Cardiovascular
● Sudden cessation of drainage from mediastinal chest tube after CABG is REALLY BAD
● Defibrillation and cardioversion both depolarize myocardial cells
● Contrast dye in cardiac catheterization ha
...
Cardiovascular
● Sudden cessation of drainage from mediastinal chest tube after CABG is REALLY BAD
● Defibrillation and cardioversion both depolarize myocardial cells
● Contrast dye in cardiac catheterization has iodine base so shellfish allergy is a red flag - DON’T PROCEED
● Diagnostic enzymes for MI:
● Left-sided heart failure - “lungs”
● Right Sided Heart Failure - “body”
● Tx for HF:
● O2 is given to client experiencing MI to prevent fatal dysrhythmias
○ An ischemic heart may develop dysrhythmias
● CAD diet
● Diet: Low Sodium
● Tropical oils such as coconut and palm oil are high in saturated fat
● Dependent edema is seen with right-sided heart failure
● Primary purpose of rest after MI is to decrease workload on heart, reduce myocardial oxygen consumption
● Characteristic signs of HF
● For acute MI administer analgesic FIRST
● Cardiac patients need to limit salt intake because sodium promotes fluid retention
● Blood cholesterol level should be less than 170 for healthy adult
○ 170-199 borderline
○ 200+ high
● During an acute MI, administering O2 is a priority
● Diet change for cardiac patients: reduce fat to less than 30% or less of total caloric intake
● Don’t give beta blockers (-lol) to patients with asthma
○ Causes bronchospasm
● Blood Pressure
○ Pressure exerted by circulating volume of blood on walls of arteries, veins, & the chambers of the heart
○ Cuff should cover 40% of the upper arm - cuff that is too SMALL = false high, cuff that is too BIG = false low
○ Normal adult BP: 120/80
● Hypertension
○ Stage 1 - 130-139/80-89
○ Stage 2 - >140/90
○ Symptoms:
■ There may be NO symptoms
■ Headache
■ Dizziness
■ Anginal pain
○ Nursing care:
■ Administer antihypertensive meds
■ Teach about side effects
■ Weight control
■ Moderate alcohol intake
■ Physical activity
■ Smoking cessation
■ Importance of health care follow-up****
● Pulse Pressure
○ Difference between systolic & diastolic pressures (normal = 30-40)
● Postural (Orthostatic) Hypotension
○ Drop in BP within 3 minutes after sitting/standing up
○ Drop of >20 in systolic pressure & >10 in diastolic pressure
○ S/S:
■ Dizziness
■ Lightheadedness
■ Syncope
○ Causes:
■ Dehydration
■ Hemorrhage
■ Vasodilation
■ Tachycardia
○ Nursing Responsibilities:
■ Ensure patient safety***
○ Client Education:
■ Change positions slowly
■ Allow at least 3 minutes in between position changes
■ Dangle legs for several minutes before standing up
■ Sit down immediately if lightheadedness or dizziness occurs
● Heart Disease
○ Angina Pectoris
■ Chest pain caused by myocardial ischemia
■ Pain is aggravated by activity, relieved with rest & nitroglycerin
■ Indications: retrosternal/L sternal pain that radiates down L side of arm
■ Lasts <5 min
■ Pain descriptors: mild-moderate, squeezing, burning, aching, or bursting pressure
■ S/S: dyspnea, pallor, palpitations, dizziness, diaphoresis
○ Coronary Artery Disease (CAD)
■ Atherosclerosis causes ischemia, which results in angina, MI, & sudden cardiac death
■ Non-modifiable risk factors: age, gender, family hx
■ Modifiable risk factors: smoking, HTN, elevated serum cholesterol, inactivity, obesity, DM
○ Cardiomyopathy
■ Disease of the heart muscle, can lead to HF, dysrhythmias, & death
■ Significant dilation of ventricles w/o hypertrophy of the muscle
■ Indications: s/s of HF
○ Cor Pulmonale
■ R ventricle fails as a result of a pulmonary condition
■ S/S:exertional dyspnea, productive cough, fatigue, weakness, JVD, peripheral edema
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