week 6: cardiac (Pipes)

Question 1

what’s the worse case scenario with valvular disease

Answer 1

complete block

Question 2

whats the first organ to show changes with changes in the vascular system

Answer 2

the brain

Question 3

which BP indicates hypertensive crisis

Answer 3

systolic BP over 180 and DBP over 120

Question 4

why is HTN considered a silent killer

Answer 4

because it is often asymptomatic, you’ll only see symptoms when BP is rlly high for a long time

Question 5

what are the main vital organs affected by hypertension

Answer 5

myocardium, coronary arteries, kidneys, brain, eyes, arterial vessels of lower extremoitisi

Question 6

whats the worst case scenario with hypertension

Answer 6

hypertensive crisis

Question 7

what is a hypertensive crisis

Answer 7

severe type of hypertension that comes on quickly and considered a medical emergency

Question 8

what are the main symptoms of hypertensive crisis

Answer 8

severe headache, blurred vision, dizzy, SOB, epistaxis ad anxiety

Question 9

whats the first thing we do if we suspect a patient is in hypertensive crisis

Answer 9

take BP

Question 10

what are the main things we monitor for regular hypertension

Answer 10

monitor blood pressure, monitor organ damage, monitor response to medication

Question 11

what is the primary intervention for hypertension crisis

Answer 11

IV meds that lower BP
Nitroprusside and Labetalol

Question 12

what is a normal O2 that standing orders are based on

Answer 12

92%

Question 13

what is the best way to manage hypertension

Answer 13

through lifestyle modifications
- excersize
healthy diet
manage stress
adequate sleep
no smoking
moderate alcohol intake

Question 14

whats the number one cause of CAD

Answer 14

atherosclerosis

Question 15

what are the main things to monitor for if a patient gets an angiogram

Answer 15

monitor kidney functioning urine output because they will be receiving contrast dye

Question 16

what will you see on an angiogram if there is a coronary artery block

Answer 16

the artery will disappear

Question 17

why would you monitor troponin if a patient has CAD

Answer 17

troponin is released when the myocardium is damaged, it shows how much the heart is damaged

Question 18

what are the main risks with an angiogram

Answer 18

bleeding, infection, kidney damage

Question 19

what are the three main interventions for stable CAD

Answer 19

monitor vital signs, administer medication, education on lifestyle changes

Question 20

what is the MAIN thing you do before giving nitro

Answer 20

check BP

Question 21

what is the worst case scenario with CAD

Answer 21

acute coronary syndrome

Question 22

what is acute coronary syndrome

Answer 22

it is a continuum of stable angina, aobstruction of blood flow to myocardium leading to symptoms of ischemia

Question 23

what are the three main ways to open a blocked artery

Answer 23

• TPA (if you’re more than 1 hour from the hospital)
• angioplasty
• CABG (coronary artery bypass graft)

Question 24

whats the difference between an angiogram and an angioplasty

Answer 24

angiogram: diagnostic
angioplasty: intervention/treatment

Question 25

what are the main things to monitor for with an angioplasty

Answer 25

- bleeding from insertion site - sudden closure of blood vessel (chest pain and ST elevation) - contrast dye reaction - vital signs

Question 26

what is coronary artery bypass graft surgery (what happens)

Answer 26

basically they take a healthy artery and use it to bypass bad artery

Question 27

when should a nurse call a dr.

Answer 27

when there is nothing they can do to fix it

Question 28

what should a nurse do if a patient has a decrease in Cardiac output

Answer 28

notify HCP

Question 29

what should a nurse do if a patient has a dysrhythmia

Answer 29

give anti arrhythmic (amnioderone) and check potassium

Question 30

what is cardiogenic shock

Answer 30

sudden severe LV failure that severely decreases perfusion to the tissues

Question 31

when does cardiogenic shock usually occur

Answer 31

after heart has been operated on (watch out for it when a patient has just had CABG)

Question 32

what is the main thing a nurse should do with cardiogenic shock

Answer 32

stabilise the paitnet until angio - they will get cardiac catheterisation with a stent

Question 33

what is peripheral arterial disease

Answer 33

a chronic condition in which partial or total arterial occlusion decreases perfusion to extremities

Question 34

what are the four stages of PAD

Answer 34

asymptomatic, claudication (pain due to lack of blood flow with movement), rest pain, necrosis/gangrene (lack of blood flow causes cells to die)

Question 35

what is the ankle brachial index and what does it test foe

Answer 35

it screens for PAD, ankle BP divided by brachial BP (less than 0.9 indicates PAD)

Question 36

what would arterial ulcers look like

Answer 36

- end of toes - minimal drainage - ulcer bed will be pale with round edges - little granulation tissue

Question 37

what are the two main non-surgical interventions to increase blood flow with PAD

Answer 37

- balloon angioplasty with stent insertion - atherectomy

Question 38

what is a balloon angioplasty with stent insertion

Answer 38

basically cath into femoral artery, balloon to open artery, and stent put in to keep artery open

Question 39

what is an atherectomy

Answer 39

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

Question 40

what is a fem-pop bypass graft path what does it help with

Answer 40

- basically puts a bypass graft through the occluded femoral artery (basically a CABG but in the legs)

Question 41

what do you do id tour client has a clot/embolism

Answer 41

- keep client still so clot doest move around - call physical immediately, - anticoagulant - remove/dissolve clot with percutaneous thrombolytic therapy

Question 42

what is percutaneous thrombolytic therapy

Answer 42

catheter is threaded through femoral artery, which infuses TPA at site of embolus