Heart Failure
How does the blood flow through the heart?
IVC--SVC--RA-TRIcuspid-RV--PUL valve--Pulm artery-- lungs--LA--biscupid--LV--aorta valve--aorta
What is orthostatic hypotension?
a sudden drop in blood pressure that occurs when you stand up from a sitting or lying position
WHAT AM I dilated with weak valves, so blood stays in the periphery? Occurs most commonly in lower extremities and trunk.
-List some teaching points you would educate your patient on with this dx?
- Varicose veins
-Stop smoking, SCD, Tight fitting clothing, or frequent crossing of legs, Avoid prolonged standing or sitting, Frequent Ambulation Remember (DAVE)
This test is done on a treadmill after 20 minutes i am feeling tired. What am I?
- Stress test
What is an MI?
- List some risk factors of MI(who is at risk for a stroke)
Myocardial Infarction aka Heart attack
•Usually caused by thrombosis resulting from a ruptured atherosclerotic plaque. An infarction is an area of necrosis in tissue caused by an obstruction to the flow of blood to that area for a prolonged period
- Risk factor: stress, smoking, DM,HTN, diet
-What is Heart Failure?
-List some common causes for HF?
- Inability of the heart to pump enough blood to meet the body’s needs
-CAD and uncontrolled HTN
What is Raynaud's Disease?
-What teachings would educate your pt of?
- Vasospasms in some areas of the body, primarily where there are smaller blood vessels. Spasms cause the patient to have issues receiving adequate blood flow
-avoid smoking, keep warm, avoid stress/illness, avoid vasoconstrictors (coffee,smoking, chocolate)
-This take blood back to the heart ?
- How would the pt leg LOOK, TEMP, PAIN, PULSE?
- How should this pt place there legs in bed?
-Veins
-Brown/ Rudy, warmth, yes pain, pulse yes
-DAVE (elevate)
What the difference between stable and unstable angina?
-Occurs with exercise or stress and usually subsides with rest. Pain lasts less than 15 min
•Pain more severe, occurs at rest or with minimal exertion, may not be relieved by nitroglycerin, and is unpredictable. Lasts more than 15 min and less than 30 min
What signs and symptoms would indicate to you(the nurse) that your patient maybe having an MI?
•Sudden, severe pain in the chest, usually described as tightness, pressure, squeezing, or crushing, that is not relieved by nitrates or rest.
•Dyspnea; nausea, vomiting; wheezing; and ashen, clammy, cool skin.
-List the types of HF?
-List s/s for right sided HF?
-List s/s for left sided HF?
- Left side & Right side
-Left :THINK LUNG PROBLEMS Anxiety, Pallor, Tachycardia, Dyspnea, Cough, Adventitious lung sounds, Dizziness, confusion, restlessness, and difficulty concentrating and remembering because of diminished blood flow to the brain
-Right: JVD, Abdominal engorgement, Dependent edema, Fatigue, Weight gain, ↓ UOP
I have two types Primary and Secondary ?
-What is considered hypertension?
- What foods would you have this patient avoid/ limit? (list 3 foods)
- Hypertension
-140/90
-Sodium restriction, Watch pt water intake, low cholesterol diet (pg464)
-Clot in a deep vein rather than in superficial vessels?
-This clot can travel causing?
-Who are more at risk for developing this complication?
-DVT (DEEP VEIN THROMBOSIS)
- Pulmonary embolism, brain, heart, etc.
-Immobile, obesity, use of oral contraceptives, smoking, hx of venous insufficiency, recent surgery.
A thin catheter usually inserted in the femoral artery, dye is injected to check for blockages. What am I?
- List some nursing interventions needed to do prior to an cardiac cath?
- Cardiac Cath
-Inform consent, checking allergies, checking pedal pulses(ABC circulation),Patient must be NPO for 6-8 h before test,must lie still during test.
What is the medical treatment for an MI?
-MONA
IV access
Heparin and or Fibrinolytic therapy
-Coronary artery bypass grafting (CABG), also called heart bypass surgery, is a medical procedure to improve blood flow to the heart.
Stent placement
What meds would you anticipate the MD to order for someone with HF?
-What is Digoxin Toxicity? List the s/s of digoxin toxicity?
- Digoxin: increase the force of heart contractility, Diuretics: are prescribed to reduce fluid retention in the lungs and lower extremities, Beta-adrenergic blockers (e.g., metoprolol [Toprol XL]) are used to slow the rate if tachycardia is causing the HF, thereby decreasing oxygen demand.
- •Yellow-green halos around lights, nausea, diarrhea, and confusion
List the complications of chronic venous insufficiency.
•Dermatitis, Cellulitis , Ulcerations (brown) exp findings
-venous stasis
-Edema
-Superficial veins become dilated
-Dry, itchy skin with cracks
PAD means:
SKIN color:
Temp:
Nails:
peripheral artery disease
-pale
cool
hard
-List some dx test/ labs may you anticipate the order may order after realizing your patient is having an MI?
-EKG/ ECG, Cardiac Cath, Chest X-ray, Troponins (Troponin is a protein that lives in the heart muscle; when injured, it releases troponin into the bloodstream. So more injury to the heart will elevate troponin), CBC, LDH, CK-MB
PVD means
Skin/ulcers
temp
hair
peripheral venous disease
brown ulcerations
warmth
present