NC 4- CARDIOVASCULAR PROBLEMS (25%) Flash Cards

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Title:	NC 4- CARDIOVASCULAR PROBLEMS (25%)
Description:	25% of excelsior nursing concepts 4 is composed of this subject
Number of Cards:	168
Save Count:	0
Author:	tifking737
Created:	2010-03-04
Tags:	25 4 cardiovascular nc problems
Private	No

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- Question
- Answer
- Side 3

- What is HYPERTENSION and what are the risk factors?
- prolonged elevation of systolic and diastolic blood pressure. Risk factors- race (African-American), aging, obesity, stress, elevated cholesterol levels, sodium intake, tobacco, oral contraceptives.
- What are the signs & symptoms of HYPERTENSION?
- usually none, asymptomatic. Hypertension strains the heart and lungs and may result in left ventricular hypertrophy, failure, CHF or pulmonary edema
- What are dx for HYPERTENSION?
- is made by serial blood pressure readings with a systolic greater than 140 and a diastolic greater than 90. Take two or more blood pressure readings rather than relying on one single abnormal reading
- What drugs are used to treat HYPERTENSION
- diuretics, antihypertensives , Vasodilators, Calcium blockers Beta-adrengergic blockers and ACE inhibitors
- Provide two examples of diuretics meds
- Lasix, diazide
- Provide two examples of antihypertensive meds
- Aldomet, Minipress
- Provide one example of a Vasodilator
- Nipride
- Provide two examples of Calcium blockers
- Procardia, Cardizem
- What is PERIPHERAL VASCULAR DISEASE?
- chronic inadequate blood flow in the lower extremities
- What are signs and symptoms of PERIPHERAL VASCULAR DISEASE
- moderate edema, burning, itching, prominent superficial veins, ulcers and skin changes
- Explain the treament of PERIPHERAL VASCULAR DISEASE
- aimed at vasodilation, pain relief, and maintaining skin integrity. Do NOT use a heating pad to keep extremities warm
- What are complications of PERIPHERAL VASCULAR DISEASE
- Complications include gangrene, and pressure sores
- What should be encouraged and avoided as it relates to PERIPHERAL VASCULAR DISEASE? What instructions should be given?
- Encourage walking and other leg exercise, watch for signs of decreased peripheral circulation. Avoid temperature extremes, prolonged standing, constrictive clothing or crossing the legs at the knee when seated. Provide instruction about foot care and exercise programs
- What type of drugs are used to treat PERIPHERAL VASCULAR DISEASE
- antiplatelet vasodilators anticoagulants Lipid reducers
- Questran is an example of what type of medication
- Lipid reducer
- Trenta is what type of medication
- vasodilators
- Mevacor is an example of what type of medication
- Lipid reducer
- Buerger’s Disease
- vascular disease linked to cigarette smoking and jewish ancestry between the ages of 20-40
- What is the most common symptom of buerger's disease
- Intermittent claudication of the instep
- What is Raynaud’s disease?
- episodic vasospasms precipitated by stress and exposure to cold. Common in women between puberty and age 40. Affects both hands and sometimes both feet
- What are signs and symptoms of Raynaud’s disease
- tingling and numbness, blanching that is relieved with warming
- What is GANGRENE
- lack of oxygen supply that leads to thrombosis and tissue necrosis and localized edema.
- What are signs and symptoms of GANGRENE
- severe localized pain, discoloration and swelling that usually occurs within 72 hours of surgery or trauma. Tachycardia, tachypnea and hypotension related to toxemia and hypovolemia.
- What is another name for ARTERIOSCLEROTIC HEART DISEASE
- CORONARY ARTERY DISEASE
- What is CORONARY ARTERY DISEASE?
- common disorder caused by a buildup of fatty, fibrous plaques that narrow the coronary artery lumen.
- What are non-modifiable risk factors for CORONARY ARTERY DISEASE
- Non-modifiable risk factors include age (over 50), gender (male) with increased incidence of disease in postmenopausal women (loss of the protective effects of estrogen) and family history
- CORONARY ARTERY DISEASE
- Other risk factors include stress, sedentary life-style, hypertension, obesity, cigarette smoking, diabetes mellitus, increased cholesterol, alcohol intake
- What are treatments for CORONARY ARTERY DISEASE
- - reduce lipid levels , reduce hypertension, modify diet to limit meat, dairy and high-fat foods, and quit smoking. Limit alcohol intake to 2 ounces
- clofibrate is an example of type of medication
- Lipid lowering agents
- cholestyramine is an example of type of medication
- Lipid lowering agents
- Questranis an example of type of medication
- Lipid lowering agents
- What are complications of CORONARY ARTERY DISEASE
- angina, MI, CHF, and
- What is ANGINA?
- dull squeezing or crushing pressure resulting from decreased blood flow to the heart. May radiate to the arms, usually lasts 3-5 minutes
- What are signs and symptoms of ANGINA
- sweating, pallor, nausea, vomiting, cool extremities and fainting. Associated with physical exertion, emotional excitement and exposure to cold.
- What are dx for ANGINA
- EKG: ST depression, T wave inversion during acute pain
- What are tx for ANGINA
- include beta-adrenergic blockers ( propranolol, Lopressor), and calcium channel blocers (Verapamil, Cardizem, Procardia). The aim is to decrease oxygen demand or increase myocardial oxygen supply.
- What should be noted about the storage of nitroglycerine?
- store in dark, glass, securely capped vial, kept fresh enough that it tingles when you place it under your tongue
- When nitroglycerine is given in paste form what should be noted?
- When using paste do not rub it in and rotate sites
- What patient teachings should be given as it relates to nitrolycerine?
- include keeping nitro available at all times, use at the first sign of pain and stop and rest until pain subsides. Seek medical attention if pain lasts more than 20 minutes. Instruct the patient about risk factors for MI
- Which activities commonly lead to aginal pain?
- are exposure to cold, emotional upset or excitement, exertion, smoking, heavy meals, and rushing about as well as decongestants, diet pills, caffeine and nicotine.
- Explain prevention as it relates to anginal pain?
- Prevention is the best treatment and includes reducing risk factors, reducing calories, fats, salt and getting regular exercise.
- What are complications of angina?
- Complications include arrhythmias, CHF, and MI.
- What is ABDOMINAL AORTIC ANEURYSM
- widening of the aorta. There are three types type
- What are the three types of abdominal aortic aneurysm? Which one is the most common and deadly?
- Ascending (most common and deadly), Descending or Transverse
- What are signs and symptoms of ABDOMINAL AORTIC ANEURYSM
- severe ripping, boring pain of the shoulder, neck, lower back or abdomen. Bradycardia, pericardial friction rub, pulse intensity disparit
- What is the dx test for ABDOMINAL AORTIC ANEURYSM
- Dx confirmed by x-ray
- Explain Life-threatening emergency as it relates to ABDOMINAL AORTIC ANEURYSM
- includes decreasing hypertension, myocardial contractility, pain control and relief of respiratory distress while preparing for surgical intervention. Abdominal aneurysm resection- surgical removal of a portion of weakened arterial wall with an end-to-end anastomosis to a prosthetic graft.
- What is CARDIAC FAILURE ? Which side usually fails
- heart can’t pump enough blood to meet the body’s metabolic needs. Left-sided heart failure caused mostly pulmonary
- What are general signs of cardiac failure?
- SOB, dyspnea, and a moist cough. Also crackles, and gallop rhythm: S3 and S4
- Explain signs and symptoms of right-side of the heart failure
- edema, swelling, dependent edema, jugular vein distention, hepatomegaly and weight gain
- What causes cardiac failure
- atherosclerosis, conduction defects, COPD, fluid overload, hypertension, MI, pulmonary hypertension, valvular insufficiency or stenosis
- How is heart failure dx as it relates to the left side of the heart
- by chest x-ray that shows increased pulmonary congestion and L ventricular hypertrophy
- How is heartfailure dx for the right side of the heart?
- R sided failure shows pulmonary congestion, cardiomegaly and pleural effusions on chest x-ray
- What are the interventions for cardiac heart failure?
- low-sodium diet, fluid restriction, IABP, O2 therapy, ACE inhibitors
- What are the nursing interventions for cardiac failure?
- keeping the patient in semi-fowler’s position to increase chest expansion and improve ventilation. Administer O2 to enhance arterial oxygenation. Monitor patient for fluid gain. Plan periods of relaxation for patients with cardiac failure. Restrict fluid intake after two consecutive days of weight gain.
- What is DYSRHYTHMIA ? What are the the 4 most common types?
- - abnormal electrical conduction or automaticity changes the heart rate and rhythm. The most common arrhythmias include atrial fibrillation, asystole, ventricular fibrillation, and ventricular tachycardia
- What are the signs and symptoms for atrial fibrillation
- Asymptomatic, Irregular pulse
- What are the signs and symptoms of Asystole arrhythmias
- Apnea
  Cyanosis
  No palpable blood pressure Pulselessness
- What are the signs and symptoms of ventricular fib arrhythmias
- Apnea
  Pulselessness
  No Palpable blood pressure
- What are the signs and symptoms of ventricular tachycardia arrhythmia
- Chest Pain
  Diaphoresis
  Hypotension
  Weak pulse
  Dizziness
  LOC Possible
- What 5 EKG changes are noted with Atrial fibrillation arrhythmias
- Irregular atrial rhythm
  Rate> 400/minute
  Uniform QRS complex
  Indiscernible PR interval
  No P waves
- What 4 EKG changes are with Asystole arrhythmias
- No rate or rhythm
  No P waves
  No QRS complex
  No T waves
- What 3 EKG changes are noted with Ventricular fib arrhythmias
- Rapid/chaotic ventricular rhythm
  
  No discernible P’s
  
  Wide/irregular QRS complex
- What EKG changes are noted with Ventricular tachy arrhythmias
- Ventricular rate 140-220
  
  No discernible P’s
  
  Wide/bizarre QRS complex
  
  Starts/stops suddenly
- What are the treaments for Atrial fibrillation arrhythmias
- Cardioversion
  
  Pacemaker
- What are the treaments for Asystole arrhythmias
- Atropine, epi
  
  Resuscitation
  
  Defibrillation
- What are the treaments for Ventricular tachy arrhythmias
- Antiarrhythmics
- What are the treaments for Ventricular fib arrhythmias
- Antiarrhythmics
  
  Resuscitation
  
  Defibrillation
- What are Ventricular tachy arrhythmias treatments?
- Antiarrhythmics
  
  Resuscitation
  
  Cardioversion
  
  Defib implant
- What are arrhythmias treatments?
- identifying and treating life-threatening arrhythmias (duh!)
- What is MI (MYOCARDIAL INFARCTION)?
- death to myocardial muscle related to lack of oxygen from inadequate perfusion
- What are the signs and symptoms of MI (MYOCARDIAL INFARCTION)?
- crushing substernal pain that may radiate to the jaw, back, and arms. It last longer than anginal pain and is unrelieved by rest or nitroglycerin. May also be asymptomatic. diaphoresis, pallor, arrhythmias
- What are are the ekg readinging to confirm an MI (Myocardial infration)
- EKG: enlarged Q wave, elevated ST segment, T wave inversion.
- What dx are used to confirm MI (Myocardial Infraction)
- CK, LDH, AST, and positive CK-MB fraction
- What may be used used to treat MI (Myocardial Infraction)
- beta-adrenergic blockers (propranolol-Inderal, Lopressor) . Thrombolytic therapy includes the use of Streptase, and Eminase