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nur305 buder > week4 > Flashcards

week4 Flashcards

1
Q

What is heart failure?

A

Heart failure is a syndrome defined as the inability of the heart to pump sufficient blood to meet the needs of the tissues for oxygen and nutrients

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2
Q

What is heart failure categorised by?

A

Fluid overload and inadequate tissue perfusion

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3
Q

What is right sided (Diastolic) heart failure?

A

It is when the right ventricle is unable to eject sufficient amounts of blood and blood backs up in the venous system

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4
Q

What is left sided (systolic) heart failure?

A

When the left ventricle is unable to pump blood effectively to the systemic circulation resulting in pulmonary congestion

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5
Q

What is heart failure most commonly?

A

Biventricular (both sides)

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6
Q

What are some of the symptoms of heart failure?

A 
Fatigue			
Weakness		
Oedema		
Weight Gain
Anorexia		
Nausea			
Ascites			
Cough/Wheeze
Orthopnoea		
Polyuria at night
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7
Q

What is the initial nursing care of a patient with heart failure

A

Subjective & Objective health history – sleep and activity

Physical Exam – mental status, respiratory assessment, cardiovascular assessment, fluid status

Assess response to medications

Further medical investigations – Chest X-ray, ECG, Bloods

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8
Q

What are the nursing interventions of a patient with heart failure?

A

Promoting activity tolerance – cardiac rehab program, encourage mobility, spread out activities

Monitoring fluid volume – daily weight, fluid restriction, FBC, low sodium diet

Oxygen therapy

Psychological support – decreasing stress = decreasing heart workload

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9
Q

What is the medical management of heart failure?

A

Eliminate or reduce contributing factors
Reduce workload of heart by reducing afterload and preload
Prevent exacerbations

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10
Q

What is ACS?

A

An umbrella term for heart conditions such as MI’s or unstable angina

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11
Q

What is the initial care of a patient with ACS symptoms?

A

12 lead ECG
Check cardiac troponins
Oxygen therapy is Sats < 93% for normal patient (COPD patients maintain sats at 88-92%)
Aspirin 300mg unless contraindicated

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12
Q

What are some ischaemic cardiovascular causes?

A

ACS
Stable Angina
Severe aortic stenosis
Tachy-arrhythmia

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13
Q

What are some non-ischaemic cardiovascular causes?

A

Aortic dissection
PE
Pericarditis/myocarditis
GI causes

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14
Q

What are some non-CV causes?

A

Musculoskeletal causes Pulmonary Herpes zoster

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15
Q

How is an irregular heart rate calculated using an ECG?

A

On a 10 second rhythm strip, count the number of QRS complexes and multiply by 6

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16
Q

How many boxes does a normal P-R interval span across?

A

Less than 5 small squares

17
Q

What is the normal width for a QRS complex?

A

2.5 small squares

18
Q

What are the 4H’s reversible causes of non-shockable rhythms?

A

Hypoxaemia- low concentration of oxygen in the blood

Hypovolaemia= decreased blood volume

Hyper/hypokalaemia- blood’s potassium levels are too low/high

Hyper/hypothermia- high/ low body temperature

19
Q

What are the 4T’s reversible causes of non-shockable rhythms?

A

Tension pneumothorax= is the progressive build-up of air within the pleural space

Tamponade= is when fluid in the pericardium builds up and results in compression of the heart.

Toxins=poisns/drugs)

Thromboembolic=PE is the obstruction of blood flow to one or more arteries of the lung by a thrombus lodged in a pulmonary vessel

20
Q

What is the blood transfusion procedure?

A

Collection of equipment
IV access
Pre-transfusion checks Documentation
Monitoring

21
Q

What are some possible adverse reactions?

A 
Increase in temperature of more than 1.5*c		Shivering
Flushing						
Shortness of breath
Pain							
Decrease in BP
Rash/urticaria						Haemaglobinuria
Anaphylaxis						Patient feels “odd”
22
Q

What do you do if a reaction is occurring?

A

Stop the transfusion and clamp the line Summon DR
Keep the blood and line so it can be sent for testing
Document
Monitor the patient’s condition re-check patient ID with blood pack

23
Q

What is another name for Glyceryl trinitrate (GTN)?

A

Anginine

24
Q

What is GTN?

A

A vasodilator which causes coronary vasodilation

25
Q

What are contraindications for GTN?

A

Cerebral haemorrhage
Head injury
Hypersensitivity
Angina caused by obstructive cardiomyopathy

26
Q

What are possible reactions to GTN?

A 
Hypotension			
Headache
Sedation			
Nausea/vomiting
Blurred vision			
Tachycardia
27
Q

What is aspirin?

A

A drug which inhibits platelet aggregation

28
Q

What are contraindications for aspirin?

A

Hepatic/renal disease
Bleeding disorders
Gastric/peptic ulcers Hypersensitivity

29
Q

What are possible reactions to aspirin?

A

GI distress Nausea/vomiting
Occult blood loss
Dizziness

30
Q

What is the normal doses of GTN?

A

600-900mcgs as soon after onset of symptoms
Elderly 300mcgs as starting dose
Buccal mucosa under tongue or in cheek

31
Q

What is the normal does of ASPIRIN?

A

75-300mg PO OD

nur305 buder (15 decks)

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