The Heart Exam 1 Flashcards
Bad trans fatty acid ex
Partially hydrogenated vegetable oils (processed foods)
Bad saturated fats ex
Red meat, dark poultry, cheese, butter, coconut
Good fat ex
Mono/poly unsaturated
Ex- canola oil, avocado, almonds, peanut butter
Omega 3 fatty acids
Ex- fish
Fiber ex
Whole wheat, bran, fresh or dried fruit, veggies
Metabolic syndrome
Risk for heart disease and diabetes. Must have 3 out of 5:
Central obesity HTN high triglycerides Low HDL insulin resistant
Nonatherosclerotic inflammatory disease (no CVD), young male, smokes, rest pain
Thromboangiitis Obliterans (Buergers disease)
Woman complains of coldness and numbness that progressed to tingling, throbbing, aching pain; her nose and ears appear cyanotic
Raynaud’s phenomenon
Nursing care for raynauds
Avoid cold, stress, caffeine, smoking (vasoconstrict), wear loose warm clothes, CCB (relax smooth muscle)
Pt arm presents pale, cold, pulselessness and they complain of a tingling, severe pain
Arterial ishemia
anticoag, affected extremity flat or 15 degrees lower, monitor for bleeding, freq vitals
Venous thromboembolism (VTE)
DVT and PE
Risk for venous disorders
Venous stasis (CHF, pregnancy, immobility, obese, surgery post op)
Injury of endothelium (fracture, disease, IV meds)
Hyper coagulation
SVT (superficial vein thrombosis) care
Phlebitis at iv site, remove cath, warm moist heat, elevate, NSAIDS
Varicose SVT
Anticoag, compression stockings, ambulate
Drugs VTE
Vitamin k antagonist, thrombin inhibit., Xa inhibitors
Interventions for PAC
Observe for worsening arrhythmia
PSVT
Paroxysmal supraventricular tachycardia
150-250 bpm (faster than sinus tachycardia) Will feel it Decreased perfusion P wave can't be seen, QRS very close Tx adenosine
PVC (premature ventricular contraction)
No p wave before each PVC, QRS wide (>0.12 secs) and abnormally shaped
Bigger concern when >6 PVC per minute
Tx for PVC
Oxygen, check electrolytes, CCB, BB, amiodarone, anti dysthymics
Ventricular tachycardia
Life threatening
Regular rhythm, no P waves
QRS is wide (>0.12) and slurred
Sx: lightheaded, dyspnea, palpitations, hypotension, angina, LOC (lack of perfusion to vital organs)
V tach tx
If stable with pulse: give antidysrhythmic and tx cause, oxygen and IV
If unstable: synchronized cardio version
Vtach with no pulse: CPR and DEFIB!!!
First degree heart block
Normal rate, rhythm, and QRS
Prolonged PR interval (>0.20) bc DELAY in conduction through AV node
Second degree heart block
Some impulses blocked at AV node and don’t reach ventricles; p wave w/o QRS
Normal or slow HR
Tx with atropine if low HR
Third degree (complete AV) block
Rate
When is defibrillation used
As emergency for VFIB and PULSELESS vtach
Synchronized cardioversion
Tx unstable tachydysrythmias
Lower joules than defib
SYNCH button on so fires shock on R WAVE
IV sedation
If become PULSELESS or vfib —> synch off and defib!!!!
ICD
Implantable cardioverter defibrillator
For persistent v tach, survivor of spontaneous cardiac death (SCD)
Detects dysrhythmia and shocks
Still requires ANTIDYSRHYTHMIC MEDS!
Indications for pacemaker
2nd and 3rd degree heart block, sick sinus syndrome, dysrhythmias, HF
Pacemaker
Must SENSE/detect intrinsic electrical activity of heart and CAPTURE the myocardium causing it to depolarize
FIXED paces at FIXED rate regardless of intrinsic rhythm
Pacemaker coding
First letter: chamber being paced
2nd: chamber being sensed
3rd: mode of response (I-inhibit or T-trigger, D-both)
Nursing management of pacemaker
Monitor 24hrs after Avoid lifting arm until healed Site for bleeding & infection no magnetic fields Med alert bracelet
1 treatment of Afib
CCB
Blocks calcium ions, slows SA and AV nodes, relaxes smooth muscle
Hallmark s/s of patent ductus arteriosus (PDA)
Bounding pulse
Widening pulse pressure
Acyanotic
Aortic stenosis
all of the blood from left ventricle can’t pump through aorta bc aortic valve stenosis causing obstruction.
Decreased CO, activity intolerance **(only tx where should lower activity), chest pain
Congenital heart defect that may go from acyanotic to cyanotic
Pulmonary stenosis
Coarctation of aorta
Narrowing in aorta where ductus arteriosus was causing decreased lower body perfusion (weak pulses), decreased CO, HTN, aneurysm
ACYANOTIC
How does someone with transposition of the great arteries (closed circuit) survive
Keeping ductus arteriosus open using prostaglandins
S/s pediatric HF
Pulmonary congestion: (tachypnea, dyspnea, nasal flare, grunt, activity intolerance (feeding, thermoreg) , cyanosis
Impaired myocardial function:
Tachycardia, fatigue, weakness, pale, cool, HYPOtension, decreased urinary output
Vascular congestion:
Peripheral edema, weight gain, ascites, neck vein distention
