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  1. intermittent claudication
    pain in lower legs
  2. reynauds effects
    digital arteries of hands and lower extremeties
  3. what two things stimulate and make reynauds worse
    cold and smoking
  4. tx reynauds
    • avoid cold temps, adequate protection, no smoking, vasodilators, ntg, ca channel blockers and beta blockers, pain control
    • surgery - sympathectomy
  5. venous thrombosis
    s/s
    pain, heat, redness, edema, + homans
  6. venous thrombosis causes
    • venous stasis
    • damage to endothelial lining of vein
    • hypercoagulation
  7. common sites
    ven throm
    pelvis and lower extremities
  8. dx ven throm
    s/s and venogram
  9. tx ven throm
    meds, br, compression stockings, elevate legs, ankle/leg exercises, surgery
  10. what does vein look like
    ven throm
    warm, red, swollen, painful when down
  11. arterial thrombosis
  12. Sudden onset of severe pain, extremity is cold, pale or cyanotic, c/o numbness and tingling; pain will be more severe when elevated
  13. dx art throm
    exam for pulses, Doppler, MRI, angiogram
  14. tx art throm
    must be immediate, leg in dependent position, BR, warm wraps, meds, and surgery
  15. art throm
    If you palpate a pulse below the extremity affected
    you will not feel a pulse
  16. art throm
    artery
  17. : COLD, PALE TO CYNATOIC, NUMBNESS, PAIN WHEN UP
  18. saphenous vein
    - commonly will see clots in, most common varicose vein
  19. Surgery for varicose veins, why would it be important to elevate early?
    Prevent blood clots and stimulate circulation
  20. dissecting aneurysm
  21. inner layer has tear and blood collects between the inner and middle layers or aneurysm
  22. s/s dis aneurysm
    may have pain near structures-if bronchial-difficulty swallowing
  23. dx diss aneur
    exam and pt collapses
  24. tx diss aneur
    bypass, replacement, antihypertensives, Jennifer also stated clipped off or stent
  25. mi
    occlusion of coronary artery
  26. touchy time for mi pts
    • onset to day 3
    • risk for dysrhythmias
  27. angina vs mi
    • angina shorter
    • mi more sever and longer
  28. Thrombolytics or Fibrolytics agents
    are used to dissolve a clot and reduce effects of MI
  29. After MI valsulva maneuver is dangerous to the patient can cause
    bradycardia
  30. When patient has dsyrhythmias-
     patient has decreased cardiac output, reduced coronary artery blood flow, has an increased oxygen need
  31. Electrical impulses start at the
    sa
  32. sa normal
    60-100
  33. bradycardia
    less than 60
  34. tachy
    more than 100
  35. Atrial Fibrillation what happens there? 
    Atrium quivers so there is rapid atrial activity.
  36. Complete heart block
    atrium and ventricles function independently, without relationship to each other. Atrium and ventricles pump whenever they want
  37. PVC-.
     has no P wave. Only serious when having multiple runs of PVC is when it leads to a serious event
  38. Cardioversion is usually done with patient
    awake just given sedative. Used to terminate rapid dysrhytmias.
  39. Patient in Ventricular fibrillation, what do they need?
    Shocked (DEFRILLATION)
  40. Endocarditis-
     is a microbial infection that affects the lining of the heart and its valves.
  41. Buerger’s disease in men,
    stop smoking and the disease will go away.
  42. Patient with aortic aneurysm what vital sign would you monitor closely?
    Blood pressure will drop due to rapid blood loss
  43. S/S of angina-
     substernal and described as viselike, burning, squeezing or smothering; may radiate into arm, shoulder, jaw, neck, or epugastrium.  May have nausea, vomiting, diaphoresis, or dyspnea. Lasts only a few minutes. Relieved by rest or nitroglycerine
  44. unstable angina
  45. Unstable angina- also called crescendo angina or preinfarction angina. Pain is more severe, occurss at rest or with minimal exertion. Often NOT relieved with nitroglycerine. These patients are at higher risk for myocardial infarction and are often hospitlized for diagnostic workup and treatment
  46. Key difference between stable and unstable angina is stable goes away with rest unstable doesn’t!
  47. Diagnosis of MI- 
    Cardiac Markers-Troponin; Cardiac Enzymes- CK, CK-MB; Myoglobin;
  48. Electrocardiogram:
    Ischemia-
    ST depression & inverted T wave
  49. ecg

    Infarction-
    ST elevation ( with complete occlusion)
  50. ecg
    q wave
  51. Q wave- greater than 1/3 height of R wave
  52. REMEMBER TROPONIN IS A MARKER SPECIFIC TO AN MI  !!
  53. Working with a patient who is having difficulty with Cardiac Output
    check pulse before and after activity (bathroom) and if pulse is less than 10 bpm difference patient can continue doing that activity.
  54. mona
  55. M-Morphine
    • O-Oxygen
    • N- Nitroglycerine
    • A-Apsirin
  56. angina pt taking ntg
  57. Patient that has angina can take up to 3 tablets of nitroglycerien 5minutes apart. If pain is not relieved 15 minutes after that 3Rd tablet they need to seek medical treatment.
  58. atropine
  59. Atropine is used
    to increase heart rate for someone in bradycardia
  60. digoxin
    • tx of afib
    • hold pulse less than 60
    • pt w afib also risk for bld clots
  61. lidocaine
    • tx in mult pvcs
    • administered iv
  62. two dysrhythmias that you can use defibrillation to correct
    vfib and pulseless ventricular tachycardia
  63. pt knows if pacemaker is working?
    • check pulse
    • pt teaching
  64. stress, anxiety, activity can cause anyone to
    tachycardia
  65. pt having chest pain w meds
    o2, nitro, asp, morphine
  66. way bd helps resupply an area w bld flow?
    collateral circulation
  67. one thing to watch a pt receiving thrombolytics closely for
    bleeding
  68. pt w afib usually takes
    baby aspirin to prevent clots
  69. applying uniboot: extremity turns cold, mottled
    impaired circulation
  70. varicose veins
    • distended, protruding veins that appear darkened and tortuous, occurs in anyone, common over 30 yo with prolonged standing, pregnancy, obese, family hx. 
    • vein wall weaken and dilates, venous pressure incr and valves become defective = veins become tortuous and distended, may c/o pain and feeling of fullness in legs
  71. s/s of thromboangiitis obliterans
    • first claudication in arch of foot, 
    • claudication in calf and digits, 
    • pain more severe at night
    • shock like pain
    • pulses diminished in distal extremeties and may be cool, red, or cyanotic
    • diagnosed by arteriogram
  72. why do we have crash cart
    everything is in one place for use in emergency
  73. method for controlling blding
    • always protect yourself w ppe
    • direct pressure
    • elevation
    • pressure point
    • tourniquet
  74. pressure points are at
    brachial, femoral, and carotid
  75. signs of venous blding
    steady flow, dark red
  76. signs of arterial blding
    spurting, bright red, large amount
  77. s/s of internal abd bleeding
    bruising, swelling, rigidity, lacerations, pain/tenderness
  78. s/s of an mi
    heavy constrictive pain below or behind the sternum, pain may radiate to arms, back, neck, or jaw, diaphoresis, light-headed, n/v, dyspnea, cold, clammy skin, feelings of impending doom, woman and diabtetics atypical sx

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Author:
 cassiekay10
ID:
 228354
Filename:
 ms
Updated:
2013-07-28 01:00:46
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ms
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