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PCC4 > Perfusion: Cardiac Dysrhythmias (Sudden Cardiac Death) > Flashcards

Perfusion: Cardiac Dysrhythmias (Sudden Cardiac Death) Flashcards

1
Q

Define Sudden Cardiac Death

A

Unexpected death occurring within 1 hour of the onset of cardiovascular symptoms

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2
Q

Define cardiac arrest

A

the cessation of heart function that precedes biologic death

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3
Q

What is SCD usually caused by?

A

VF (ventricular fibrillation) and cardiac arrest

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4
Q

Who are at risk for SCD?

A
  1. adults in their mid-30s to mid-40s
  2. men more than women
  3. patients with dysrhythmias such as recurrent VT
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5
Q

What are the cardiac causes of SCD?

A
  1. coronary heart disease
  2. reperfusion following ischemia
  3. myocardial hypertrophy
  4. cardiomyopathy
  5. inflammatory myocardial disorders
  6. valve disorder
  7. primary electrical disorders
  8. dissecting or ruptured aortic or ventricular aneurysm
  9. cardiac drug toxicity
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6
Q

What are the noncardiac causes of SCD?

A
  1. PE
  2. cerebral hemorrhage
  3. autonomic dysfunction
  4. choking
  5. electrical shock
  6. electrolyte and acid-base imbalances
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7
Q

What are the risk factors of SCD?

A
  1. smoking
  2. obesity
  3. hypertension
  4. DM
  5. sedentary lifestyle
  6. high-fat diets
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8
Q

What are the best ways to prevent SCD?

A

prevent conditions like hypertension and atherosclerosis:

  1. heart-healthy diet
  2. no smoking
  3. regular physical activity
  4. managing stress
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9
Q

What race is most at risk for SCD?

A

African American

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10
Q

What are the clinical manifestations of SCD?

A
  1. severe chest pain
  2. dyspnea or orthopnea
  3. palpitations or lightheadedness
  4. complete loss of consciousness and death within minutes
  5. If VT precedes cardiac arrest, consciousness and mentation may be impaired prior to collapse and loss of consciousness
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11
Q

What is the goal of care for SCD?

A

Restore CO and tissue perfusion

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12
Q

What are the ways to give treatment for SCD?

A
  1. Basic life support (CPR with an AED)
  2. Advanced life support (airway support with a mask or intubation, IV drugs for airway and oxygenation maintenance, defibrillation, and cardiac pacing)
  3. post-resuscitation care (treat the underlying disease, IV infusions to prevent further dysrhythmias)
  4. care for the family
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13
Q

What are the important aspects of nursing care for SCD?

A
  1. treat the patient, not the monitor. Recognize signs and symptoms of cardiac compromise
  2. Activate the emergency medical services system
  3. Begin and continue basic cardiac life support
  4. Continually assess the effectiveness of emergency interventions
  5. defibrillate pulseless VT or fibrillation as soon as possible
  6. Initiate advanced life support protocols early
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14
Q

How should nurses care for the family following SCD?

A
  1. provide honest information about the patient’s condition to the family in a supportive manner and assess the family’s coping abilities and resources
  2. offer them a private consultation room
  3. notify family if they are not present that the family member is not doing well
  4. offer pastoral care or the family’s choice of spiritual support during this difficult time
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15
Q

If a pregnant woman goes into cardiac arrest, what are the guidelines for a perimortem cesarean delivery?

A
  1. 5 minutes after maternal cardiac arrest if resuscitation measures were not successful in the first 4 minutes, especially if the fetus is greater than 20 weeks gestation or if the uterus extends to or above the line of the umbilicus
  2. Gravid uterus is large enough to cause aortocaval compression
  3. do not deliver a fetus less than 20 weeks
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16
Q

How would a nurse assess CO?

A
  1. Look for signs of decreased CO
  2. Monitor ECG
  3. assess the patient for underlying causes of dysrhythmias
  4. Assess serum electrolytes and digitalis and antidysrhythmic drug levels
  5. Be prepared to administer antidysrhythmic meds
  6. If appropriate, instruct the pt to perform the Valsalva maneuver for SVT or VT without angina
  7. Prepare to assist the patient with cardioversion
  8. After cardiac arrest, transfer the patient to critical care. Do a full assessment
  9. Notify family of significant changes in the pt’s condition or cardiac arrest
17
Q

How often should a pt’s VS, ECG, and o2 sats be monitored?

A

every 5-15 minutes during acute dysrhythmic episodes and during antidysrhythmic drug infusions

18
Q

What discharge instructions should a nurse give following SCD?

A
  1. take all medications
  2. how to monitor pulse daily and keep a record
  3. avoid caffeine, tobacco, and alcohol
  4. reduce BP, monitor cholesterol levels, lose weight, heart-healthy diet, stop smoking, regular exercise

PCC4 (38 decks)

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