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NUR 333 Fund Adult Nursing Care 2 > Week 2 Cadiac > Flashcards

Week 2 Cadiac Flashcards

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1
Q

Afterload

A

The amount of pressure that the heart needs to exert/eject the blood during ventricular contraction

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2
Q

Cardiac Output

A

Volume of blood pumped by the heart in one minute

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3
Q

Ejection Fraction

A

The % of blood pumped out of left ventricle with each contraction

Normal >50%

Less than 40% = HF

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4
Q

Hypertension

A

HTN = high blood pressure

Causes adverse effects on arterial walls: ⬆️ PVR

Untreated, causes ⬇️ blood flow

Silent killer

Diagnose: average of 2 or more readings on at least two subsequent health care visits above 120/80

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5
Q

Hypotension

A

SBP <90 mm/hg

Drop in BP, organs are not getting perfused

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6
Q

Infarction/necrosis

A

Obstruction of blood supply to an organ or region of tissue causing death to the tissue

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7
Q

Ischemia

A

Inadequate blood supply to an organ or part of the body, especially heart

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8
Q

Myocardial contractility

A

How hard the heart muscle contracts

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9
Q

Orthostatic hypotension

A

Drop in BP when someone goes from sitting to standing

SBP - ⬇️ 20 mmHg or more
DBP - ⬇️ 10 mmHg or more

Measure BP within 1-3 minute of position changes

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10
Q

Preload

A

The amount of stretch experienced by the heart at the end of ventricle filling (EDV) during diastole.

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11
Q

Pulmonary embolism

A

Blood clot that’s traveled to the lung

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12
Q

Pulse pressure

A

Difference between SBP and DBP

Normal 1/3 of SBP

High?

  • atherosclerosis
  • exercise

Low?

  • severe HF
  • hypovolemia
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13
Q

Pulsus Alternans

A

Regular rhythm but strength of pulse varies with each beat

Possible etiology: HF

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14
Q

Stroke

A

Blood clot in the brain

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15
Q

Stroke volume

A

Volume of blood pumped out of the LEFT ventricle of the heart during SYSTOLE

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16
Q

Venous thrombo-embolism

Who’s at risk?
S/S?
Nursing care?
Treatment?

A

Obstruction of a blood vessel by a blood clot that has become dislodged from another cite in the circulation

Most commonly starts in the legs and moves to the lungs (pulmonary embolism)

Who’s at risk?
- Venous stasis (pregnant, blood pooling, immobile)
- Hypercoagulability (thickened blood, dehydrated, BC,
platelet disorders)
- Endothelial damage (IVF, drugs, fractures, hx of DVT, DM)

S/S?
- redness, tenderness, swelling, warm, unilateral, calf pain

Nursing care?
- Teds, SCDs, Calf pumping

Treatment?

  • Prevention
  • IVC filter (catches clot before lungs)
  • Anti-Coag meds
  • Thrombolytics
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17
Q

Perfusion

A

Passage of fluid through the circulatory system or lymphatic system to an organ or tissue

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18
Q

Things that affect cardiac output

A
  • Heart rate
  • Stroke volume
  • Myocardial contractility
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19
Q

Blood pressure

A

Force exerted by the blood vessel walls

  • Must be adequate to maintain tissue perfusion during
    activity and rest
  • Need to know patient’s baseline BP
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20
Q

Cardiopulmonary Resuscitation (CPR)

A

When is it needed?
- No pulse, no RR

C-A-B
- Early defibrillation

Rate of compressions

  • 30 to 2 (compressions to breaths)
  • 100 - 120 compressions

Depth of compressions
- 2 inches

21
Q

C.A.B.

A

Compressions
Airway
Breathing

22
Q

Peripheral Vascular Resistance (PVR)

A

Amount of effort the heart has to overcome to get the blood out of the heart and into the periphery

23
Q

Blood Pressure Categories

A

Normal——————— <120 AND <80
Elevated——————- 120-129 AND <80
HTN stage 1 ————- 130-139 OR 80-89
HTN stage 2 ————- 140⬆️ OR 90⬆️
Hypertensive crisis —- 180⬆️. AND/OR. 120⬆️

24
Q

Factors influencing BP

A

Age, stress, ethnicity, genetics, gender, daily variation, medications, activity, weight, smoking

25
Q

Modifiable risk factors with BP

A

DM, elevated serum lipids, excess Na+ intake, obesity, sedentary lifestyle, stress, smoking, alcohol

26
Q

Non-Modifiable risk factors with BP

A

Family history, race/ethnicity, increasing age, gender, chronic kidney disease, OSA

27
Q

HTN symptoms

A

Dizziness, headache, heart palpitations (NOT INCREASED HR), nose bleeds, SOB, anger, red face, visual problems, fatigue, insomnia, sore knee, raised temp.

28
Q

Complications of HTN

A

Cardiovascular dz, MI (heart attack), stroke, peripheral vascular disease, renal dz, retinal dz

29
Q

Nursing care & Treatment for BP

A
  • BP management
  • implement pt centered plan for lifestyle modifications
  • goal: prevent heart dz, stroke, or renal dz
  • promote heart healthy nutrition
  • weight reduction
  • smoking cessation
  • pt. education
30
Q

Patient education

A
  • develop a BP screening program based on BP
  • explain potential dangers
  • manage HTN
  • lifestyle modifications
  • proper nutrition
  • exercise
  • stress management techniques
  • drug therapy education
  • seek immediate care if in HTN crisis
31
Q

Hypertensive crisis

A

HTN urgency

  • develops over days to weeks
  • 180/110
  • NO SYMPTOMS

HTN emergency

  • develops over hours to days
  • 220/140
  • SYMPTOMS
  • IV meds
32
Q

Foods high in salt

A

Cheese, saltines, condiments, pickles

33
Q

Symptoms of HoTN

A

Pale skin, skin mottling, clammy, decreased perfusion to the brain, dizziness, confusion, blurred vision, chest pain, increased HR, decreased UO, N/V

34
Q

Treatment of HoTN

A

Treat the cause:

  • Vasodilation
  • Loss of blood volume
  • Failure of heart muscle to pump
35
Q

Nursing implementation: HoTN

A
  • Monitor VS frequently
  • Assess for symptoms
  • Interventions aimed to treat the cause
  • Consider adding more salt to diet
  • Drink more water or IVFs
  • Compression hose
  • Meds
36
Q

Hyperlipidemia

A

High lipid levels in the body

37
Q

Hyperlipidemia Nursing Care

A
  • Check, change, control
  • Maintain healthy weight
  • Be active
  • Limit smoking and alcohol
  • Dietary modifications
  • Meds
38
Q

Dietary modifications for HLD

A
  • Reduce saturated fats and trans fats
  • Increase complex carbs and fiber
  • Limit major sources of cholesterol
  • Limit alcohol & simple sugars if you have ⬆️ TGs
  • Eat fatty fish weekly
  • Foods high in omega-3 fatty acids (nuts)
39
Q

Complete Blood Count

Hgb & Hct

A

Hgb - iron containing pigment
—> F (12-16) M (14-18)

Hct - % total volume of blood made up of RBCs
—> F (37-47%) M (42-52%)

40
Q

Electrocardiogram

ECG

A

Normal sinus rhythm
- originates in SA node

P wave
PR interval
QRS complex
QT interval

41
Q

Electrodes/Tele

A

“Snow over grass”
“Smoke over fire”
“Chocolate next to my heart”

42
Q

Nursing problems r/t cardiac

A
  • unstable BP
  • activity intolerance
  • decreased CO
  • decreased tissue perfusion
  • fatigue
  • impaired gas exchange
  • ineffective airway clearance
  • fluid volume excess or deficit
  • risk for injury (Orthostatic HoTN)
43
Q

Nursing Assessment r/t cardiac

A
  • inspection and palpation
  • auscultation
  • history of heart assessment
  • assess and monitor VS and O2 sats
  • skin
  • changes in LOC
  • peripheral pulses
  • calf tenderness
  • edema
  • JVD (jugular venous distention, 45 degree
44
Q

Nursing Assessment - Heart sounds

A

S1 — normal, lub
S2 — normal, dub
S3 — “ventricular gallop” — “Ken-TUCK-y”
S4 — “atrial gallop” — “TEN-nes-see”

Murmurs:
Location, radiation, loudness, pitch, quality, systolic vs diastolic

Clicks:
Mechanical valve, metal comes together

Rubs:
Pericardial sac, sounds scratchy

45
Q

5-Ps

A 
P - Pain
P - Pulse
P - Pallor
P - Paresthesia 
P - Paralysis
46
Q

Cardiac Nursing Implementation

A
  • Strict I&O
  • Monitor labs
  • Oxygen prn
  • Tele
  • Heart healthy diet
  • Limit stress
  • Meds
  • Prevent thrombus formation
47
Q

Nursing Care: Pt Teaching

A
  • Pt centered plan
  • Goals & resources
  • Avoid smoking and alcohol
  • Limit stress
  • Control HTN, HLD, DM
  • Nutrition
  • Exercise
48
Q

Nursing care: Evaluation

A
  • Evaluate progress
  • Meet goals?
  • If no, what is your next step to help them obtain their goal?

NUR 333 Fund Adult Nursing Care 2 (4 decks)

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