Module 7
If a patient shows ST elevation on the ECG then what is the next step?
Cardiac Cath Lab
What do you want to monitors for post op with PCI, if any of these signs show what is next?
Chest pain
ST Elevation
Bleeding at insertion cite
Reaction to contrast
Hypotension
Hypokalemia
Dysrhythmias
NEXT: Call provider/rapid response
Abdominal, Flank or leg pain
Tachycardia
Nausea
Changes in LOC
If a patient with diabetes insipidus starts to show signs of hypovolemia what can happen next?
Shock
Coma
Signs of cushing disease?
Moon face
Hump back
Enlarged abdomen
Thin extremities
Bruises easily
Admitted with NSTEMI TO cardiac unit
Try to treat with meds
What medications will the patient be sent home with who had a PCI?
Two antiplatelet
Treatment of Addisons crisis?
Aggressive fluid replacement
IV hydrocortisone
IV vasopressors
Treat the hyperkalemia
What are nursing interventions for diabetes insipidus?
Replace fluids and electrolyte
Oral chlorpropamide
Desmopressin acetate
Hypertonic saline
I and Os
Vitals
Daily weights
Interventions for cushing disease?
Restore fluid balance
Prevent injury
Prevent infection
Prevent acute adrenal insufficiency
If a patient doesn't show ST elevation on ECG and doesn't have positive troponin but still has cardiac symptoms whats next?
Serial EKGs and troponin to look for changes
Stress test if those are negative
Signs of Addisons disease?
Hyperkalemia
Hyponatremia
Muscle weakness
Hypoglycemia
Diarrhea
Orthostatic hypotension
What is the treatment for hyperkalemia?
Dextrose and Insulin
Patient education with diabetes insipidus?
Teach them to weigh themselves
monitor weight
Lifelong vasopressin
early detection of dehydration
What are hyperpituitarism disease?
Cushings
SIADH
What is stable chronic angina?
Chest pain that relieve with rest
Patient education with Addison's disease?
Lifelong hormone replacement
Prednisone and Fludrocortisone
Regular feeding
Adequate rest
Avoid stress
What are the nursing interventions for addisons?
Monitor for arrhythmias
hypotension
check vitals frequently
monitor labs
glucose hourly
Signs of SIADH?
Confusion
Seizures
LOC
Weight gain/edema
muscle cramps/weakness
Oliguria
What is hypopituitarism diease?
Addisons
Diabetes insipidus
What is unstable angina?
Chest pain with rest or exertion
causes severe activity limitation
When can addisons crisis happen?
When patient stops taking their steroids'
Signs of diabetes insipidus?
Polyuria
Polydipsia
Weakness
Fatigue
Interventions for SIADH?
Restrict fluids
Sodium Chloride
Diuretics
monitor for fluid overload
safe environment
Nuero changes
What is the surgical treatment for hyperpituitarism?
Hypophysectomy