Medications
This medication prevents the opening of calcium channels, resulting in arterial dilation
What is Calcium Channel Blockers
amlodipine (Norvasc)
diltiazem (Cardizem, Tiazac)
felodipine (Plendil)
verapamil (Isotopin)
Remember, ends in ines
Amount of ventricular stretch, affected by fluid infusions or vascular dilation
Preload
Originating from the SA node, HR>100 but less than 120, increased demand for CO, or reduced stroke volume
sympthethetic activity=venous constriction
decreased parasympathetic activity
common causes=fever, hyperthyroidism, pain, increased metabolism, low blood pressure, hypoxia
Sinus tachycardia
Anti thrombotic-NSAID-asp, Warfarin, heparin
HR control-beta blocker/diltiazem
rhythm conversion-amiodorone, ACE, ARB
medication regimen for A fib
Cardiac output for patient in Asystole
0
initiate CPR
get IV
prepare to defib
(Adrenergic agonist) epinephrine with asystole or PEA
This medication blocks the binding of angiotensin so vasodilation occurs to reduce blood pressure
What is Angiotensin II Receptor Antagonist (ARBS)
losartan (Cozaar)
Valsartan (Diovan)
Olmesartan (Benicar)
Measurement of vena cava/r atrium and reflects filling
pressure of r ventricle
Normal is 2-6mmHg
Central Venous Pressure
CVP>6mm Hg = elevated r ventricular preload
CVP<2mm Hg=r reduced r ventricular preload
Slowed impulse that is generated from the SA node
Increased parasympathetic activity
sleep, drugs, increased stroke volume, HTN, athletes
Sinus bradycardia
-atropine (anticholinergic)
-epinephrine (adrenergic receptor
Rupture of Coronary Plaque that develops int acute thrombus which may partially/fully obstruct the artery
coronary heart disease and arthrosclerosis are precluding conditions
females<45 years have six fold decreased risk of MI than men
ACS
Unstable angina-partial occlusion
MI-NSTEMI vs STEMI
cardiac arrest
Trauma, Toxins, Tamponade, Tension, Pnuemothorax, Thrombus
Hypoxia, Hypovolemia, Hydrogen Ion, Hypo/Hyperglycemia, Hypo/Hyperkalemia, Hyperthermia
H’s & T’s to assess during cardiac arrest
This medication flushes excess water and sodium from the body. Must watch Pottasium Levels.
Diuretics
Furosemide (loop diuretic, fast acting, pulmonary edema)
loop diuretics-furosemide (lasix), bumetanide
thiazide diuretics-low dose, assist w/BP
pottasium sparing-spironolactone, eplernone, weaker diuretic but decrease risk of salt imbalance in blood
Amount of resistance heart must overcome to open aortic valve and push blood volume out, affected by changes in venous dilation/contraction
Afterload
Irregular, irregular rhythm (irregular a/v)
Atrial fibrillation
-valvular heart disease (CHF)
-myocardial hypertrophy, fibrosis, dilation
cardiac inflammatory disease (pericarditis, myocarditis, amyloidoidosis)
Post PCI risk for nursing to be aware of
Bleeding
ACLS stops when this is acheived (not TOD)
Return of spontaneous circulation (ROSC)
Targeted Temperature Management x 24 hrs, why?
This medication blocks a chemicals that causes salt and fluid retention.
Aldosterone receptor antagonists
spironolactone
mgmt of heart failureworks at mineralocorticod receptor
This pressure reading assesses L ventricular function
Pulmonary artery pressure
Regular atrial impulse between 200-400 BPM
saw tooth p wave
Atrial flutter
Adenosine-calcium channel blockers
cardioversin
vagal maneuvers-targets the vagus nerve
Enzymatic digestion of thrombus using steptokinase and tissue plasminogen (tPA)
Thrombolysis
60 min door to balloon/needle time
Functional, Pathological defect in the AV node, Bundle of His, Bundle Branches
can result from MI or congenital heart defects
Heart blocks, 1st, 2nd, 3rd
anticholinergic-atropine
transcutaneous pacing
pacemaker implantation A paced, v-paced, ICD, dual paced
Prevents production of angiotensin II so blood vessels dilate and reduced blood pressure
ACE inhibitors- “pril”
Enalapril(Vasotec)
Lisinopril (Zestril)
Captopril
Hand Hygiene
Sterile Dressing change
catheter site assessment, avoid femoral site
remove unnecessary catheters ASAP
replace transducers, tubing, continuous, flush device, and flush solution every 96 hr.
Do not submerge in water (bathing consideration)
What HAI are these all meant to prevent?
CLABSI
Central Line Acquired Blood Stream Infection
Additional complications of central line catheters are air embolism and pneumothroax
Bizarre, widened QRS
an aberrant electrical activity not activated in the SA
PVCs
CAD, drug overdose, electrolyte disturbance, caffeine, nicotine, alcohol, HF, tachycardia, digitalis toxicity, hypoxia, acidosis
amiodarone (potassium channel blocker)
Severe complication that may occur in patient exposed to heparin containing products-fall in platelet counts and hypercoagulable state.
Heparin-induced thrombocytopenia
Idiopathic thrombocytopenia purpora-ITP-immune system attacks platelets
dessseminated intravascular coagulation-DIC-abnormal blood clots, leading to bleeding in other areas (IV fluids) acute renal failure, liver failure, respiratory distress (Severe sepsis)(d-dimer increased)Thrombocytopenic Purpura (TTP)-endothelial defect clotting in small vessels-low platelet count
This medication inhibits the effect of sympathetic nervous system to reduce oxygen need of the heart. Block effects of hormone epinephrine (adrenaline)
Beta Blockers (lol)
metoprolol
carvedilol
propanolol