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__________ are dilated and tortuous superficial veins, which may cause aching, itching, burning, throbbing, cramps and restlessness.
This is relieved by ?
Therapy is called?
Varicose Veins
elevation of the legs
Intravenous injections called sclerotherapy
You expect this on assessment with someone with cardiac tamponade? WHY? Is this a medical emergency?
Muffled heart tones, JVD, and narrow pulse pressure
MEDICAL EMERGENCY!!!!!!! BLOOD or fluid build up in the pericardial sac!! This leads to the impediment of the function of the ventricles.
Which ethnic group has a larger incidence of heart failure?
African American
Intervention for symptomatic bradycardia???
Atropine!
Anticholinergic. HR <60. Are they symptomatic?
Super fit athletics will be brady... so assess your pt!!!
Intervention for vfib and vtach??
DEFIB!!!!
_________________ diet focuses on consuming fruits, veggies, low fat dairy, whole grains, fish, and beans. It avoids red meats.
DASH diet
You suspect this with a sudden onset of dyspnea and blood tinged, frothy sputum?
Intervention? WHY??
Pulmonary edema
High flow 02 and then place pt in dependent high fowlers position with legs dependent which decreases preload and reduces the volume of blood in the heart and pulmonary vasculature. Then admin Lasix.
A pt with an invasive device, such as a dialysis catheter, has a high risk for _________ which is an infection that enters the bloodstream and infects the valves or endothelial tissue?
Endocarditis
List sternal precautions and when would a pt use these?
splinting a pillow against chest when coughing and avoiding lifting or pushing up with arms.
CABG pt.
Interventions for SVT?
SVT is a HR greater than 150. Vagal maneuver, Adenosine (What's gonna happen?), sync cardioversion.
A decrease in cardiac output results in these clinical findings?
decrease in perfusion to the tissues and organs, causing decreased urine output, hypoactive bowel sounds, weak pulse, and hypotension.
What is the cardiac diet?
low fat, low sodium, low cholesterol. lean meats, veggies, fruit.
Avoid foods that are breaded and canned. Know what veggies are high in fat and cholesterol like avocados. Know what meats are high in sodium like ham.
_________ are early beats generated from the ventricles?
What causes this?
PVCs
ventricular irritability. Hypoxia (check O2 sat), electrolytes (labs), cardiomyopathy, smoking, caffeine, stress, anxiety
Stop what's causing it.
___________________________ is a defect resulting in a backflow of blood in the heart which increases pressure and leads to the complication of ______________________? A common symptom is dyspnea.
Mitral Valve Regurgitation
Heart failure
Diltiazem is what drug class?
MOA:
Adverse reaction due to the MOA?
Pt education?
CCB
Inhibits calcium ions, which causes smooth muscle relaxation, resulting in vasodilation.
Constipation or muscle cramping due to the smooth muscle relaxation. Report to HCP.
Take BP and HR before taking.
_______________________ results in peripheral edema, ascites, and JVD?
_______________ results in pressure and volume backing up in the lungs and decreased CO?
Right sided HF
Left sided HF
Teaching for a pt with a new permanent pacemaker?
Count your pulse for 1 min each AM, Avoid lifting arm above waist for at least a week to prevent lead dislodgement. Avoid all body scanners and request handheld metal detector at airports (magnets can deactivate pacemaker), microwaves are safe to use. Avoid wearing tight fitting clothing over insertion site.
Importance interventions and pt education with digoxin?
Dig Tox includes nausea, vomit, anorexia, vision changes (yellow halos). Hold if less than 60bpm. Take apical pulse for a complete 1 min. Dig tox occurs with hypokalemia- check lab levels.
This causes brown discoloration in the skin of the lower legs as the elevated venous pressure causes capillary leakage of the red blood cells, which eventually break down and release hemosiderin?
Pt education?
Chronic venous insufficiency
Avoid prolonged standing or sitting. elevate legs above the heart level to reduce edema. daily walking program. avoid trauma to limbs. proper foot and leg care. diet high in protein for wounds for leg ulcers. moist dressings. daily moisturizing. flex feet and extend ankles if standing or sitting for long times. Compression therapy.
Interventions for pericarditis?
Position side lying as supine increases pain, strict bed rest to decrease activity demand on the heart, encourage to drink fluids or may require IV fluid infusion.
Labs for a suspected MI?
Troponin I, CK-MB to measure heart muscle cell death. and C-reactive protein to measure inflammation.
You are about to perform a sync cardioversion on your pt in afib.... priorites?
THIS IS A SHOCK!!!! MAKE SURE EVERYONE IS CLEAR! Remove O2!!!!!!!! (or there will be an explosion of fire.......) IV lines are okay, BP cuff is fine. You can use a bite guard if you want to.. not common. pt will be sedated slightly- it is mean not to. You will SYNC the Zoll so it will fire on the R complex. If it is not sync and you fire on the T....... YAY CPR and VTach and another shock to get them back into a livable rhythm!
Pt teaching for Raynaud's?
Avoid extreme temps, exercise inside if it's cold, avoid excessive heat on their hands, avoid vasoconstriction meds. Know your triggers and avoid them.
Explain a carotid endarterectomy and its interventions
surgical procedure to remove a build-up of plaque in the carotid artery. incision is along the carotid artery on the side of the neck. Assess for bleeding and swelling as this can obstruct airway. Have trach kit and B-M-V devise at bedside. Neuro checks.
Intervention for 2nd degree heart blocks?? What's happening here?
This drug is CONTRAINDICATED for most heart blocks!!!!
Transcutaneous pacing to increase CO. 2nd degree electrical conduction is interrupted, usually at the AV NODE! and does not conduct through the purkinje fibers. Results in failure of the ventricles to contract, which decreases CO.
Atropine!!!! Atropine increases the firing of the sinoatrial node (atria) and conduction through the atrioventricular node (AV) of the heart by blocking the action of the vagus nerve. With 3rd-degree block, there is a complete block and disassociation of the electrical activity that is occurring in the atria and ventricles. .