what are some signs and symptoms of digoxin toxicity?
GI upset (nausea, vomiting, diarrhea, abdominal pain)
confusion
yellow rings around vision/colored vision
dysrhythmias
what does ONMA stand for?
Oxygen
Nitro
Morphine (decreases BP, HR and venous return to reduce myocardial oxygen consumption)
Aspirin (324mg)
how often must a client with heart failure be weighed?
Daily before breakfast
why must a patient with a pacemaker notify the physician for a heart rate of less than 60?
Pacemaker is not functioning appropriately
calculate the BPM based on the 6 second tele strip:
30 BPM. NOT GOOD.
(6 second strip x10 = beats per minute)
Atropine. If symptomatic, we sedate and attempt external pacing.
What blood pressure reading characterizes a hypertensive crisis?
BP > 180/120
What blood test is a biomarker for cardiac damage?
Troponin
less than or equal to 0.03 ng/mL
What lung sounds would you expect to auscultate for a patient diagnosed with Left Sided Heart failure?
crackles
wheezes
What is cardioversion?
It is used to correct dangerous arrhythmias.
Identify the Rhythm
Atrial Fibrillation
what are key considerations when placing a patient on a statin?
check liver function tests routinely
report any signs of muscle pain/aching (rhabdomyolysis)
Do not take with grapefruit juice
What are characteristic signs of a myocardial infarction?
Chest pain Dyspnea
Nausea/Vomiting Diaphoresis
Radiation to jaw, shoulder, back, or arm
What are 3 expected signs and symptoms characteristic of right sided heart failure?
Ascites Dependent Edema
Anorexia and GI c/o Weight Gain
Distended Jugular Veins Hepatosplenomegaly
Increased Peripheral Venous Pressure
What blood test measures the "stretch" factor of the heart and pressure changes related to fluid volume?
BNP
<100 pg/mL
Identify the Rhythm
Ventricular Tachycardia
What are 2 organs that are very sensitive to uncontrolled hypertension?
Eyes
Kidneys
Heart
Brain
At what point does a patient with diagnosed angina notify their physician of chest pain when using nitro?
after using nitro PRN q5min 3 times without resolution of pain
What electrolyte abnormality increases a patient's risk of developing Digoxin toxicity?
hypokalemia
Your client has undergone a permanent pacemaker placement surgery. Provide 3 key pieces of education for this patient.
Do not initially lift arm away from the body
Keep incision dry
Monitor for drainage, erythema, or fever
Avoid contact activities
Avoid generators or MRIs
Wear a medical alert bracelet
Carry pacemaker card information
Use phone on opposite side of the body
What changes an EKG strip would make you suspect an MI?
ST elevation- STEMI!! (myocardial infarction)
ST depression or inversion- (myocardial ischemia)
ACLS Medical Training
why does HTN cause cardiomyopathy and heart failure?
Narrowed arteries and higher causes the heart to work harder to pump the blood.
Over time, a higher workload leads to an enlarged heart, and it becomes thicker and larger- it becomes less efficient and is unable to meet the body's oxygen needs.
What factors increase risk of coronary artery disease?
> 40 years old familial history
post-menopausal women high LDL
women on hormone replacement therapy
smoking diabetes
obesity men
Your client is ordered a low-sodium diet. In addition to education on not adding salt at the table, provide 4 additional foods that your client should avoid to decrease dietary sodium.
Processed meats canned soups/broths
canned beans Sauces/Condiments
Canned meats Fast Foods
Junk Food Pickled Veggies
TV dinners/ frozen meals
Sardines and other canned fish
Why is cardiac tamponade life threatening?
What is the treatment?
Excessive fluid restricts filling and pumping of the heart.
extreme hypotension-> organ failure-> shock-> death
Pericardiocentesis
What is your immediate intervention when finding a Full Code patient in this rhythm?
CPR!!
then, call for help, defibrillate with AED, and call 911