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168.362 > week 3 > Flashcards

week 3 Flashcards

1
Q

What does AVPU stand for?

A

Alert
Verbal
Pain
Unresponsive

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2
Q

What can increase HR and RR?

A
  • Compensated shock
  • Infection
  • Stress
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3
Q

What can decrease RR?

A
  • Medications (e.g. racemic)

- Exhaustion

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4
Q

What can cause decreased HR?

A
  • Hypoxia

- End stage shock

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5
Q

What is angina?

A
  • Symptom of coronary artery disease
  • Chest pain due to lack of blood supply and oxygen to the heart
  • Pain often spreads to shoulders, arm, neck and jaw
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6
Q

What does angina feel like?

A
  • Squeezing
  • Pressure
  • Heaviness
  • Tightness
  • Pain in the chest
  • Can be sudden or recur over time
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7
Q

How can angina be treated?

A

Depending on severity, can be treated by lifestyle changes, medication, angioplasty or surgery

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8
Q

What is atherosclerosis?

A

Build up of plaque

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9
Q

What is arteriosclerosis?

A

Thickening of walls of arteries

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10
Q

What is chronic stable angina?

A
  • Same pattern of onset, duration, intensity of symptoms
  • Pain lasts 5-15 mins
  • Usually predictable - provoked by exertion
  • Relieved by rest or GTN
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11
Q

What is unstable angina?

A
  • New in onset, occurs at rest (or with minimal exertion), has a worsening pattern
  • Other symptoms: SOB, fatigue, indigestion, anxiety
  • Not relived with GTN
  • Unpredictable
  • Associated with plaque rupture exposing a thrombus
  • MEDICAL EMERGENCY
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12
Q

What is acute coronary syndrome (ACS)?

A 
The name given to three types of CAD that are associated with sudden plaque rupture: UA, N-STEMI, STEMI
Unstable angina (partial occlusion) , Non elevated-ST Elevated MI (partial occlusion), ST Elevated MI (total occlusion).
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13
Q

How does the patient with acute coronary syndrome present?

A 
	Pale and clammy 
	Chest pain/ Dyspnoea 
	Nausea and vomiting
	Hypotensive
	Pulmonary oedema
	Collapse, sweating
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14
Q

Which acute coronary syndrome has a elevated ST segment?

A

STEMI

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15
Q

Which acute coronary syndrome doesn’t have a elevated ST segment but has elevated cardiac enzymes?

A

N-STEMI

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16
Q

Which acute coronary syndrome doesn’t have a elevated ST segment and doesn’t have elevated cardiac enzymes?

A

Unstable angina

17
Q

What are complications of MI?

A
  • Arrhythmias - atrial fibrillations, ectopic beats ( premature, irregular beats), heart failure, cardiogenic shock, pulmonary oedema, acute respiratory failure
  • Cardiac arrest- only VF and VT are shock able. Asystole and PEA provide CPR and adrenaline
18
Q

What are diagnostic studies for MI?

A 
Lab Tests 
•	(lipid profile)- high cholesterol 
•	Serum cardiac markers (Trop T, CK)
Medical Imaging
•	12-lead ECG
•	Cardiac catheterisation + coronary angiography
•	Chest x-ray
•	Echocardiogram (heart ultrasound)
19
Q

What are acute nursing interventions for cardiac problems?

A
  1. Pain assessment and relief – IV access
  2. Ongoing monitoring & assessment, cardiac monitoring, frequent vitals
  3. Rest and comfort; positioning (sit upright), bed rest, limited activity for 12-24 hours
  4. Alleviation of stress and anxiety
  5. Understanding patients emotional and behavioural reactions – life defining event - loss, grief, depression
    Oxygen therapy; drug therapy: GTN and aspirin;

MDT CARE
• Rapid diagnosis and treatment extremely important
• Clinical decision making re treatment, pharmacology, surgical management (PCI, CABG)

20
Q

How to reperfuse STEMIs with thrombolysis?

A
  • dissolve thrombus (streptokinase)

* percutaneous catheter infusion (PCI)- allows stent insertion

21
Q

What is surgical revascularisation - CABG?

A

coronary artery bypass graft- adding vessels/veins, to bypass the obstructed part of the artery

22
Q

What are nursing interventions for acute heart failure:pulmonary oedema?

A
  • C-XRAY
  • Monitoring
  • Treat cause
  • Positioning
  • Oxygen therapy– nasal prong, high flow, CPAP/BiPAP
  • Drug therapy (cardiac Mx and anxiety Mx; intravenous)
  • Daily weight
  • Rest
  • Regular assessment
  • Combine physical, psychosocial and relational needs with each care encounter
23
Q

What is heart failure?

A

sometimes known as congestive heart failure, occurs when your heart muscle doesn’t pump blood as well as it should.

24
Q

What are the types of heart failure?

A

Right-sided heart failure. (Back-ups in the area that collects “used” blood)
Left-sided heart failure. (Failure to properly pump out blood to the body)
Congestive heart failure. (Fluid backs up into the lungs and tissues)

25
Q

What is DKA?

A

serious complication of type 1 diabetes and, much less commonly, of type 2 diabetes. DKA happens when your blood sugar is very high and acidic substances called ketones build up to dangerous levels in your body

26
Q

What are the three clinical features of DKA?

A

 Hyperglycaemia- polyuria, polydipsia, polyphagia
 Dehydration and electrolyte loss- Nausea/vom, LOC,
 Acidosis - increased work of breathing and rate (Kussmual respirations), pale and clammy, cold,

27
Q

What is HHNS (Hyperglycaemic hyperosmolar non-ketotic syndrome)?

A

Condition resulting from very high blood glucose levels. Can affect both types of diabetics, yet it usually occurs amongst people with T2DM

28
Q

What are nursing assessments and interventions for DKA?

A

 Treating hyperglycaemia – insulin infusion
 Correcting dehydration- fluid infusion
 Correcting electrolyte loss- Do not add to the first litre of fluid infused
 Correcting acidosis
Monitoring of vital signs, LOC, ECG, O2 saturations, urine output – 1/24
Monitor FBC 1/24

29
Q

What are signs of hypokalaemia?

A 
Low blood levels of Potassium
	Fatigue
	Muscle weakness, leg cramps, soft, flabby muscles
	Nausea and vomiting, paralytic ileus 
	Paraesthesia, decreased reflexes
	Weak, irregular pulse
	Polyuria
	Hyperglycaemia
	ECG changes: ST segment depression, flattened T wave, presence of U wave, Ventricular arrhythmias, bradycardia
30
Q

What are the three categories of AKI causes?

A

prerenal, intrarenal and postrenal

31
Q

What are prerenal causes of AKI?

A

Hypovlaemia
decreased cardiac output
vasodilation
decresased renovascular blood flow

32
Q

What are intrarenal causes of AKI?

A

Nephrotoxic injury- antibiotics, contrst

interstitial nephritis

33
Q

What are postrenal causes of AKI?

A 
benign prostatic hyperplagia
bladder cancer
neuromuscular disorders- affect bladder function
prostate cancer
spinal cord disease
strictures- narrowing of vessels
trauma
34
Q

What does RIFLE mean?

A 
Risk- GFR < 75%
Injury - GFR < 50%
Failure - GFR < 25%
Loss- complete loss of function
End-stage kidney disease
35
Q

What is nursing management for AKI?

A

 Treat precipitating cause
 Fluid restriction (600 mls + previous 24 hours loss) Fluid and electrolyte balance
 Nutritional therapy (enteral nutrition)
 Measures to lower potassium- lower potassium levels (insulin and dextrose)
 Calcium supplements
 Dialysis - Haemodialysis, Peritoneal
 Monitor vital signs
 Urine assessment
 Respiratory assessment
 Skin assessment
 Prevent infection
 Monitor fatigue and potential anxiety
 Monitor of complications – arrhythmias, infection

36
Q

What are the different types of dialysis?

A

Peritoneal

haemodialysis

168.362 (4 decks)

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