FLUID&E
What is the difference between hypovolemia and dehydration? Name the symptoms. How do you treat both.
Dehydration is the loss of water alone while hypovolemia is the loss of water and electrolytes
symptoms for dehydration are thirst, dark urine, headache, and lightheadedness, treat with IV Hypotonic solution I&O q8h and weight, assess SKIN MENTAL STATUS AND MUCOSA
symptoms for hypovolemia are hypotension, tachycardia, oliguria, dry mucosa, flat neck veins
treat with IV ISOTONIC FOR HYPOTENSION THEN HYPOTONIC
Modifiable vs nonmodifiable risk factors
Modifiable -hyperlipidemia, tobacco, hypertension, obesity, physical, inactivity, metabolic syndrome, insulin resistance, lipidemia, and prothrombotic state
Non-modifiable-family, history, age race, premature menopause
What is pericarditis and myocarditis? And what are the symptoms?
Pericarditis is inflammation of the pericardium sack that surrounds the heart causes our infection post MI cancer and potential complications are pericardial effusion and cardiac tamponade symptoms are fever. New heart murmur friction rub at lower left sternal border.
Myocarditis inflammatory process involving myocardium USUALLY VIRAL complications are cardiomyopathy and heart failure
Symptoms are osler nodes, Janeway lesions, Roth spots, splinter hemorrhages
Heart failure risk factors
Obstructive sleep apnea, high sodium diet, hypertension, coronary artery disease, viruses, smoking
Pulmonary edema, symptoms, and treatment
Severe hypoxia, shortness of breath, cough, rapid breathing, cool clammy skin, weak, rapid, pulse, lung, congestion, moist, noisy, respirations frothy blood tinged sputum production treat with furosemide oxygen auscultate lungs
Name the symptoms and treatment of hypervolemia
Symptoms are edema, JVD, Pulmonary edema, hypertension and a bounding pulse
treat with diuretic, fluid restriction, monitor sodium intake and place in semifowlers for lung expansion as well as compression socks
CAD - management
Control cholesterol Mediterranean diet 115 minutes of activity per week medication’s like statins, anti-hypertensive, diabetes control, sensation of smoking
What is rheumatic endocarditis and ineffective endocarditis?
Rheumatic endocarditis-occurs most often in school-age children after a group a beta hematic, tropical pharyngitis need to promptly recognize and treat strep throat to prevent rheumatic fever
ineffective endocarditis - usually develops in people with prosthetic heart valves or structural defects also occurs in patients who are IV drug abusers, and those with the debilitating diseases in dwelling catheters prolonged IV therapy
Left side of the heart failure symptoms
Pulmonary congestion, crackles, S3 or ventricular gallop, dyspnea on exertion, dry, nonproductive, cough, then pink and frothy, oliguria
thromboembolism types, and treatment
Arterial thrombosis- located in arteries, supplying blood to heart and can cause ischemic stroke, M and peripheral artery disease
Venous thromboembolism- in veins, cause DVT pulmonary embolism
Treat with unfractionated heparin,low molecular weight heparin,warfarin,rivaroxaban
Hypokalemia causes, symptoms and treatment
Causes-G.I. suction, hyperaldosteronism, respiratory alkalosis or metabolic alkalosis, digoxin and insulin
Symptoms-decreased motility ventricular asystole/fibrillation leg cramps, hypotension FLAT T WAVES!!
treat-potassium chloride pump never push EKG
Angina symptoms and treatment
Symptoms are tightness choking heavy sensation. Retrosternal can radiate to the neck, jaw, shoulders back or arms, anxiety, accompanies pain.
Stable is predictable requires nitrates
Unstable increase frequency and duration, easily induced indicate disease
Medication- nitroglycerin beta blockers to reduce myocardial oxygen demand Koutsias blockers decreased workload of the heart
Give oxygen at onset stop activity and sit in semi position carry nitroglycerin 24/7
Valve replacement types
Mechanical valve or bio prosthetic
Mechanical requires long-term anticoagulation and bioprosthetic needs to be replaced after 10 to 20 years
Right sided heart failure symptoms
Peripheral congestion, jugular vein distention, dependent edema, ascites, weight gain
Pericardial, effusion and cardiac tamponade symptoms and treatment
Symptoms are I’ll defined chest pain or fullness, pulse paradoxus, and engorged neck veins low blood pressure shortness of breath
Cardiac tamponade- falling systolic blood pressure, narrow pulse pressure rising Venus pressure distant heart sounds
Treatment- pericardiocentesis
Hyperkalemia causes, symptoms, treatment
Causes-hyporaldosteronism metabolic acidosis blood transfusion ACE ARB ADDISON’S DISEASE
Symptoms-intestinal, colic, paresthesias, cramps, weakness, heart block, cardiac arrest
PEAKED T WAVES
TREAT- calcium gluconate and calcium chloride for the heart, sodium bicarbonate and albuterol, kayexalate
Acute coronary syndrome and myocardial infarction, cues diagnostics and labs
Cues are chest pain occur suddenly and continues despite rest or medications, shortness of breath, indigestion, nausea, anxiety, cold, pale, skin, increased heart rate, and respiratory rate
Diagnostics use EKG
Labs, cardiac enzymes and bio markers Tronic creatine, kinase myoglobin
Unstable angina-cues but no bio markers or ECG changes
NSTEMI- increased bio markers no ECG changes
STEMI-elevation to ST2 continuous leads damage to myocardium
Atrial regurgitation , Hallmark symptom
High-pitched murmur during S2 at third and fourth left intercostal space why didn’t pulse pressure less blood flow to coronary arteries
Mitral valve prolapse hallmark symptom
Heart murmur click at fifth intercostal space
When performing CPR how deep must you push into the patient’s chest and how many compressions do you do per Minute?
2 inches deep 100 to 120 compressions per minute allow full chest recoil
Hyponatremia symptoms and treatment
Symptoms-muscle cramps, weakness, spasm, twitching, nausea, and vomiting, lethargy confusion, seizures
treat-3% sodium chloride
STEMI INTERVENTIONS
Oxygen aspirin, nitroglycerin, morphine, cardiac, and PCI within one hour, thrombolytic agents, cardiac rehab, elevate head of bed
Mitral regurgutation hallmark symptoms
Shortness of breath with exertion or lying flat equals pulmonary congestion, holosystolic harsh murmur, heard on fifth intercostal space, pulmonary hypertension, enlarged left atrium or fluid accumulation in lungs
Mitral stenosis, Hallmark symptoms
hemopytisis, increased pressure of pulmonary veins and capillaries, orthopnea, low pitched, rumbling, sound in left lateral decubitus position
How would you treat ventricular fibrillation and asystole
Ventricular fibrillation- fatal within three minutes must defibrillate CPR epinephrine
Asystole- DEFIBRILLATOR WILL NOT WORK CPR AND PUSH EPI