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Nursing care for heart transplant
balance rejection vs. infection, diet, meds, labs, clinical visits
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Side effect of antirejection meds
osteoporosis
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Survival rate for heart trans
1 yr is 80-90% and 10 yr is 50-70%
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Meds for heart transplant
prograft, prednisone, cyclosporine
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Heart trans info
no nerve connections to rest of body, may express guilt that took herat from another person, sad about family role changes, HR is 70-90 but increases
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Monitor heart trans platient for
SOB, fatigue, fluid gain, ABD bloating, new bradycardia, hypotension, afib/flutter, decreased activity tolerance, decreased ejection fraction (late sign)
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Cultural aspects of heart transplant
Buddhist-dying process takes several hours which could make organ unusuable; Chinese-will not donate to an open system, but may consider donating if allowed to choose recipient; muslim brotherhood will only donate to another muslim brother
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Aneurysm
thoracic aortic or ABD aortic which is most common, pt can be asymptomatic
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Risk factors for aneurysm
HTN, athlerosclerosis, smoking
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How to monitor for ABD aneurysm
adb, flank or back pain; pulsation in upper abd
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How to monitor for thoracic aneurysm
back pain and manifestations of compression on adjacent structures; SOB, hoarseness, difficulty swallowing; mass may be above suprasternal notch
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Signs of graft occlusion or rupture
pulse changes, cool or cold extremities, white or blue extremities, severe pain, ABD distention, decreased urine output
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