WEEK 3 : cardiac unit ( altered perfusion) Flashcards
name the problems of the heart
congenital heart defects
muscle : cardiomyopathies , pericarditis
valve: valve disorders ( endocarditis )
electrical conduction ( dysrthmias )
true or false. fluid in the legs ( increase venous return comes into the lungs and have a hard time breathing )
true
why do we take portable xray ?
because the patient is not stable enough to move
can dysrthmias lead into heart failure ?
yes it can lead to heart failure
what is chest xray good at ?
it’s good at looking at the fluid for example : pulmonary edema
echo allows us to see ejection fraction, typically what is a good ej?
and below 30 indicates what ?
typically it is good to be in 55-60 range
below 30 needs a hf specialist
for bnp what is this used for under the blood work category ?
ventricles are being strecthed
gets stretched when there is too much blood bnp is elevated and supports diagnosis of hf
exercsie/stress test why is this a good diagnostic rests to assess the heart function
heart failure is due to ischemia
stressing the heart a little bit ( changes in ecg )
related to ischemia
the worst case scaerion is acute decompensated hf
what do we use to utilize /
increase HOB/reassure
admin oxxygen as indicated ( above 92 )
assess vitals
notify md
admin meds as ordered ( nitro, furosemide, morphine )
true or false. we want to decrease the preload in ADHF
yes this is true. call for help and do not leave a pt in a distress
meds : furosemide, nitro, morphine
altered perfusion : pump problems : take action
interventions will focus on optimization of
gas exchange ( oxygen )
cardiac output ( meds )
food and fluid ( restriction )
activity level (keep moving)
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
true
it is important to optimize gas exchange , in this case what are we doing ?
position patient to reliver dyspnea
admin oxygen as needed
monitor resp status
db and c
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.
this is true
why do we want to db and c ?
and fluids sitting in their lungs ( do this regularly )
avoid resp complications if we do
heart failure zone chart
what does this indicate?
we teach them how to use the map
tool on what to do when their symptoms change
aorta is between aorta and left ventricle
as people get older what typically happen ?
lots of wear and tea aortic stenosis is wear and tear
mitral valve- chambers ( left side of the heart between left atrium and left ventricle )
yes this is true
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 ?
hemoptysis and blood sputum
where else can we hear pericardial friction rub ?
glomerular nephrolitis
which one is more common
transesophageal or transthoracic?
transesophageal
has a probe and holding it over the heart, and move it over positions see how good the heart is pumping
what do we have to make sure with transesophageal ?
make sure they are npo ( so they do not aspirate )
- they need sedation - need an iv
true or false. check vitals
- risk is bleeding
hypertension ( they got sedation, and make sure they are awake and gag reflex returns )
transesophageal
yes this is true
how long do we often change peripheral iv ?
cange 3 to 5 days
post op care to prevent complications after valve surgery
- maintain septic technique ( sterile )
- monitor vs ( bleeding )
3.db and c - early ambulation ( DVT )
it is important to listen to the cardiac : post op to rpevent complications after valve surgery
listen to heart sounds
cardaic monitoring
monitor for signs of heart failure
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)
chambers are small and no room to fill the blood
cardiomyopathy - what happens when heart strcuture changes - hf is going to be
yes
why do we utilize : Diagnostic Tests: * Xray
* Labs: BNP
* Echo
* Angiography * EKG
as a diagnostic tests for cardiomyopathies
xray - usually we recognize this on the xray
labs : bnp : dilated myopathy stretch out ventricles
echo : how much its able to pump
ekg :dysrthmias
what are the 3 cardiac dysrthmias : ventricular arrhythmias
pvcs
vtach
ventricular fibrilliation
define vtach
repetetive firing ventricular ectopic focus
rate is usually 140-180true
true or false. vtach can be intermittent or sustained
true
what happens if a patient is stable and has a pulse when it comes to vtach
cardioversion
if unstable ( no pulse ) when it comes to vtach
defibrilliation
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
true
