Objective 17 and 18.txt

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Objective 17 and 18.txt
2013-09-02 14:27:57
Objective 17 18

Objective 17 and 18
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  1. Nursing care for heart transplant
    balance rejection vs. infection, diet, meds, labs, clinical visits
  2. Side effect of antirejection meds
  3. Survival rate for heart trans
    1 yr is 80-90% and 10 yr is 50-70%
  4. Meds for heart transplant
    prograft, prednisone, cyclosporine
  5. 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
  6. Monitor heart trans platient for
    SOB, fatigue, fluid gain, ABD bloating, new bradycardia, hypotension, afib/flutter, decreased activity tolerance, decreased ejection fraction (late sign)
  7. 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
  8. Aneurysm
    thoracic aortic or ABD aortic which is most common, pt can be asymptomatic
  9. Risk factors for aneurysm
    HTN, athlerosclerosis, smoking
  10. How to monitor for ABD aneurysm
    adb, flank or back pain; pulsation in upper abd
  11. 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
  12. Signs of graft occlusion or rupture
    pulse changes, cool or cold extremities, white or blue extremities, severe pain, ABD distention, decreased urine output