Lab
A blood test helpful in determining if a patient is experiencing left-sided heart failure versus a respiratory cause.
What is BNP (B-type Natriuretic Peptide). If the BNP is not elevated, in conjunction with H & P, heart failure is ruled out as the cause of acute dyspnea and will point to a primary lung dysfunction.
Age, Gender, Ethnicity, Family history, Genetic predisposition.
What are nonmodifiable risk factors for coronary artery disease.
The amount of blood pumped by the left ventricle with each heartbeat.
What is the ejection fraction. >70 %: high function, 55% to 70%: normal, 40% to 55%: low function, <40%: possible heart failure.
Obesity, smoking, stress, family history
What are risk factors for developing hypertension.
A focused beam of radiation to look at a specific area.
What is a chest x-ray. This can tell if the heart has become enlarged. Nursing responsibilities is to provide a lead shielding, remove jewelry, ask about pregnancy.
These are obtained before administering antibiotic medications.
What are blood cultures.
Decrease saturated fats (sausage, bacon, cheese) and cholesterol in diet, decrease red meat, whole milk, and increase complex carbs and omega-3 fatty acids.
What is nutritional therapy and education for patients at risk or who have coronary artery disease.
Hypertension, MI of the left ventricle, and valvular disease.
What are typical causes of left-sided heart failure.
Sodium restriction, weight reduction, exercise, smoking cessation, decrease stress levels.
What are lifestyle modifications to reduce the risk of hypertension or to control hypertension.
This records the electrical signal from the heart to check for different heart conditions.
What is ECG/EKG. Nursing responsibilities are to apply electrodes/leads. Instruct the patient not to move during the monitoring period and it is not painful.
This is released into the blood stream after an infarction and is helpful in diagnosing an MI.
What is Troponin. When cells are injured within the heart muscle, they release their contents including enzymes/proteins called biomarkers. Troponin is the specific biomarker for the heart.
What is angina. Chronic stable angina occurs intermittently over a long period of time with similar patterns. It lasts a few minutes and can be relieved with Nitro. Unstable angina does not have a set pattern.
Jugular vein distention, dependent edema, ascites, increased abdominal girth due to fluid build-up.
What are clinical manifestations of right sided heart failure. The right ventricle cannot empty completely which results in increased volume and pressure in the venous system.
Paresthesia (feelings of pins and needles), diminished or absent pedal, popliteal, or femoral pulses, thin shiny skin.
What are clinical manifestations of peripheral artery disease.
This uses sound waves to create pictures of the heart and can show blood flow through the heart and heart valves.
What is an echocardiogram. Nursing responsibility is to assist the patient to lie on the left side.
lab value that is monitored for warfarin therapy.
What is INR (international normalized ratio).
This is an abrupt stoppage of blood flow through the coronary artery, causing irreversible myocardial necrosis.
What is an MI (Myocardial Infarction). MI does not usually resolve when oxygen supply and demand is resolved as with angina. Care includes ABC's, ECG monitoring, VS, pain relief (opioids), and oxygen.
Acute confusion due to hypoxia, breathlessness/dyspnea, oliguria (decreased urine, body not perfusing so less urine formation/production) fatigue and weakness.
What are clinical manifestations of left-sided heart failure. The left ventricle is dysfunctional, preventing normal, forward blood flow causing blood to back up into the left atrium and the lungs/pulmonary system.
Unfractionated heparin, enoxaparin, or warfarin.
What are drug therapies for a deep vein thrombosis.
This is an alternative way to perform an echocardiogram. A probe with an ultrasound transducer at the tip is passed into the patient's esophagus.
What is a Transesophageal echocardiogram (TEE). Nursing responsibilities include informed consent, Pt to be NPO 6 hours prior. Monitoring of vitals, monitor for return of gag reflex because local anesthetic is sprayed at the back of the throat. Patient may not eat or drink until gag reflex returns.
This lab should be checked before administering Lovenox (Enoxaparin).
What is platelet count.
lipid deposits within the intima (inner most part) of the artery and endothelial injury with inflammation of the artery.
What are the major causes of coronary artery disease.
IV drug use, use of intravascular devices, prosthetic valves, increased age with decreased immunity, frequent connections with renal dialysis.
What are risk factors for Infective endocarditis.
calf or groin pain, unilateral leg swelling, redness and warmth around the affected area.
What are symptoms of a deep vein thrombosis. A pulmonary embolism is the most common complication of a DVT.
This uses a thin tube guided through a blood vessel to the heart to locate narrowing or blockages in the blood vessels.
What is cardiac catheterization. Nursing responsibilities include informed consent, check patient for iodine allergy, give sedative if ordered, after procedure, monitor circulation to extremity by checking CMS and pulses every 15 minutes for 1 hour. Watch for hematoma and abnormal heart rate. Educate the patient that they must report chest pain.