week 6: cardiac (Pipes) Flashcards
what’s the worse case scenario with valvular disease
complete block
whats the first organ to show changes with changes in the vascular system
the brain
which BP indicates hypertensive crisis
systolic BP over 180 and DBP over 120
why is HTN considered a silent killer
because it is often asymptomatic, you’ll only see symptoms when BP is rlly high for a long time
what are the main vital organs affected by hypertension
myocardium, coronary arteries, kidneys, brain, eyes, arterial vessels of lower extremoitisi
whats the worst case scenario with hypertension
hypertensive crisis
what is a hypertensive crisis
severe type of hypertension that comes on quickly and considered a medical emergency
what are the main symptoms of hypertensive crisis
severe headache, blurred vision, dizzy, SOB, epistaxis ad anxiety
whats the first thing we do if we suspect a patient is in hypertensive crisis
take BP
what are the main things we monitor for regular hypertension
monitor blood pressure, monitor organ damage, monitor response to medication
what is the primary intervention for hypertension crisis
IV meds that lower BP
Nitroprusside and Labetalol
what is a normal O2 that standing orders are based on
92%
what is the best way to manage hypertension
through lifestyle modifications
- excersize
healthy diet
manage stress
adequate sleep
no smoking
moderate alcohol intake
whats the number one cause of CAD
atherosclerosis
what are the main things to monitor for if a patient gets an angiogram
monitor kidney functioning urine output because they will be receiving contrast dye
what will you see on an angiogram if there is a coronary artery block
the artery will disappear
why would you monitor troponin if a patient has CAD
troponin is released when the myocardium is damaged, it shows how much the heart is damaged
what are the main risks with an angiogram
bleeding, infection, kidney damage
what are the three main interventions for stable CAD
monitor vital signs, administer medication, education on lifestyle changes
what is the MAIN thing you do before giving nitro
check BP
what is the worst case scenario with CAD
acute coronary syndrome
what is acute coronary syndrome
it is a continuum of stable angina, aobstruction of blood flow to myocardium leading to symptoms of ischemia
what are the three main ways to open a blocked artery
- TPA (if you’re more than 1 hour from the hospital)
- angioplasty
- CABG (coronary artery bypass graft)
whats the difference between an angiogram and an angioplasty
angiogram: diagnostic
angioplasty: intervention/treatment
what are the main things to monitor for with an angioplasty
- bleeding from insertion site
- sudden closure of blood vessel (chest pain and ST elevation)
- contrast dye reaction
- vital signs
what is coronary artery bypass graft surgery (what happens)
basically they take a healthy artery and use it to bypass bad artery
when should a nurse call a dr.
when there is nothing they can do to fix it
what should a nurse do if a patient has a decrease in Cardiac output
notify HCP
what should a nurse do if a patient has a dysrhythmia
give anti arrhythmic (amnioderone) and check potassium
what is cardiogenic shock
sudden severe LV failure that severely decreases perfusion to the tissues
when does cardiogenic shock usually occur
after heart has been operated on (watch out for it when a patient has just had CABG)
what is the main thing a nurse should do with cardiogenic shock
stabilise the paitnet until angio
- they will get cardiac catheterisation with a stent
what is peripheral arterial disease
a chronic condition in which partial or total arterial occlusion decreases perfusion to extremities
what are the four stages of PAD
asymptomatic, claudication (pain due to lack of blood flow with movement), rest pain, necrosis/gangrene (lack of blood flow causes cells to die)
what is the ankle brachial index and what does it test foe
it screens for PAD,
ankle BP divided by brachial BP
(less than 0.9 indicates PAD)
what would arterial ulcers look like
- end of toes
- minimal drainage
- ulcer bed will be pale with round edges
- little granulation tissue
what are the two main non-surgical interventions to increase blood flow with PAD
- balloon angioplasty with stent insertion
- atherectomy
what is a balloon angioplasty with stent insertion
basically cath into femoral artery, balloon to open artery, and stent put in to keep artery open
what is an atherectomy
cath inserted into femoral artery, rotational tip attached to end of catheter, breaks up plaque by spinning it around (kind of like drilling a hole through the clogged artery
what is a fem-pop bypass graft path what does it help with
- basically puts a bypass graft through the occluded femoral artery (basically a CABG but in the legs)
what do you do id tour client has a clot/embolism
- keep client still so clot doest move around
- call physical immediately,
- anticoagulant
- remove/dissolve clot with percutaneous thrombolytic therapy
what is percutaneous thrombolytic therapy
catheter is threaded through femoral artery, which infuses TPA at site of embolus
