WEEK 3 : cardiac unit ( altered perfusion)

Question 1

name the problems of the heart

Answer 1

congenital heart defects
muscle : cardiomyopathies , pericarditis

valve: valve disorders ( endocarditis )

electrical conduction ( dysrthmias )

Question 2

true or false. fluid in the legs ( increase venous return comes into the lungs and have a hard time breathing )

Answer 2

true

Question 3

why do we take portable xray ?

Answer 3

because the patient is not stable enough to move

Question 4

can dysrthmias lead into heart failure ?

Answer 4

yes it can lead to heart failure

Question 5

what is chest xray good at ?

Answer 5

it’s good at looking at the fluid for example : pulmonary edema

Question 6

echo allows us to see ejection fraction, typically what is a good ej?
and below 30 indicates what ?

Answer 6

typically it is good to be in 55-60 range
below 30 needs a hf specialist

Question 7

for bnp what is this used for under the blood work category ?

Answer 7

ventricles are being strecthed
gets stretched when there is too much blood bnp is elevated and supports diagnosis of hf

Question 8

exercsie/stress test why is this a good diagnostic rests to assess the heart function

Answer 8

heart failure is due to ischemia
stressing the heart a little bit ( changes in ecg )
related to ischemia

Question 9

the worst case scaerion is acute decompensated hf

what do we use to utilize /

Answer 9

increase HOB/reassure
admin oxxygen as indicated ( above 92 )
assess vitals
notify md
admin meds as ordered ( nitro, furosemide, morphine )

Question 10

true or false. we want to decrease the preload in ADHF

Answer 10

yes this is true. call for help and do not leave a pt in a distress

meds : furosemide, nitro, morphine

Question 11

altered perfusion : pump problems : take action

interventions will focus on optimization of

Answer 11

gas exchange ( oxygen )
cardiac output ( meds )
food and fluid ( restriction )
activity level (keep moving)

Question 12

true or false. cannot tell activity tolerance by ejection fraction
for rexample : ej of 12 : can wlak around and tolerate ativity for example : 20 percent SOB
do not look at numbers as much as u look at the pts

Answer 12

true

Question 13

it is important to optimize gas exchange , in this case what are we doing ?

Answer 13

position patient to reliver dyspnea

admin oxygen as needed

monitor resp status

db and c

Question 14

auscultation of the lungs
crackles or wheezes when u give meds like diuretics ( they will diuresis and lungs will improve )

is this true or false.

Answer 14

this is true

Question 15

why do we want to db and c ?

Answer 15

and fluids sitting in their lungs ( do this regularly )
avoid resp complications if we do

Question 16

heart failure zone chart
what does this indicate?

Answer 16

we teach them how to use the map
tool on what to do when their symptoms change

Question 17

aorta is between aorta and left ventricle

as people get older what typically happen ?

Answer 17

lots of wear and tea aortic stenosis is wear and tear

Question 18

mitral valve- chambers ( left side of the heart between left atrium and left ventricle )

Answer 18

yes this is true

Question 19

left atrium gets full - goes to the lungs
starts to get high pressure from high vessels of the lungs

due to this they can experience what ?

Answer 19

hemoptysis and blood sputum

Question 20

where else can we hear pericardial friction rub ?

Answer 20

glomerular nephrolitis

Question 21

which one is more common
transesophageal or transthoracic?

Answer 21

transesophageal
has a probe and holding it over the heart, and move it over positions see how good the heart is pumping

Question 22

what do we have to make sure with transesophageal ?

Answer 22

make sure they are npo ( so they do not aspirate )
- they need sedation - need an iv

Question 23

true or false. check vitals
- risk is bleeding
hypertension ( they got sedation, and make sure they are awake and gag reflex returns )

transesophageal

Answer 23

yes this is true

Question 24

how long do we often change peripheral iv ?

Answer 24

cange 3 to 5 days

Question 25

post op care to prevent complications after valve surgery

Answer 25

1. maintain septic technique ( sterile )
2. monitor vs ( bleeding )
   3.db and c
3. early ambulation ( DVT )

Question 26

it is important to listen to the cardiac : post op to rpevent complications after valve surgery

Answer 26

listen to heart sounds
cardaic monitoring
monitor for signs of heart failure

Question 27

Discharge Education for Infective Endocarditis or Post Valve Sx
just read :
* Avoidingpeoplewithinfection
* Good oral hygiene
* Inform HCPs about your condition
* WearMedicalertbracelet
* Prophylacticantibioticsbeforeprocedures
(ex: dental work)
* Fatigue is normal after surgery
* Importanceoftakingmeds(*anticoagulants)

Question 28

chambers are small and no room to fill the blood
cardiomyopathy - what happens when heart strcuture changes - hf is going to be

Answer 28

yes

Question 29

why do we utilize : Diagnostic Tests: * Xray
* Labs: BNP
* Echo
* Angiography * EKG
as a diagnostic tests for cardiomyopathies

Answer 29

xray - usually we recognize this on the xray
labs : bnp : dilated myopathy stretch out ventricles
echo : how much its able to pump
ekg :dysrthmias

Question 30

what are the 3 cardiac dysrthmias : ventricular arrhythmias

Answer 30

pvcs
vtach
ventricular fibrilliation

Question 31

define vtach

Answer 31

repetetive firing ventricular ectopic focus
rate is usually 140-180true

Question 32

true or false. vtach can be intermittent or sustained

Answer 32

true

Question 33

what happens if a patient is stable and has a pulse when it comes to vtach

Answer 33

cardioversion

Question 34

if unstable ( no pulse ) when it comes to vtach

Answer 34

defibrilliation

Question 35

true or false. left atrium gets full - goes tot he lungs
starts to get hugh pressure from high vessels of the lungs
can experience hemptyopsis
bloody suputum

Answer 35

true