Cardiac

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Michelle25
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101672
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Cardiac
Updated:
2011-09-19 14:25:11
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cardiac
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cardiac
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  1. What is the number one cause of coronary artery disease?
    atherosclerosis
  2. Imbalance between oxygen supply and demand
    Angina
  3. Which type of angina is increased with exertion and relieved with rest and NTG?
    Stable angina
  4. What type of angina is poorly relieved with NTG and occurs at rest?
    Unstable angina
  5. What type of MI is most deadly?
    Inferior MI
  6. If you have an ST elevation in inferior lead, you would assume what part of the heart is infected?
    Left ventricle
  7. What do positive chronotropic drugs do?
    Increase heart rate (atropine, epi, dopamine)
  8. What do negative chronotropic drugs do?
    Decrease HR (beta blockers)
  9. What reflects the filling pressure of the right ventricle (preload)?
    Central venous pressure monitoring
  10. What reflects the Left ventricular preload?
    Pulmonary capillary wedge pressure (PCWP)
  11. What is normal CVP?
    2-6 mmHg
  12. Client has a CVP reading of 8, what is the appropriate nursing diagnosis?
    Fluid volume overload (Hypervolemia)
  13. Client has a CVP reading of 1, what is the appropriate nursing diagnosis?
    Fluid volume defecit (hypovolemia)
  14. What is the primary cause of decreased preload with a CVP line?
    Hypovolemia
  15. What is the normal range for PCWP?
    6-12 mmHg
  16. If the patient has a high PCWP (18), what does this indicate?
    Fluid is built up in the Right side of the heart
  17. What is the main interventions you need to remember with the Persantine (adenosine) stress test?
    • Withold all medications such as theophylline. It's ok to give morning cardiac meds, but would still hold theophylline.
    • NPO for 4 hours
    • No smoking, no alcohol
  18. Which test would you expect to be done on a patient who can not breathe without taking theophylline?
    Dobutamine stress test
  19. What are the nursing interventions for a thallium scan?
    • Continuous telemetry
    • Large bore IV site (big gauge- 18g)
    • Patient needs to lie very still for thallium scan
  20. What is the priority nursing intervention post- procedure for cardiac catherization?
    • Check neurovascular status of the leg that was cathed
    • Other interventions include: 4-6 hrs bed rest, keep legs straight for multiple hours
  21. What is the invasive procedure where there is rapid inflations and deflations of cath to break up the plaque?
    Percutaneous transluminal coronary angioplasty (PCTA)
  22. What invasive procedure is when: woven stainless mesh that provides support to a vessel at risk of acute closure?
    • Coronary artery stent
    • - Stent may be coded in medication so that platelet will not stick to it
  23. Catheter shaves and removes plaque from artery
    Atherectomy
  24. Graft around blocked arteries to restore adequate blood flow to heart muscle: take vessels from another part of the body, and graft them into where coronary arteries are blocked in order to feed the heart muscle
    coronary artery revascularization bypass (CABG)
  25. What level is therapeutic for heparin?
    aPTT will be 1.5 to 2 times the normal
  26. If your _______ is below 60, you will go into renal failure within hours.
    MAP: mean arterial pressure
  27. What are the signs and symptoms of a retroperitoneal bleed (retroperitoneal hematoma)?
    • Flank pain
    • back pain
    • abd pain
    • hypotension
    • tachycardia
  28. How often should you measure blood pressure post-op to a CABG?
    Arterial b/p every 15 minutes
  29. How often should you measure urine output post-op CABG?
    • 1/2- 1 hour.
    • You should have 1/2-1 cc/kg/min. Minimum of 30 cc an hour.
  30. What type of nutritional teaching should the patient be given post-op invasive coronary artery procedures?
    low sodium, low cholesterol, low cards
  31. What symptoms does the patient post- coronary artery procedure need to report?
    • fever
    • dyspnea
    • chest pain with minimal exertion
  32. When can the patient have sex post- coronary artery procedure?
    3rd or 4th week post - op
  33. What is teh main goal of cardiac rehab?
    Extending and improving the quality of life
  34. What are the phases of cardiac rehab?
    • Phase I- in hospital
    • Phase II- after discharge
    • Phase III- usually self directed
  35. Systole is the sound of what?
    Mitral and tricuspid valves closing
  36. Diastole is the sound of what?
    aortic and pulmonic valves closing
  37. ______ is when a portion of one or both valve leaflets stretch into the atrium during systole
    mitral valve prolapse
  38. _____ is when blood flows back from the left ventricle into the left atrium during systole
    mitral regurgitation
  39. ____ is when valves do not close- not enough blood gets thru
    Mitral stenosis
  40. What are the causes of mitral valve prolapse?
    • congenital
    • direct damage (IV drug use)
    • rheumatic fever
  41. What grade murmur is associated with cardiac disease
    III
  42. What is mitral stenosis most often caused by?
    rheumatic endocarditis
  43. Pulsations in the head and neck, and a widened pulse pressures indicates what?
    aortic regurgitation
  44. What procedure separates leaflets?
    commissurotomy
  45. What is the target INR for coumadin?
    2.0-3.5
  46. What needs to be taught in infectious endocarditis prevention?
    • Antibiotics prior to dental procedures
    • avoid toothpicks
    • tattoos
    • iv drug use
  47. What happens in cardiomyopathy?
    • Structural and functional abnormalities of the heart muscles itself (myocardium)
    • - you get low stroke volume
    • -patient has tighter vessels
    • -starts retaining salt
  48. _______: ventricles are dilated without hypertophy of the muscle wall itself.
    Dilated cardiomyopathy
  49. _______ heart muscle increases in size and mass
    Hypertrophic cardiomyopathy
  50. _______: rigid ventricular walls, idiopathic
    Restrictive cardiomyopathy
  51. What do you need to be careful of with hypertrophic cardiomyopathy?
    Dehydration! Avoid dehydration
  52. ______ endocarditis: develops rapidly. May result in death
    Acute
  53. syndrome caused by bacterial or viral infection that causes inflammation of the pericardial sac
    Pericarditis
  54. What are the 3 signs associated with acute cardiac tamponade?
    Becks triad- hypotension, JVD, muffled heart tones
  55. inflammation fo the heart muscle, usually viral cause or immune related
    myocarditis
  56. When medicating the patient with myocarditis, what do you need to be careful about?
    • Sensitive to dig b/c of inflammation of cells
    • Do not give beta blockers- may block cells that are giving correct passageway
  57. What are the side effects of Ace inhibitors (PRILS)?
    • Dizziness/ hypotension
    • check bp, renal function, and K+
  58. What is the digoxin safe level?
    0.5-0.8 ng/mL

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