What shall we take?
This medication class can cause lowered B/P, heart rate, and even lower respirations. It can also cause blood sugar to be lower than normal. The goal of this med is to decrease the workload of the heart.
Give the drug class and an example of a med in the class
Beta Blockers
Atenolol, Metoprolol
How does an altered rhythm pattern affect the heart?
The heart can not effectively meet the needs of the body if it is not strong and rhythmic. Affect the heart's ability to pump blood effectively.
How do you monitor malignant htn?
automatic b/p reading
direct blood pressure monitoring
Your patient has pulmonary edema, he is very anxious and is breathing very rapidly. What medication can I give that will promote muscle relaxation, slow respirations, and overall reduce the work of breathing?
Morphine Sulfate
Patient teaching for automatic implanted cardioverter defibrillator (AICD)
You can use your microwave.
You can use your power tools.
You need to notify the MD of frequent "kicks".
You need to opt for hand search instead of metal detector scans at the airport.
I can only breathe when I am sitting upright.
I have ______________.
Orthopnea
Crackles bilaterally, exertional dyspnea, pink frothy sputum, low SPO2 reading.
Left sided heart failure
This medication helps with HTN r/t high volume. It inhibits the angiotensin converting enzyme.
It can cause Angioedema, dry cough, and electrolyte imbalances
Name the drug class and an example of a med in the class
ACE Inhibitors
Captopril, lisinopril, enalapril
Why are clients with atrial fibrillation put on anticoagulants, like warfarin?
Prevention of stroke
Blood pressure is high, the body system that is primarily involved in regulating arterial blood pressure is the
Kidneys / Renal system
Before suctioning a client that can not clear secretions from the lungs, the nurse must make sure that they have adequate oxygenation by doing what?
Hyperoxygenation with 100% oxygen
Low sodium diet teaching - How will reducing sodium help? and which foods and condiments to avoid
Lowering sodium will decrease fluid retention and improve cardiac output.
Regular canned veggies, olives, pickles, processed / packaged foods like hamburger helper,
ketchup, soy sauce, etc.
I get so tired when I shower and get dressed. I can't walk very far. (often an early sign of heart failure)
Exertional Dyspnea
What is direct blood pressure monitoring and when and why is it used?
An arterial catheter will be placed measuring the systolic, diastolic, and mean arterial pressures continuously on a monitor. It is used in clients with severe and sustained hypertension or hypotension and during and after cardiac surgery.
This medication class blocks the reabsorption of sodium/chloride and prevents water reabsorption in distal convoluted tube and thus helps with high B/P related to excess volume. We have to be careful to monitor potassium levels with these meds. First choice of treatment for essential htn.
Name the class and a med example.
Thiazide diuretic: HCTZ
The only treatment for a life-threatening ventricular arrythmia such as pulseless v-tach and v-fin is?
Defibrillation
So, your patient has heart failure and we need to decrease the edema that is present. How can we do that?(two interventions) and how will we know that it is effective?
Low sodium diet, diuretics, compression stockings.
Urinary output should increase, weight should decrease as edema lessens.
How will blood pressure be monitored in a client with malignant hypertension?
via automatic B/P recording machine, every few minutes.
How can you teach your client about some of the risk factors that are causing the recurrent DVTs? (name 2)
Drink plenty of fluids. dehydration
Change from oral contraceptive to something else.
Make sure to be as mobile as possible.
Vein injury
To qualify for a heart transplant, you must always be ready. The heart must be harvested from the donor and then transplanted to the recipient within ______ hours.
6
What medication is administered to a pt with pulmonary edema to slow respiratory rate and relieve anxiety?
Morphine
Helps lower B/P that is related to increased resistance. Keeps a certain mineral out of the blood and allows vasodilation to decrease the resistance in the vasculature. We must check B/P and HR before.
Name the drug class and an example of a med in the class
Calcium Channel Blocker
nifedipine, amlodipine
A single atrial impulse outside the SA node causes the atria to contract at an exceedingly rate. No P wave, no p-r interval, with normal qrs; atrial waves show as a sawtooth pattern on ecg strip.
Your patient needs a coronary artery bypass. We have to find a vein somewhere! What is the most commonly harvested vein used for the grafting?
Your patient is having difficulty breathing. Crackles are heard in the lungs. The heart rate is elevated and their respiratory rate is elevated. What position will you put them in?
Why will this be helpful?
head of bed elevated to high-Fowler's with feet lowered to decrease venous return and give the lungs time to recover and exchange oxygen.
2 proper skills procedure on Suctioning(Trach)
Hyperoxygenate with 100% O2
Do not suction more than 10-15 seconds
Mid-to-high fowler
Intermittent apply suction while withdrawing and rotating catheter
Pickup catheter with dominant sterile hand
Place catheter tip in sterile saline solution and apply suction to check connection
DO NOT APPLY SUCTIONING WHILE INSERTING
Anyone that has had a valve replaced with a mechanical valve must understand that they must take a(n) ________________ forever.
anticoagulants
Teaching and expected findings after cardiothoracic surgery.
It will take several weeks for normal appetite to return. Depression is normal and temporary, Refrain from lifting, pushing, or pulling over 10-15 lb until restriction released (6-12 weeks).
You have A-fib and need something to slow the heart so that it beats more effectively(stronger contraction). I expect you will be prescribed ____________. I have to be careful of toxicity of this drug, especially if taking __________ for your hypertension. The risk is even higher if you are geriatric!
Digoxin
Furosemide
If a client is complaining of frequent or near constant "fluttering" or "palpitations", they may show irregular beats when the pulse is palpated. This patient will be monitored by EKG and show early and independent QRS before the p wave at times(no preceding p-wave). The reading will likely show ___________.
PVCs
I'm having chest pain! I have an order for nitroglycerin ______ (route). Teach me how to take it.
Sublingual
One tab every 5 minutes x 3 doses. Lay down and rest. Call 911 when you take your second dose.
let you Dr. know that you had to take the nitro, even if it goes away.
Clients that is placed on cardiopulmonary bypass will be required to take this medication class to prevent clots.
anticoagulant
Your patient just had surgery. We do not want wound dehiscence which is ____________. To prevent it, we teach the client to do what?
Dehiscence is the opening of the surgical incision. Teach the client to splint the incision with a pillow with doing the needed coughing and deep breathing.
A transplanted heart beats ____________ than the client's natural heart. the average is about _____ to ______ beats/min because nerves that affect heart rate have been severed. It also takes _______ to increase the heart rate in response to exercise.
Faster
100 - 110
Longer
Gradual unexpected weight gain, wakes up at night with SOB, +3 pitting edema to the BLE, JVD, lack of appetite and nausea
Right sided heart failure