It's Electric
What is the action to follow if the patient is experiencing ventricular fibrillation.
What is defibrillation?
Define b/p.
What is:
Blood pressure (BP) is the force produced by the volume of blood in arterial walls.
What is often the most common first symptom of heart failure?
What is dyspnea?
What is bradycardia?
Drug class that is contraindicated with bradycardia
heart rate < 60 bpm
beta blockers
Explain cardiopulmonary bypass (extracorporal circulation)
What is:
Mechanically circulating and oxygenating blood outside of the body whilet he beating heart isstoppe
What is the purpose of regular/rhythmic electrical conduction of the heart?
What is:
The conduction system of the heart and the inherent rhythmicity of cardiac muscle produce a rhythm pattern which greatly influences the hearts ability to pump blood effectively.
What is the body system that primarily involved in regulation of arterial blood pressure?
What is:
Renal System
Name 3 s/s of lft sided heart failure.
What is:
hypoxemia, unusual fatigue withactivity, exertional dyspnea (first symptom), orthopnea,paroxysmal nocturnal dyspnea (sleep with several pillowsin bed or in a chair), pulmonary congestion, pulse rapid orirregular, displaced apical pulse, S3 heart sound(gallop),BP elevated, cough, frothy sputum, hemoptysis, moistcrackles, urine output diminished, altered mental status,organ failure, nocturia
Name 2 important teachings/nursing interventions for digoxin
What is
Complications: heart failure and dysrhythmias(hypokalemia, increased dig-levels,heart disease and older adults), DIG toxicity= fatigue/weakness, visionchanges(blurred vision, yellow/green/white halos around objects)• Do not use with pregnancy, v-fib, advanced heart failure, altered electrolyte levels;ACE inhibitors and ARBs, Verapamil• Nursing/Education: Assess pulse/rate prior, notify MD if HR<60, admin at sametime, assess digoxin levels; Teach s/s of dig toxicity, do not double dose• Dig toxicity: stop med and K+ wasting diuretics, monitor K+, admin if low, treat bradycardia with atropine, ANTIDOTE: activated charcoal, cholestyramine, digoxinimmune Fab
Name 3 indications for a heart transplant?
What is:
cardiomyopathy, end-stage coronary artery disease, end-stage heart failure, congenital cardiac defects
Explain a-fib and what medication is always ordered to prevent further complication r/t decreased blood circulation?
What is:
Instead of SA node initiating the impulse, several areas in the rt atrium initiate the impulse resulting in disorganized rapid activity(firework activity, nightclub); Atria quiver rather than contract leading to not a good ejection of blood, blood accumulates in atria and coagulates(SA has lost control, Atria gone wild)
Anticoagulant
Explain systolic and diastolic bp.
What is:
Systolic blood pressure is determined by the force and volume of blood that the left ventricle ejects(contraction)
Diastolic blood pressure reflects arterial pressure during ventricular relaxation.
Name 3/3 rt sided heart failure.
What is:
gradual unexplainedweight, ascending dependent pitting edema,ascites, hepatomegaly, jugular vein distention,fatigue/weakness, nausea/anorexia, polyuria atrest(nocturnal)• Enlarged abdominal organs: dyspnea• Fluid retention: rings, shoes, or clothing becometight• Accumulation of blood in abdominal organs:anorexia, nausea, and flatulence
What drug class is verapamil?
What is calcium channel blocker?
2 complications of heart transplant?
What is:
rejection, infection
Explain a PVC.
What is:
Ventricular contraction that occurs early and independently in the cardiac cycle before the SA node initiates an electrical impulse; no P wave precedes the wide,bizarre-looking QRS complex; look big • ECG strip: Irregular rhythm, NO p wave, no PR interval, wide and Bizarre QRS
Name 2 nursing considerations/teachings for beta blockers?
What is:
Complications: Bradycardia= pulse <60 pbm, withhold and notify provider; DM, can mask tachycardia; hypoglycemia; HF(sob, edema,weight gain, fatigue), AV block(ECG), orthostatic hypotension; postprandial hypotension • Contraindicated: AV block and sinus bradycardia• Nursing/Education: Take with food, DO NOT DC without PCP approval,Monitor heart rate and BP; assess/teach s/s of overdose: bradycardia,cyanosis, dizziness, drowsiness
Name 3 Nursing Interventions/Teachings r/t heart failure:
What is:
Administer medications; monitor for therapeutic and adverse effects• Monitor for signs of excess fluid volume, evidence of electrolyte imbalance; I&O; weigh daily; report 2 lb weight gain in 24 hr• Low sodium diet will decreased fluid retention and will thus improve cardiac output; decreased edema will increase urinary output; restrictfluid intake per md orders• Promote oxygenation, balance activity with rest encourage bed rest until stable, energy conservation• Dyspnea, position high fowlers with feet dependent to decrease venous return which will decrease the workload of the heart and increase cardiac efficiency; will improve the quality of ventilation• Monitor for s/s of dig toxicity• Support family members; emotional support
A client develops cardiogenic pulmonary edema and is extremely apprehensive. What medication can the nurse administer with physician orders that will relieve anxiety and slow respiratory rate?
A Furosemide
B Nitroglycerin
C Dopamine
D Morphine sulfate
What is D
3 important nursing interventions/teaching post heart surgery?
What is:
Client education:-cough and deep breath post op; splint incision; arm and leg exercises;pain(most stems from harvest sign); endotracheal tube/mechanicalventilator) for several hours postop; incisions; chest tubes/foley, pacemakerwires-meds: diuretics 2-3 days before surgery, aspirin/anticoagulant 1 weekbefore procedure, K+, antidysrhythmics, htn meds,Post op: bony prominences, family communication, patent airway(suction);report crackles, dangle and turn client from side to side as tolerated within 2hrs following extubation, assist to chair within 24 hrs, ambulate 25-100 ft3xs/day, Consults?, chest tubes- report 150 mL+, PAIN CONTROL, I&O, K+levels, Infection; nitro for angina, Heart healthy diet(low fat/cholesterol/salt,high fiber)Activity: Remain home 1st week, resume normal activities slowly, avoidlifting more than 15 lbs for 6-12 weeks, decreased appetite is normal forcouple weeks, assess s/s of depression
What is the difference between cardioversion and defibrillation?
What is:
Elective electrical cardioversion: nonemergency procedure to stop rapid, but not necessarily life-threatening, atrial arrhythmias; depolarizes the entire myocardium
Defibrillation is an emergency treatment for life-threatening cardiac arrhythmias, specifically ventricular fibrillation and non-perfusing ventricular tachycardia. A defibrillator delivers a dose of electric current to the heart.
What is malignant htn and 2 pieces of equipment always at the bedside with this dx?
What is:
occur in clients with undiagnosed hypertension or those who fail to follow up or comply with medical therapy– Abrupt onset; if untreated, severe symptoms andcomplications follow rapidly; hypertensive crisis– Malignant hypertension is fatal unless BP is quicklyreduced.– Kidneys, brain, and heart may be permanently damaged; arterial blood vessels may rupture or will soon; retinal hemorrhages may lead to blindness;stroke can occur; aneurysm may burst and cause hemorrhage and shock; pulmonary edema or MI,renal failure; atherosclerosis impairs circulation to the kidneys which results in renal failure
Automatic bp machine/cuff; crash cart
You are reinforcing teaching with a HF client who has anew prescription for furosemide and digoxin. Which of the following information should the nurse include(select all that apply)?
a. Weigh daily, first thing in the morningb.
b. Decrease intake of potassium.
c. Expect muscle weakness while taking digoxin.
d. Hold digoxin if heart rate < 70 bpm.
e. Decrease Na intake
What is a and e
What labs are monitored with Coumadin and what are the values?
PT:18- 24 seconds; INR 2-3-most accurate
Name 2 safety measures during suctioning?
What is :
hyperoxygenate, do not oxygenate more than 10-15 sec, elevate hob,