoconstriction , increases heart rate, increases stroke volume, bring blood pressure back up, Bronchodilation
