Unit IV Cardiac Study guide

Card Set Information

Author:
Edgcomb358
ID:
202148
Filename:
Unit IV Cardiac Study guide
Updated:
2013-02-20 18:48:32
Tags:
cardiology
Folders:

Description:
Unit IV Cardiology
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user Edgcomb358 on FreezingBlue Flashcards. What would you like to do?


  1. Differentiate between acute & chronic CHF
  2. Differentiate between the pathophysiology and clinical manifestations of right-sided and left-sided congestive heart failure
  3. Analyze the pathophysiology, clinical manifestations, compenatory mechanisms, diagnostiv abnormalities, complications, therapeuric/nutritional,pharmacologic, and nursing management (including actue care, health promotions & maintenane ) of a patient with CHF
  4. Integrate the pathophysiology & clinical manifestation with the diagnostic abnormalities, therapeuticpharmacologic, and nursing management (including acute care, health promotion & maintenance) of a patient with CHF
  5. Relate the actions of medications used to treat CHF to the pahtophysiology of the condition
  6. Compare & contrast medications used to treat CHF
  7. Compare and contrast CHF as a primary disorder with CHF as a secondary disorder from pulmonary disease
  8. Discuss the physiological principles of hemodynamic monitoring i.e., pulmonary aretery catheter, intra-aortic balloon catheter (May be tested on again in this unit as it applie sto the subject matter)
  9. Descrive basic nursing care of a patient with hemodynamic monitoring ie pulmonary artery catheter, intra-aoric balloon catheter
  10. Discuss the rationale for use of the pulmonary artery catheter
  11. Discuss the rationale for use of the intra-aoric balloon pump for patients with CHF
  12. Compare cardiogenic (CHF) & non-cardiogenic pulmonary edema (ARDS)
  13. Analyze the pathophysiology, clinical manifestations, therapeutic, pharmacologic, and nursing management of a patient with pulmonary edema
  14. Interate the pathophysiology & clinical manifestations of pulmonary edema with the pahyophysiology of CHF
  15. Propose a nursing plan of care for a patient with CHF and pulmonary edema
  16. Breifly describe the pre-op & post-op care of the patient undergoing cardiac surgery
  17. Analyze the pathophysiology, clinical manifestation, diagnotic abnormalities, therapeutic, pharmacologic, and nursing managemtn (includeing acute care, health promotion & maintenance) of rheumatic fever & rheumatic heart disease
  18. Integrate the pathophysiology & clinical manifestation with the diagnostic abnormalities, therapeutic, pharmacologic and nursing management (including acute care, health promotion & maintenance) of thrumatic fever & theumatic heart disease
  19. Analyze the pathophysiology, clinical manifestation, diagnostic abnormalities, theraputic, pharmacologic and nursing mgt (including acute care, health promotion & maintenance) of valvular heart disease
  20. Compare & contrast the inflammatory hear conditions: pericarditis, endocarditis & myocarditis
  21. Analyze the pathophysiology, clinical manifestation, diagnostic abnormalities, therapeutic, pharmacologic, and nursing mgt of the inflammatory heart conditions
  22. Integrate the patho & clinical manifestation with the diagnostic abnormalities, theraputic, pharmacologic, and nursing mgt (including acute care, health promotion & maint) of the inflammatory heart conditions
  23. Analyze the patho & clinical manifestation, diagnostic abnormalities, therapeutic, pharmacologic, and nursing management of the following congenital heart conditions : acyanotic (ventricular septal defect (VSD), atrial septal defect (ASD), coarctation fo the aorta, patent ductus arteriosus, pulmonary stenosis, aortic stenosis); cyanotic (tetralogy of fallot, transportation of the great arteries, truncus arteriosus, hypoplastic left heart)
  24. Intefrate the pathophysiology & clinical manifestation with the diagnostic abnormalities, therapeutic, pharmacologic, and nursing mgt (including acute care, health promotion & maintenance) of the following congenital heart conditions ; acyanotic(centricular septal defect, atrial septal defect, coarctation of the aorta, patent ductus arteriosus, pulmonary stenosis, aortic stenosis) cyanotic (tetralogy of fallot, transportation fo the great arteries, trucus arteriosus, hypoplastic left heart
  25. Propose a plan of care foan infant or child with congenital heart defects
  26. Propose a plan of care for an infant or child with CHF
  27. Discuss the role of the nurse in assisting the child & family to cope with congenital heart disease
  28. Explain the mechanisms of action, uses, contraindications, normal doses, side-effects, and nursing considerations for medication used to treat the cardiac conditions discussed in the unit (ex. antidysrhythmics)
  29. Identify components of the EKG waveforms
  30. Calculate the rate and rhythm of ECG strips
  31. Analyze the significance of the ECG waveforms
  32. Alalyze the significance of the ECG waveforms
  33. Interpret the following ECG rhythm strips, NL sinus, Sinus Brady, Sinus Tach, Sinus Arrythmia, A-Fib, Premature Ventricular Contractions, V-Tach, V-fib- Asystole
  34. Integrate the pathophysiology & clinical manifestation with the therapeutic, pharmacologic, and nursing mgt of patients with the following dysrythmias : S Bradycardia, S Tachycardia. S Arrythmia, A-Fib, PVC,  V-Tach, V-Fib, asystole
  35. Compare and contrast various methods of electrophysiologic therapy ie. pacemakers, cardioversion & defibrillation (implantable & external
  36. Discuss the therapeutic and nursing mgt of patients with pacemakers (temporary & permanent ) & implantable defibrillators
  37. Medication treament for dysrhythmias
  38. Three methods of Electrical Therapy - Defibrillation ,Cardioversion, Pacemakers, Implantable Defibrillator
  39. S&S of CHF
  40. Goals in acute CHF
    • Improve L ventical functions by:
    • *Decreasing intravascular volume = Diuretics - Loop diuretics drugs of choice bec fast acting
    • *Decreasing venous return = Hi fowler's position
    • *Decreasing afterload = nitroprusside (Nipride) or morphine
    • *Improving gas exchange = morphine
    • *Increasing CO = digoxin (dobutamine {Dobutrex}, amrinone {Inocor}, milrinone {Primacor})= increase contractility w/o increase in O2 demand
    • *Reducing anxiety = Morphine
  41. Medications of CHF
    • (+) inotropics
    • Diuretics
    • Vasodilators
    • Morphine
  42. Intra-aotric balloon pump (CHF)
  43. Cardiomyopathy
  44. Inflammatory heart conditions
    • Myocarditis = inflammation of the myocardium
    • Pericarditis = inflammation of the pericardium
    • Endocarditis= inflammation of the endothelial tussue of the hrt including hrt valves
  45. Valvular Hrt Disease
  46. Rheumatic fever & hrt disease
  47. Congenital Hrt Disease
  48. Sinus Bradycardia
    • S&S : Syncope & CHF
    • TX = Atropine or Isoproterenol : pacemaker may be needed
  49. Sinus Tachycardia
    • S&S - Decreased CO = fatigue, dyspnea & dizziness
    • Tx = Digoxin, beta blockers = propranolol (inderal) or diltiazem
  50. Atrail Fibrillation
    • S&S - decreased CO = fatigue, dyspnea & dizziness
    • TX = To decrease ventricular rate = diltiazem, digoxin, verapamil, quinidine, flecainide (Tambocor) beta blockers
    • Slow ventricular response = atropine;
    • -Other meds - propafenone (Rythmol), satalol (Betapace), & amiodarone (cardarone)= Careful monmitoring needed
    •  - Cardioversion = if meds do not work
    •  - Anticoagulants if pt in Afib  greater than 24hrs - Coumadin
  51. Premature Ventricular Contractions
    • S&S: Decreased CO
    • TX - When; six or more PVC's/min : multifocal PVC's, Couplets or triplets ; R&T phenomenon : USE 1st drug of choice = lidocaine; 2nd drug of choice = procainamide (pronestyl)
  52. Ventricular Tachycardia
    • S&S ; Decrease CO
    • TX - lidocain - ofter first drug used - 2nd drug Procainamide - 3rd bretylium, Meds not working= if has a pulse = cardioverison -
    • IF unconscious + no pulse = defibrillate
    • - amiodarone may be used to surpress VT
  53. Ventricular Fibrillation
    • S&S = unconscious, no pulse, apnea, seizures
    • TX - Defibrillate & CPR
  54. Goals for TX of CHF -
    • * Improve cardiac function = Digoxin & Ace inhibitors
    • * Remove excess fluids & sodium = DDiuretic & low NA+ diet
    • * Decrease cardiac demands = rest
    • * Improve tissue exygenation & decrease O2 consumption
  55. Choice of Meds for CHF depends on:
    • *Etiology of dysfunction
    • *Need for acute or long-term management
  56. Digitalis Glycosides (+ Inotopics)
    Action
    • * Increases myocardial contractility  (force of contraction) = C.O. ejection fraction
    • * Reduces hrt, rate by slowing the rate of impulse through the conduction tissue (allows more filling of ventricles & enhances coronary circulation = decrease myocardial O2 demand = decreases supply of O2 & nutrients to myocardium)
    • *Slows the conduction of impulses through the AV node & purkinje fibers & increases the AV nodal refractory period,
    • * Diuretic effect dueto increased renal bld flow & filtration secondary to increased CO
  57. Digitalis Glycosides (+ Inotopics)
    Use
    • *Increased CO in acute & chronic CHF
    • * Control atrial arrhythmias = slows transmission of impulses from atria protecting ventricles from over stimulation
  58. Digitalis Glycosides (+ Inotopics)
    dosing
    **** Caution It is commonly used ; Use is limited bec range between therapeutic & toxic doses is extremely narroTherapeutic Range 0.5-2ug/mlkids 0.8-2Watch for dig toxicity if K+ less than 3.0eq/l or serum magnesium is low

    • Usual dose 0.125-0.25 mg Qd
    • Available in elixir (0.05mg/ml) form ; infants - dose is calculated in micrograms (1000ug= 1mg)

    • Give IV slowly over at least 5 min
    • IM not advised
  59. Digitalis Glycosides (+ Inotopics)
    Side effects and nursing care
    • Nausea, vomiting, anorexia, bradycardia, dysrhythmias, visual disturbances (yellow borders around dark objects, flickering lights, blurry vision)
    • Nursing care = Take apical pulse for 1min immediatly before giving med
    • * Adults - if pulse is less than 60 hold med and call dr
    • Infants and young children hold if pulse is less than 110 and older children less than 70
    • Be sure to get a written order from the dr to hold the med.
    • **** infants rarely receive more than 1ml in one dose always double check dose with another nurs
    • Check K+ levels before giving and watch for signs of hypokalemia   

What would you like to do?

Home > Flashcards > Print Preview