Shared Flashcard Set

Details

Med/Surg
Cardiac
253
Nursing
Not Applicable
04/03/2013

Additional Nursing Flashcards

 


 

Cards

Term
What is the outer muscle layer?
Definition
Epicardium
Term
What is the middle muscle layer?
Definition
Myocardium
Term
What is the inner muscle layer?
Definition
Endocardium
Term
What is located at the SVC/RA?
Definition
SA node
Term
What is found at the septum where the atria and ventricles meet?
Definition
AV node
Term
Where is the Bundle of His located?
Definition
In the ventricular septum
Term
What is found at the base of the ventricles?
Definition
Perkinje Fibers
Term
What runs through the septum on the left and right sides?
Definition
Right and Left bundle branches
Term
What increases BP by constricting arterioles?
Definition
Alpha 1 Neurohumoral Control
Term
What increases HR via conduction system?
Definition
Beta 1 Neurohumoral
Term
What decreases BP by relaxing smooth muscle in arterioles and bronchioles?
Definition
Beta 2 Neurohumoral
Term
What bundles of nerve tissue in carotid arteries that monitor BP and change HR PRN?
Definition
Barorecptors Neurohumoral
Term
What is the pacemaker of the heart?
Definition
SA node
Term
What monitors O2 and CO2 levels?
Definition
Chemoreceptors
Term
What increases as the HR increases?
Definition
Temperature
Term
Which electrolytes are essential for cardiac muscle contraction?
Definition
K+, Ca++, Mg+
Term
What does Epinephrine increase?
Definition
HR, T3 and T4
Term
What are some changeable risk factors for CV Dz?
Definition

Obesity

Diet high in sat fats and cholesterol

Smoking

Stress

Limited exercise

 

Term
What are some non-changeable risk factors for CV Dz?
Definition

Family Hx

Diabetes

HTN

COPD

Term
Name the 3 ways to do a physical assessment of the heart
Definition

Inspection

Palpation

Percussion

Term
What 2 ways to inspect the heart?
Definition

Symmetry

Visible pulsations

Term
What 3 ways is there to palpate the heart?
Definition

Sternal notch

Xyphoid Process

PMI= 5th ICS L midclavicular line

Term
What can identify the borders of the heart?
Definition
Percussion
Term
How many heart sounds are there?
Definition
2
Term
What is the name of the atrial valves closing?
Definition
S1 systole
Term
What name is the ventricular valves opening?
Definition
S2 diastole
Term
What is normal in children and young adults?
Definition
S3 sounds like Kentucky
Term
What usually indicates CHF?
Definition
S4 gallop
Term
What produces the "gallop"?
Definition
the valves opening at different times
Term
What is caused by the vibrating or blowing sounds caused by stenosis and regurgitation?
Definition
Murmurs
Term
What happens when the valve leaflets are stiff and don't close?
Definition
Stenosis
Term
What is the backward flow of blood through an incompetent valve?
Definition
Regurgitation
Term
What can be heard at the 4th ICS R sternal border?
Definition
Aortic Valve
Term
What can be heard at the 4th ICS L sternal border?
Definition
Pulmonic Valve
Term
What can be heard at the lower 1/3 sternal border?
Definition
Tricuspid Valve
Term
What can be heard at the 6th ICS L midclavicular line?
Definition
Mitral Valve
Term
What is the force of contraction of the ventricles?
Definition
Systole
Term
What is the resting pressure of BP system?
Definition
Diastole
Term
What is MAP?
Definition
Mean Arterial Pressure
Term
How to calculate MAP?
Definition
diastolic # + 1/3 systolic #=MAP
Term
What range is the ideal MAP?
Definition
70-100
Term
Below 70 MAP does what to the system?
Definition
decreased renal perfusion
Term
Above 100 does what to the system?
Definition
damage to vessels
Term
Taking BP & HR with patient flat then raise HOB to 90 degrees then stand them up is called?
Definition
Orthostatic Hypotension
Term
If systolic drops by 10 points or diastolic drops by 5 points or HR increases by 10-20 bpm the patient is said to have what?
Definition
Orthostatic change
Term
What may orthostatic change indicate?
Definition
dehydration, mitral valve prolapse. or may be SE of BP meds
Term
Where are the pulse sites?
Definition

R & L carotid

Brachial

Radial

Femoral

Popliteal

Dorsalis pedis

Posterior tibial

Term
Noted cool and pale skin indicates what?
Definition
arterial disease
Term
Noted warm and discolored skin indicates what?
Definition
venous disease
Term
Pulse quality of a 0 indicates?
Definition
cannot palpate or find pulse with doppler
Term
Pulse quality of 1+ indicates?
Definition
hard to palpate/requires use of doppler
Term
Pulse quality of 2+ indicates?
Definition
palpable but disappears if press to hard
Term
Pulse quality of 3+ indicates?
Definition
easily palpated
Term
Pulse quality of 4+ indicates?
Definition
bounding-so strong it moves vessel and fingers up and down
Term
What kind of pulse indicates fluid overload?
Definition
Bounding
Term
What is JVD?
Definition
Jugular Vein Distention
Term
What are a few abnormal things to note about Peripheral veins?
Definition

varicosities

cords (hard, knot like)

spider veins

Term
In what condition are the jugular veins visible with patient in high fowlers?
Definition
CHF
Term
What is indicated by visible jugular veins?
Definition
volume overload
Term
What is total body edema?
Definition
Anascarca
Term
When tissue fluid is leaking through skin due to increased interstitial pressure is called what?
Definition
Weeping
Term
Skin is what kind of organ?
Definition
Excretory
Term
what is one-sided edema?
Definition
localized
Term
What is both side edema called?
Definition
systemic
Term
What is assessed by measuring the depth of depression left by fingertip over the tibia or foot?
Definition
Pitting
Term
What are some assessments to measure edema?
Definition
Daily wt, I&O and measure circumference of edematous area
Term
What does the blood test CBC measure?
Definition
Hemoglobin carries O2
Term
What blood test measures inflammation?
Definition
Sedimentation Rate
Term
What is seen in IV drug users or clients with artificial valves or pacemakers?
Definition
Endocarditis
Term
What is used in the assessment of autoimmune heart dz?
Definition
Sedimentation Rate
Term
Which electrolytes affect muscle contraction and conduction through the body's electrical system?
Definition
K+, Ca++, Mg+
Term
What type of cholesterol should be below 200?
Definition
Serum cholesterol
Term
What "good" cholesterol should be above 40?
Definition
HDL
Term
What "bad" cholesterol should be below 160?
Definition
LDL
Term
What condition is found if cholesterol is below 100?
Definition
CAD
Term
Which "form of fat" should be below 150?
Definition
Triglycerides
Term
How many hours must be fasting for a Lipid panel?
Definition
12h
Term
What range is LDH 1 specific for heart muscle?
Definition
20-90
Term
How many days after MI will LDH peak?
Definition
4 days
Term
CK-MB should be "negative" and will peak how many hours after MI?
Definition
12-24h
Term
Troponin T below 0.1 will peak how many hours after MI?
Definition
4-6h
Term
Relative Index of 2.5 with positive CK-MB indicates what?
Definition
MI
Term
Troponin 1 below 1.5 will peak in how many hours after MI?
Definition
14-18h
Term
Myoglobin less than 100 will peak how many hours after MI?
Definition
3-15h
Term
What is BNP?
Definition
Brain Natriuretic Peptide
Term
What chemical indicates ventricular hypertrophy?
Definition
BNP
Term
The injection of dye through arteries which shows actual % of arterial dz is ?
Definition
Angiography
Term
BNP is a very reliable indicator of what condition?
Definition
CHF status and morbidity
Term
What is normal BNP for adults under 70y/o?
Definition
under 100
Term
What shows structural image of the heart?
Definition
CXR
Term
What is an ultrasound of the heart?
Definition
Echocardiogram
Term
What does the Echo measure?
Definition
the % of blood leaving the ventricles with each heart beat
Term
What is an ultrasound done through the esophagus?
Definition

TE Echo

Transesophageal echo

Term
The TE Echo makes it easier to see what in the heart?
Definition
valve problems ex. mitral valve
Term
What does the Stress test look for in the heart?
Definition
Ischemic change
Term
What uses a nuclear isotope to show areas of ischemia while heart is exercising?
Definition
Thallium Stress Test
Term
What medication is used to cause stress on the heart for those who can't exercise?
Definition
Adenosine or persantine
Term
What measures pressure in the RA?
Definition
CVP
Term
What measures pressure in the RV, PA, and reflects pressure in the left side of the heart?
Definition

Swan-Ganz

only in 48h

Term
What is the continuous measurement of BP?
Definition
Arterial Lines
Term
What tests conduction defects in the heart?
Definition

EPS

Electrophysiology Studies

Term
What do P waves measure?
Definition
atrial depolarization (contraction)
Term
What do QRS waves measure?
Definition
Negative-Positive-Negative deflection
Term
What does the QRS complex represent?
Definition
Ventricular depolarization
Term
What does the T wave represent?
Definition
ventricular repolarization
Term
What is the normal PR interval time?
Definition
0.12-0.20 seconds
Term
What is the range for the QRS interval?
Definition
0.04-0.10 seconds
Term
What are some intraoperative risk factors?
Definition
arrest, stroke, hemorrhage, infection
Term
What are the post op steps in the ICU?
Definition

Maintain oxygenation

Maintain perfusion

Prevent infection

Term
How does the nurse maintain oxygenation?
Definition

ventilator

2-3 chest tubes between the medial sternum

Term
How does the nurse maintain perfusion?
Definition
many IV's, temp pacemaker, arterial lines, pulmonary artery cath, hourly urine output
Term
How does the nurse prevent infection?
Definition

IVPB antibiotics

Dressing changes

increase activity ASAP

Term
What are some interventional procedures?
Definition
cardiac cath, balloon angioplasty, stent placement
Term
Where are the interventional procedures done?
Definition
in a special lab with fluoroscopy and resuscitative equipment
Term
A patient must lie flat for how long after a procedure?
Definition

2-12h

2h for femoral

up to 12 for more interventions

Term
What procedure requires overnight stay due to IV NTG and blood thinners?
Definition
Balloon/ Stent procedures
Term
Why is it important to keep artery/stent open?
Definition
risk of spasming shut
Term
How long should a patient limit activities after a procedure?
Definition
2-7 days
Term
What are some Platelet Aggregate Inhibitors?
Definition

ASA

Plavix

both prevents graph/stent from closing

Term
What are some Anti-lipemics?
Definition

Lipotor, Crestor, Zetia

decrease cholesterol, raise HDL

Term
What is a beta-blocker?
Definition

Lopressor (metoprolol)

decrease HR and BP to decrease heart's work load

Term
What is an outcome for high risk of hemorrhage R/T invasive procedure?
Definition
Client recovers without bleeding
Term
What is an outcome for an Altered level of comfort R/T invasive procedure and immobility?
Definition
pain managed effectively
Term
What is an outcome for knowledge deficit R/T CAD, risk factors, post-procedure care, medications?
Definition
verbalizes understanding of s/s of CAD risk factor management, medications, and activity restrictions
Term
What are some NI for procedures?
Definition

Monitor VS, EKG, pain levels

I&O-keep track of dye or pickup on uriniary retention

FF- flush out dye

Bleeding precautions d/t meds

Assess arterial puncture site

Assess peripheral pulses-to puncture site

Be sure pt voids-before leaving

Term
What teaching does the client receive?
Definition

Do not drive for 48 hours

Do not lift more than 10# for 1 wk

Report any swelling or drainage from puncture site

Rest frequently

Bleeding precautions

If puncture site bleeds or develops hard lump, lie down apply pressure and call 911

If experience chest pain, sit down and call 911-stent may be closed up or clot

Gradually increase activity as per MD

Term
What are the 2 types of HTN?
Definition

Primary

Secondary

Term
What is Primary HTN?
Definition

Something wrong with the arteries

most common

Term
What is Secondary HTN?
Definition
something else causing HTN
Term
What are the 3 major controls of  BP?
Definition

Na+ secretion

Sympathetic Nervous System

Renin-Angiotensin System

Term
If Na+ process is altered and increased intake results in increase water retention what else occurs?
Definition

Volume overload

Increase BP

Term

What do high levels of epinephrine cause?

 

Definition

increased HR

increased BP

usually results in high systolic readings

Term
Where is Renin produced within the body?
Definition
kidneys
Term
What does Renin-Angiotensin produce?
Definition

vasoconstriction

increased sympathetic NS response

increased aldosterone

increased anti diuretic Hormone

increased thirst

Term
The Renin-Angiotensin System increases result in what?
Definition

increased PVR

peripheral vascular resistance

Term
What does increased PVR result in?
Definition
increased MAP
Term
What are some symptoms of HTN?
Definition
HA, epitaxis, fatigue, vision changes
Term
How does one Dx HTN?
Definition

serial BP measurements

systolic above 150

diastolic above 90

pre-hypertensive is now

systolic above 120

diastolic above 80

Term
What is the treatment goal of HTN?
Definition

MAP below 100

decrease preload-venous side of pump

decrease PVR- arterial side of pump

decrease HR-pump

Term
What medications decrease preload?
Definition

diuretics

 Furosemide, HCTZ, Bumex

all K+ losing diuretics

 Spironoaldactone, Triemterene

K+ sparing diuretics

Term
What medications decrease PVR?
Definition

direct vasodilators

Apresoline

Minoxidil

Nitroprusside

Hyerstat

Term
What are some Beta-blockers and Ca++ channel blockers that decrease HR primary and decrease BP and SNS response secondary?
Definition

Propanolol, metoprolol, atenolol-Beta

verapamil, nifedipine, diltiazem-Ca++

Term
What is monitored when administering diuretics?
Definition
I&O, monitor K+ levels, weight, and BP
Term
What is monitored when administering Beta-blockers and Ca++ channel blockers?
Definition

Monitor HR and BP

hold for bradycardia 40 and below

causes orthostatic hypotension

Term
What medications are administered to decrease PVR that are Alpha 1?
Definition

Doxazosin (Cardura)

Methyldopa (Aldomet)

Prazosin (Minipress)

Term
What is monitored when administering Direct Vasodilators?
Definition

cause sever orthostatic change

give at HS if possible

affect male GU system-used in treatment of BPH

continuous BP monitoring

Term
What are some ACE inhibitors to decrease afterload primary?
Definition
captopril, enalapril, lisinopril, cozaar, diovan
Term
What is monitored when administering ACE inhibitors?
Definition

cause hyperkalemia

excellent for CHF as well as HTN

monitor I&O, weight and BP

Term
What is an outcome for Knowledge deficit R/T disease process, medications and risk factors?
Definition
verbalizes understanding of HTN, s/s of ER conditions, medications, ways to reduce risk factors
Term
What is an outcome for high risk for injury R/T medication SE?
Definition
no injury sustained
Term
What are some client teaching topics?
Definition

Medication does not cure underlying disease

continue to take meds even if feeling better

modify diet

increase exercise

decrease or stop smoking

monitor and record BP weekly

report any dizziness, weakness, fainting

Term
What is an aneurysm?
Definition
ballooning of wall of artery
Term
What is Occlusive Arterial Disease?
Definition
plaque forms on walls of peripheral arteries
Term
What is Raynauds?
Definition

spasm of smaller arteries

most common in smokers and butchers

Term
What is Buergers?
Definition

Inflammation of arterial wall

at temple-emergency

treated with steroids

Term
What is a sudden pain at line of demarcation if rupture or dissection occurs?
Definition
aneurysm
Term
What s/s are intermittent claudication, pain that increases with activity and resolves with rest, parasthesias?
Definition
Occlusive Arterial Disease
Term
What is the treatment for Aneurysms and OAD?
Definition

surgical repair-remove diseases portion of artery and replace with graft material

Stent placement

Term
What medications are taken with an aneurysm and OAD?
Definition

direct vasodilators

anti-lipemic

platelet aggregate inhibitors

Term
What is wet gangrene?
Definition
painful, limb is severely discolored, swollen, tissue feels mushy (macerated) to touch, foul odor, requires amputation
Term
What is dry gangrene?
Definition
little or no pain, limb appears withered, tissue feels hard to touch, no odor or drainage, may require amputation
Term
What are some assessments for gangrene?
Definition

quality of peripheral pulses

skin temp and color (lying flat and with legs dependent)

pain characteristics

Term
What is a NI for altered level of comfort r/t hypoxia of peripheral tissues?
Definition
monitor peripheral pulses
Term
What is a NI for impaired circulation r/t narrowing &/or spasm of peripheral arteries?
Definition
report loss of pulse, cool or pale skin immediately to surgeon
Term
What is a NI for potential for infection r/t impaired circulation?
Definition
assess for s/s of infection
Term
What is a NI for potential for injury r/t impaired circulation?
Definition
maintain/improve mobility
Term
What are some expected outcomes for gangrene?
Definition

peripheral circulation is restored

able to ambulate without pain

changeable risk factors addressed

Term
What is some client teaching for gangrene?
Definition

take meds as directed

regular exercise necessary, regular observation of extremity for infection/injury,safety proof home, follow low fat/low cholesterol diet, stop smoking, avoid weight gain

Term
What is thrombophlebitis or DVT?
Definition

inflammation of vein

trauma, chemical or mechanical

Term
What are varicose veins?
Definition

incompetence of vein leaflets

vein cant hold against gravity

Term
What are some symptoms of DVT?
Definition
edema, pain, redness of affected extremity
Term
What are some symptoms of varicose veins?
Definition

enlarged, distended, visible veins,

c/o aching/throbbing feeling in legs

Term
What is the max of Coumadin per day?
Definition
10 mg
Term
What is the treatment for DVT?
Definition

administer anticoagulants to  prevent further clots- heprin or lovenox

 

Term
What is an embolectomy?
Definition
surgical removal of blood clot
Term
What is the Greenfield IVC filter?
Definition
mesh umbrella to catch blood clots
Term
What are treatments for Varicose veins?
Definition

support hose, weight loss,

stripping or ligation

Term
What is a Pulmonary Embolus?
Definition
part or all of clot breaks loose and travels through venous system eventually lodging in pulmonary circulation
Term
What are some s/s of PE?
Definition
sudden chest pain, dyspnea, blood tinged sputum...or no symptoms
Term
How is PE Dx?
Definition

V/Q scan-ventilation/perfusion ratio

spiral chest CT

Term
What is a stasis ulcer?
Definition
large, shallow ulcers, tend to weep because of increased venous pressure
Term
Where do stasis ulcers tend to appear?
Definition
around ankles, feet, heel or lower leg
Term
What are slow to heal and easily infected?
Definition
stasis ulcers
Term
What are some assessments to do on stasis ulcers?
Definition
edema, pain level, skin color and temp, ask if any chest  pain or dyspnea for possible PE
Term
What is a potential for infection r/t impaired circulation?
Definition
cellulitis
Term
What is a potential for injury r/t impaired circulation?
Definition
stasis ulcer
Term
What is a NI for impaired circulation r/t incompetent venous valves &/or presence of thrombus?
Definition
avoid positions/treatments that increase pressure on venous system-improperly fitted AES, crossing legs
Term
What is a NI for altered level of comfort r/t congestion of venous circulation?
Definition
assess for pain-especially chest pain or dyspnea
Term
What is a NI for potential for hemorrhage r/t anticoagulant therapy?
Definition
elevated extremity-avoid pressure on popliteal area
Term
What is a NI for potential for hypoxia r/t movement of thrombus into PVS?
Definition
assess edema-measure daily
Term
What are some bleeding precautions for anticoagulant treatment?
Definition
electric razor, soft toothbrush, guiac stools, observe urine, gums, skin for obvious or occult bleeding
Term
What are some NI for clients on anticoagulant treatments?
Definition
monitor lab test for appropriate levels, keep antedotes available, avoid foods high in Vit K-DGLV, avoid multiple venipuncture or injections
Term
What are some expected outcomes for clots?
Definition

client will not develop any further thrombi

client will verbalize understanding of anticoagulant medication effects, safety issues, and need for regular blood tests

Term
What are some client teachings for clots?
Definition

avoid positions or clothing that restrict venous return

rest with feet higher than heart at least 30"/day

if taking anticoagulants, avoid foods high in Vit K(coumadin only)

Term
What is CAD?
Definition

coronary atherosclerosis

accumulation of plaque causes decreased elasticity of coronary arterial

Term
What is angina?
Definition
sudden onset of chest pain caused by ischemia
Term
What is Myocardial Infarction (MI)?
Definition

sudden occlusion of coronary artery

dead tissue

Term
What are some symptoms of Angina?
Definition
chest pain-heartburn, pain may radiate, VS generally remain stable, skin remains warm/dry, testing negative for MI (cardiac enzymes), 12 lead EKG may show ischemia if done during episode
Term
What are some symptoms of MI?
Definition

sudden, severe, crushing pain

radiates to arms, jaw, back

some clients have NO pain-silent MI, N/V, diaphoresis, VS changes-HR and BP will increase-if process not interrupted will see signs of shock, testing positive in cardiac enzymes, 12 lead EKG will show area of damage

Term
What are the treatments to relieve Angina?
Definition
relieve pain, prevent recurrence of pain, reduce risk factors
Term
What is given for angina to relieve pain?
Definition
NTG, morphine, O2
Term
What is given to prevent recurrence of pain?
Definition

Isosorbide-Imdur

NTG patch

Term
What are some things to reduce risk factors?
Definition

treat underlying disease

HTN, DM, hyperlipidemia-statins(Zetia),smoking, weight

Term
What are some treatments for MI?
Definition
Relieve pain, decrease workload on heart, monitor for/prevent complications
Term
What are some things to relieve pain in angina?
Definition
NTG, morphine, O2
Term
What are some things to decrease workload of heart in MI?
Definition
avoid further damage, bedrest with  BRP, antihypertensives, beta-blockers to decrease HR
Term
What are some thing to monitor for/prevent complications in MI?
Definition
ICU monitored bed, PA cath, arterial line, FC, ventilator, Intra Aortic Balloon Pump, meticulous nursing assessments, anti-dysrhythmics, anticoagulants
Term
What are some complications with angina and MI?
Definition

Death-dysrhythmias

Cardiogenic Shock-pump failure-metabolic acidosis

Acute PE- LV failure

CHF-R side, L side or both

Term
What is Sudden Cardiac Death?
Definition
Secondary to irregular heart beats=dysrhythmias
Term
What is the first s/s of SCD?
Definition

toxicity

 

Term
What are some other s/s of SCD?
Definition
confusion, bradycardia
Term
What are some oral meds for SCD?
Definition
beta-blockers, Ca++ channel blockers, amiodarone
Term
What may SCD monitoring entail?
Definition
continuous cardiac monitoring, may require defibrillation, EPS testing, and placement of implantable defibrillator
Term
What is Cardiogenic Shock?
Definition
Pump failure secondary to infarct
Term
What are some s/s of Cardiogenic shock?
Definition
increasing dysrhythmias despite meds, chest pain and dyspnea, decreased urine output, severe hypotension
Term
What causes ischemia to tissues throughout body?
Definition
Lactic acidosis
Term
What are some treatments for Cardiogenic shock?
Definition

vasoconstrictors, vasodilators, diuretics

ventilator, PA cath, arterial line, FC

Intra Aortic Balloon  Pump

Term
What is Acute PE?
Definition
Left ventricle failure-blood pools in lung vessels-tissue fluid shifts into alveoli because of pressure change
Term
What are some s/s of Acute PE?
Definition
sudden onset of dyspnea at rest with tachypnea, tachycardia, rales audible without stethoscope, anxiety, hypoxia (low O2 sats)
Term
What are some treatments for APE?
Definition

Elevate HOB, apply or increase O2 (1L)

VS, decrease IV rate to 20 cc/hr

Term
What are some meds for APE?
Definition

Furosemide-40mg IV push

Morphine- 2-4 mg IV push

Term
What do meds do to system for APE?
Definition
antianxiety, decrease RR, causes venous pooling in extremities which decreases venous return to heart
Term
How does a nurse rotate tourniquets?
Definition
never take off all at once....they decrease venous return to heart if all off at once will go into shock
Term
Why is a Foley cath inserted with APE?
Definition
to decrease stress on heart related to polyuria induced by furosemide admin
Term
What is CHF?
Definition
a damaged heart that cannot pump effectively
Term
What causes CHF?
Definition
any stress on the heart (phy exertion, infection)-fluid begins to pool in damaged ventricle
Term
What are some signs of R sided CHF?
Definition

peripheral edema

decreased activity tolerance

Term
What are some signs of L sided CHF?
Definition

chronic pulmonary edema-dry freq cough

DOE

PND-paroxysmal nocturnal dyspnea

Term
What are some assessments for CHF?
Definition

presence of  pain or dyspnea

edema-pedal, periorbital, perineal area, ascites

lung sounds, O2 sats, cough

wt, activity intolerance, VS, I&O

Term
What is a NI for fluid volume excess r/t pump failure?
Definition
accurate I&O, daily wt
Term
What is a NI for activity intolerance r/t hyoxia and pump failure?
Definition
plan rest/activity periods to avoid overexertion and stress on heart
Term
What is a NI for potential for injury r/t hypoxia, activity intolerance, medication effects/side effects?
Definition
increase activity gradually after acute episode
Term
What is a NI for potential for electrolyte imbalance r/t mediation effects/side effects?
Definition
caution with administration of IV fluids or blood products...especially after surgery or serious infection
Term
What are some expected outcomes for CHF?
Definition
fluid excess eliminated, tolerating usual ADL's without dyspnea or pain, effects and side effects of medication managed without injury, patient verbalizes understanding of need for meds, planned rest activity, daily wt log in home setting, patient verbalizes understanding of symptoms requiring immediate medical care
Term
What are some medications for CHF?
Definition

Diuretics-furosemide, bumex, zaroxolyn-fluid excretion

Beta-blockers-metoprolol-slow HR/decrease BP

Cardiac Glycosides-digoxin-slows HR/increase contractions

ACE inhibitors-ACE I-interrups angiotension cycle;ACE II- opens artery

Electrolyte supplements-K+

Coronary Vasodilators- NTG patch, Isosorbide(imdur)-prevent chest pain

Term
What are some client teachings?
Definition
weight daily and record, report wt gain of more than 2# in 24h or 5# in 1 wk, avoid overexertion, follow diet restrictions as ordered, avoid crowds during flu/pneumonia season, take meds as directed even if feeling better, seek med attention immediately for chest pain or acute SOB (does not go away when sit down)
Term
What causes Rheumatic Heart Disease?
Definition
Strep
Term
What is RHD?
Definition
body's immune system mistakes heart connective tissue for antigen and destroys tissue
Term
What is Bacterial Endocarditis?
Definition
Blood borne pathogens attack lining of heart
Term
What are some s/s for Bacterial Endocarditis?
Definition
chest pain, dyspnea, tachycardia, and high fever
Term
What is the treatment for endocarditis?
Definition
pericardiocentesis- sticking needle to drain fluid around heart
Term
What is a cardiac tamponade?
Definition
disorder of fluid around heart
Term
What is pericarditis?
Definition
inflammation or infection of pericardial sac
Term
What are s/s of pericarditis?
Definition

chest pain

fever

Term
What is treatment for RHD?
Definition

diuretics, anti hypertensives, anti coagulants to treat immediate symptoms

valve replacement

prophylactic PCN for 2-5 yrs and before any invasive procedure

Term
What are treatments for SBE?
Definition

blood cultures and appropriate antibiotic treatment

identify/treat underlying cause

Term
What are treatments for Pericarditis?
Definition

pericariocentesis or surgery to create pericardial window-drains accumulated fluid

appropriate antibiotic if caused by infection

treatment of underlying cause

Term
What are some NI for Auto-immune and infectious disorders?
Definition
VS, heart and lung sounds, edema, activity tolerance, pain
Term
What are some NI for decreased cardiac output r/t mechanical dysfunctions of heart?
Definition
cardiac monitor, I&O, daily wt
Term
What are some NI for pain r/t valve dysfunction or infection?
Definition
analgesics or anti-inflammatory meds
Term
What are some expected outcomes for autoimmune and infectious disorders?
Definition

cardia output restored to functional levels

infection source eliminated

Term
What are some client teachings for SBE and Pericarditis?
Definition
seek immediate medical attention for recurrence of symptoms
Term
What are some client teachings for RHD?
Definition

need for antibiotic prophylaxis prior to any surgical/dental procedures

need for long-term PCN

if valve replaced-need for life-long anticoagulant treatment...blood test, safety factors

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