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Chapter: 17 & 18

Terms in this set (79)

Physical Assessment for cardiac
Weight
Paleness
Diuretics
Flushed skin
Increased bp
Qualify of pulse
>3 lbs/24hr = fluid retention
General blood work
CBC
Lipid profile
Electrolytes
Blood glucose
Cardiac blood work
Troponin t
Troponin I
CKMB
CKMB
Specific to Cardiac muscle
Elevation = severe damage
Troponin peak?
(3-6hr after pan mI)
Injury levels are the highest 10-24hrs
CKMB peak
-6-8hr
How do you diagnose heart problems?
Blood:
CBC
lipid profile
Troponin
CKMB
BNP
Diagnostic for heart failure
Nothing > 100
non-invasive tests (heart)
EKG
CT scan
PET scan
Invasive tests (heart)
Cardiac catheter
TEE
TEE
transesophageal echocardiogram - through nose measures (EF)
EKG
(electrocardiogram) instrument used in measuring the electrical potential during a heartbeat
CT scan
a series of x-ray photographs taken from different angles and combined by computer into a composite representation of a slice through the body
PET scan
a visual display of brain activity that detects where a radioactive form of glucose goes while the brain performs a given task
CAD
coronary artery disease
coronary artery
The artery that supplies heart tissue with oxygenated blood
Atherosclerosis
condition in which fatty deposits called plaque build up on the inner walls of the arteries
arteriosclerosis
hardening of the arteries
Hypertension
high blood pressure
Pre HTN
120/80
Stage one of HTN
130/90
Stage 2 HTN
140/90
HTN Etiology
"Silent killer"
African Americans
Hispanics
Genetics
Are predispositions
primary hypertension
No precursor
secondary hypertension
high blood pressure caused by the effects of another disease
S/s of HTN
Light Headedness
Dizziness
Ringing in ears
Fatigue
Tachycardia
Nose Bleeds: Relieve pressure
treatment HTN
Lifestyle modifications such as improved diet,
stress reduction,
physical activity,
and smoking cessation
Medications
Diuretics are often first prescribed.
Potassium supplements are often needed.
PAD
peripheral artery disease
intermittent claudication
Suffocation of calf's
Since narrowing causes lack of o2
So pain when walking
collateral circulation
circulation by secondary channels after obstruction of the principal channel supplying the heart
PVD (abbreviation)
peripheral vascular disease
Veins
Brings unoxygenated blood back to
The heart via values
PVD
Valve failure
Causes backflow
Verns are very baggy
3 important s/s
3 S/S for PVD
1. Varocose veins
2. Venous insufficiency
3. DvT
DVT
deep vein thrombosis
varicose veins
enlarged, twisted veins usually in the legs
Females > males
Standing for too long
Pregnancy
Obesity
Tx for varicose veins
Sceloro therapy
SceriaDerma
Sceloro therapy
Hardening of vein
Venous insuffiecy
Vessel s don't allow blood flow
Back to the heart
Causes of Venous insuffiecy
Obesity
sitting for to long
thrombitis
Venous insuffiecy s/s
Ulcers (less painful)
Virchows triad
3 elements
Hypercoagbility
Impaired blood flow
Damage to blood vessels
S/s of DVT
Calf and groin pain
Tenderness
Sudden swelling
Larger circumference
Chest pain
Becomes embolus
Diagnostic for DVT
D- dimer test
Pt & Ptt
Platelet count
Venous duplex
People @risk for DVT
Pregnancy
Immobility
Smoking on BC
Active cancer
Jugular filter
Prevent blood clot to the brains, ischemic stroke is a precursor toa larger stroke
TPA
Tissue plasminogen Activation
TPA function
Clot Buster
Filter needed
Monitor for bleeding
Raynaud Disease
Vasospasms: constriction & dialation
Raynard Tx
Vasodialators & Aspirin
BUerger Disease
Affects veins & arteries
Young male smokers are higher risk
Aneurysm
weakened wall (mainly aorta)
out pouching
sacular aneurysm
One outpouching
Fusi- aneurysm
2 walls with an outpouching
AAA
Abdominal aortic aneurysm
AAP s/s
Flank or back pain (lower)
Pulsesting mass (no palpitation )
Bruit
Increase bp
Injured artery

'
Thorastic aneurysm - s/s
servere headaches
Chest pain
Dyspnea.
Horseness cough
Lowered urinary output
S/S of poor arterial profusion
Pallor
5'p s
5 ps
Pallor
Pain
parastheia
Paralysis
Pulselessness
Abdominal aneurysm
Distention
Pain
Anti-platelet US. Anti - coagulant
Anti platelets Aid anticoaglants
Anti-platelets
Prevents platelets sticking together
Aspirin
No clot formation
150,000-400,000.
Anti-coagulant,
Blood thinner
heparin $r Coumadin
Ace inhibitors
-Prile
Blocks action of angiotersion 1 to angiotersion 2
Regular kidney function
Patient teaching for ACE inhibitors
Take medication exactly as prescribed. Do not stop taking it abruptly.
Do not use with potassium supplements or increased dietary intake of potassium.
Move and change positions slowly to prevent postural hypotension.
This medication may cause an irritating dry cough.
Impaired taste may be an adverse effect that may last up to 2 to 3 months after the drug has been discontinued.
Monitor blood pressure and understand which parameters to report.
Don't give ACE too...
Pregnant women in their 2 & 3rd trimester
CCB
calcium channel blocker
Slows down ca movement (no Ca = no excitement)
Causes a dilation of the arterioles
Alpha Blockers
-zosin
Relaxes sm= decreased bp

Monitor for hypotension
Beta Blockers
decrease heart rate and dilate arteries by blocking beta receptors

Beta I: Heart (LOL)
Beta 2: lungs (labetalol)

Affects heart rate & bp
Vasodilators
medications that cause dilation of blood vessels

nitroglyceride (MI)
SlS vasodialater
Servere headaches
Tingling on tongue
Heparin
Anticoagulant that is used to treat and / or prevent symptoms of blood clots caused by medical condition
Heparin pt. teaching
Heparin does not dissolve clots; it stops new clots from forming

Don't use if u nave a lack of platelets

Never flush wit Iv
Heparin monitoring
Monitor aPTT (should be 1.5-2 times 30-40 seconds), have protamine sulfate ready
Coumadin (warfarin)
Prevents blood clots from forming or growing larger (blood thinner)
Coumadin pt teaching
Dose/timing of meds: take at same time everyday... takes a few days to reach therapeutic levels
-Observe for bleeding
-(easy bruising)
-avoid ASA and NSAIDS: also are AC
-Diet concerns about healthy foods high in vit k... do not limit healthy foods just cause they're high in Vit K, adjust dose of drug to accommodate for Vit K in diet, don't adjust vt K in diet for the drug
Aspirin
Antiplatelet blood thinner that reduces cell's ability to clump together. Can reduce serious problems: stroke
aspirin pt teaching
Take medication exactly as directed, do not double dose. Notify HCP promptly if fever, chills, sore throat or unusual bleeding or bruising occurs.Ovoid taking OTC meds containing aspirin or NSAID's w/out consulting HCP.
Aspirin monitoring
Bun, creatine, glucose, urine

Given PO NOT IV
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