Cardiac Assessment
Where is the heart located?
Give 2 Modifiable Risk Factors and 2 Non-modifiable risk factors.
Modifiable: Stop smoking, Low-cholesterol diet, Lipid-lowering agents, Normal blood pressure, Normal blood sugars
Non-Modifiable: Age, Race, Gender
A thrombus that broke off and traveled.
Embolism
Which area of the body does PAD mostly affect?
Lower Extremities
Give 3 causes for heart failure.
- coronary artery disease (most often)
- myocardial infarction
- Cardiomyopathy
- heart valve problems
- hypertension (HTN)
- Any heart problem can potentially lead to HF
- In the older adult, the most common cause of HF is cardiac ischemia
What node initiates the heartbeat?
SA Node
Due to ischemia resulting from a reduction in coronary artery blood flow and oxygen delivery to the myocardium. _________is a symptom, not a disease
Angina
Name the two types of PVD
2) Venous
Disease associated with all types of tobacco use.
Buerger Disease
Hypertension is the major cause of _______?
Left Sided HF
Explain Orthostatic hypotension.
A drop in systolic BP greater than 15 mmHG. A drop or slight increase in diastolic BP greater than 10 mmHG. And increase in heart rate greater than 20 beats per minute in response to the drop in BP.
Occurs with moderate exertion in familiar pattern, usually stops with rest/NGT, pain is predictable.
Stable Angia
Name 2 medications used for anticoagulant therapy.
Heparin/Lovenox or warfarin (coumadin)
Symptom described as leg pain, pale extremity, cool to touch, may have hair loss.
Intermittent claudication
Patient is taking ___________ medication for HF. The patient is complaining of decreased libido, mood swings and involuntary leakage of urine.
Carvedilol
A condition where the nail base elevates, the angle exceeds 180 degrees, and the nail feels spongy when squeezed. Due to oxygen deficiency over time.
Severe Clubbing
Pain is unpredictable. Occurs with less exertion, at rest or during sleep. Unrelieved with rest or SL NTG.
Unstable angina
Name the Six P's for clinical signs of acute arterial occlusions.
Pain, Pallor, Pulselessness, Paresthesia (numbness), paralysis, poikilothermia (assumes the environmental temperature)
Local overreaction by the blood vessels that results in vasospasm, primarily in the digits, when exposed to cold or emotional stress.
Raynaud Disease
3 Classic manifestations of right-sided heart failure.
1) hepatomegaly
2) lower extremity edema
3) ascites
Can generate the beat of the ventricles, but at the much slower rate of about 20 to 35 beats per minute.
Bundle of His
Name 3 classes of Anti-Anginal medications and 1 medication for each class.
Vasodilators- Nitrates
Beta Blockers- Metoprolol, Atenolol
Calcium Channel Blockers- Amlodipine, dilitiazem, felodipine, verapamil
Antiplatelets- aspirin, clopidogrel
Satins- Atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin
Give 4 SNS of Arterial Thrombosis/Embolism.
•Abrupt onset with acute arterial occlusion
•Chronic arterial insufficiency symptoms may develop more slowly if collateral circulation is present.
•Symptoms depend on artery occluded and tissue supplied by artery.
•Gangrene may develop rapidly.
-There is decreased movement in the affected extremity.
-The extremity is pale, mottled, and without pulses distal to the occlusion.
-The extremity will feel cold because blood provides warmth.
Give 1 ND for PAD, 1 smart goal and 3 interventions.
ND: Ineffective Peripheral Tissue Perfusion
Smart Goal: Patient will have capillary refill < 3 seconds, +3 peripheral pulses and no edema noted by 1800.
Interventions: 1) Check extremity peripheral pulses, capillary refill, color, temperature, and presence of edema, and skin status every 4 hours, and report abnormal findings. 2)Maintain extremities lower than heart, feet on floor in sitting position, or head of bed elevated on blocks. 3)Avoid bending knees, pillows under knees, prolonged sitting, or crossing legs.
Describe the 3 types of cardiomyopathies.
1) Dilated: heart responds to increased workload by enlarging its chambers. Excessive stretching of the ventricles
2) Hypertrophy: increasing its muscle mass, creating more contractile force.
3) Restrictive: heart walls stiffen, reducing the heart’s ability to effectively pump.