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Lifespan III;
Test 1 Material
183
Other
Undergraduate 4
11/06/2010

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Term
Defintion of Dysrhythmias
Definition
Abnormal Cardiac rhythum
Term
Cause of Dysrhythmias
Definition
Abnormal electrical conduction
(accessory pathways, cadiomyopathy, conduction defects, heart failure, MI valve disease)
Acid-base imbalance, alcohol, caffeine, tobacco, increased O2 demand, metabolic conditions
Term
P-wave
Definition
electrical impulse through atrium-causes atrial depolarization
Term
PR interval
Definition
time for the impulse to spread through the atria-right before ventricular contraction
Term
QRS Interval
Definition
ventricular depolarization
Term
T Wave
Definition
ventricular repolarization
Term
U Wave
Definition
Hypokalemia
Term
ST segment
Definition
time b/t ventricular depolarization and repolarization
Term
QT interval
Definition
entire time taken for electrical repolarization and depolarization of ventricles (on strip, it is the R to R interval)
Term
Normal Wave Values
Definition
P wave-.06-.12 sec
PR interval-.12-.2 sec (SA-AV node)
QRS-.04-.12 sec
ST-.12 sec
T-.16
QT-.34-.43 sec.
Term
How to calculate HR
Definition
Boxed b/t R intervals (each is 10)
Take the number of boxes X 10
Term
Normal Sinus Rhythum
Definition
Rate 60-100
P wave-.06-.12
PR-.12-.2
QRS-.04-.12
T wave upright
Term
Systematic approach to assess Cardiac Rhythm
Definition
Is there a p wave for each QRS? Is it upright?
Are the QRS evenly spaced?
Calculate P wave
Measure PR interval
Calculate ventricular rate
Measure QRS complex
ST segment and T wave-returning to baseline?
Measure QT interval
Term
Atrial Flutter
Definition
Waves flutter
Atrial rate 250-350 BPM
Patterned waves before (Called F-waves)QRS
Term
Risks with Atrial Flutter
Definition
Thrombus
AV not completely emptying, lots of times on blood thinners
Term
Atrial Fibrillation
Definition
Atrial rate: 350-600 BPM
F-waves present
QRS complex .04-.12
Term
F-waves
Definition
tooth shaped waves before QRS in A-Flutter
Term
A-Fib risks
Definition
High stroke risk, compermised CO2, VTAC
Term
Tx VTAC-w/o pulse
Definition
CPR
Term
Ventricular Tachycardia
Definition
No P waves
Ventricular rate-150-250
PR interval not measurable
QRS wide and distorted
Term
Definition of PVC
Definition
Premture ventricular contraction 3 or more PVC=VTAC
Term
Nursing Interventions Ventricular Tachycardia
Definition
Need pulse (stable)-if pulse absent-patient not perfusing If no pulse-patient not perfusing-unstable
Term
S/S of Ventricular Fibrillation
Definition
Derangement of heart rhythm; ventricle quivering like bag of worms-not beating
Ventricular and atrial rates not measurable. P wave absent, QRS not measurable.
Term
Nurs. Interventions Ventricular Fibrillation
Definition
Check leads; treat w/CPR
Term
PaceMaker
Definition
Electronic devices used to pace the heart when normal conduction pathway is damaged
Term
Pacing Circuit Components
Definition
Power source, leads, myocardium
Term
Indications for Pacemaker
Definition
Heart block (AV block, bundle branches)
Cardiomyopathy
Heart failure
Hypertensive carotid sinus syndrome (barrel receptors diminish and slow heart rate down)
SA node dysfunction
Tachydysrhythmias
Term
Patient Teaching - Pacemakers
Definition
report infections, keep incision dry for 4 days post/op, avoid lifting until cleared by Dr., avoid MRI, monitor pulse and report bradycardia, carry carda and wear medic alert bracelet
Term
ICD
Definition
(Implantable Cardioverter-defribillator)
Term
Placement ICD
Definition
Non-dominant side
Leads can become misplaced
Term
Ptnt Teaching - ICD
Definition
report s/s infection, incision dry for 4 days post/op, avoid lifting, driving or sexual activity until cleared by Dr., avoid magnets (MRI), If ICD fires, call Dr., 911 if fires more than once, medic alert bracelet
Term
Inefective Endocarditis
Definition
Inflammatory disease of heart; inside perameter of the heart
Term
Sub-Acute Endocarditis
Definition
Pre-existing valve disease. Course extends over months
Term
Acute Inefective Endocarditis
Definition
Healthy valves, rapidy progressive illness
Term
S/S Endocarditis
Definition
Endocardium infected; most likely valves are to
Term
Etiology/Patho of Inefective Endocarditis
Definition
Strep/staph infections; bacteria in blood grown on heart valves or endothelial surface previously damaged, lesions, embolization
Term
Embolization-IE
Definition
R side - Lung
L side - brain kidney
Term
Risk for IE
Definition
HIGH-prosthetic valves, shunts, vascular grafts, complex cyanotic, CHD.
MODERATE: acquired valvular dysfunction, hypertrophic cardiomyopathy, mitral valve prolapse
LOW: old grafts, CNS shunts, pacemakers, ICD, previous CABG, stents, murmurs
Term
Prophylactic Antibiotics-Endocarditis
Definition
Dental procedures, tonsillectomy, bronchoscopy, upper/lower GI, cystoscopy, laparoscopy, prostate surgery
Term
Nursg. Care-IE
Definition
Hyperthermia-fever, chills, stress on heart, administer antibiotics, pyretic, watch peaks/troughs, monitor VS, decreased CO, activity intolerance, knowledge deficit
Term
Definition Pericarditis
Definition
The sack that the heart is in
Term
CAUSES-Pericarditis
Definition
Infections (viral, bacteria, TB, fungal, toxoplasmosis, lyme disease)
Non-infections (uremia, MI, neoplasm, trauma, raditation)
Hypersensitivity or autoimmune (post MI syndrome, post pericardiotomy, rheumatic fever, drug rctions)
Term
CL Man. Pericarditis
Definition
Severe chest pain Pleuritic nature Worsens with deep inspiration, relieved by sitting, radiate to left arm, shoulder and neck, radiates to back, shoulder, upper back via phrenic nerve, pericardial friction rub heard at lower left sternal border
Term
COMPLICATIONS-Pericarditis
Definition
Effusion-fluid around the heart, distant heart sounds
Cardia Tamponade-rapidly increasing fluid around the heart, abnormal pulse rate during inspiration
Term
Nurse Mgmt-Pericarditis
Definition
Manage pain (precordium or left trapezius ridge, sharp pleuritic and increases with inspiration; relieved by sitting forward), anxiety, distinguish pain from angina pain. Bed rest; HOB 45 degrees, anti-inflammatory meds, explain not a heart attack, monitor cardiac tamponade-could drain with needle (cardiscentesis)
Term
MYOCARDITIS
Definition
Caused by virus-most common
can be bacterial, fungal, radiation therapy, chemothereapy. linked to dialated cardiomyopathy
Term
Cl. Man. Myocarditis
Definition
Looks like S/S of viral infection, fever, fatigue, malaise, myalgias, N/V; heart failure, SCD
Term
Avoid what? With Myocarditis
Definition
Digoxin
Term
Nursing Care-Myocarditis
Definition
Diuretics to decrease preload, vasodilators to decrease afterload, anticoagulants to decrease stroke risk, immunosuppresants (ribavirin and interferon), IVIG, O2, bed rest to decrease O2 demand
Term
Nursing Care Cont-Myocardititis
Definition
Watch S/S heart failure, semi-fowlers, space activities with lots of rest, quiet environment. KEEP ANXIETY DECREASED
Term
Rheumatic Fever
Definition
RF is complication of strep infections
Term
RF and Cardiac
Definition
Cardiac lesions & valve deformitites
Term
Which valve is primarily affected by RF?
Definition
Mitral most of the time.
Other valves-tricuspid and aortic can be affected also
Term
CL. Man of RF and Heart
Definition
Heart murmur or mitral stenosis; tachcardia, muffled heart sounds, chest pain, friction rub, fever, joint pain, stiffness, redness, swelling, limited ROM, non itchy pink rash
Term
RF Collaborative Care
Definition
Best rest, antibiotics, corticosteroids, non steroid anti-inflammatory drugs
Term
What are the two semilunar valves?
Definition
aortic and pulmonic
Term
What are the two atrio-ventricular valves?
Definition
Mitral and tricuspid
Term
Definition of stenosis
Definition
Constriction or narrowing of the valves-manifested by increased pressure
Term
Definition of Regurgitation
Definition
Incomplete closure of the valves causing the backflow of blood
Term
CL. Manifestations of Mitral Valve STENOSIS
Definition
DOE, palpitations, load accentuated S1, low pitched, rumbling diastolic murmur, atrial fib on ECG
Term
CL. Man of Mitro Valve REGURGITATION CAN BE ACUTE OR CHRONIC
Definition
Acute-pulmonary edema, shock, new systolic murmur Chronic-weakness, fatigue, palpitations, S3 gallop
Term
CL. Man. Mitro Valve PROLAPSE
Definition
Palpitations, dyspnea, chest pain, activity intolerance, midsystolic click
Term
CL. Man. of Aortic Valve STENOSIS
Definition
Angina, syncope, dyspnea on exertion, heart failure
Term
CL. man of Aortic Regurgitation Can be ACUTE or CHRONIC
Definition
Acute-abrupt onset of dyspnea, chest pain, L ventricular failure and shock Chronic-Fatigue, extertional dyspnea, orthopnea, systolic ejection click
Term
Cl. Man of Tricuspid Valve
Definition
Peripheral edema, ascites, diastolic low-pitched murmur w/decreased intensity during inspiration
Term
Valve disease and collaborative care
Definition
CXR, ECG, Echo, cardiac cath
Term
Non-surgical methods of treatment for valve disease
Definition
prophylactic antibiotics, NA restrictions, meds--nitrates, ace inhibitors, diuretics, B-blockers, anticoagulants, antidysrhythmics
Term
Surgical Therapy for Valve Disease
Definition
Commissurotomy, valvuloplasty, prosthetic valves
Term
Prosthetic Valves
Definition
Increased risk of thrombo-embolism, LT anticoagulant therapy, mechanical/biological valves.
Term
Nursing DX: Valvular Heart Diseased Patients
Definition
Activity intolerance, excess fluid volume, decreased cardiac output, knowledge deficit
Term
Definition of Cardiomyopathy
Definition
Group of diseases that affect the structural and functional ability of the myocardium
Term
3 types of Cardiomyopathy
Definition
Dilated, Hypertrophic, restrictive
Term
Dilated Cardiomyopathy
Definition
Seen with alcohol/cocaine abuse, genetic, hypertension, ischemia, muscular dystrophy, myocarditis, pregnancy, valvular heart disease
Term
S/S Dilated Cardiomyopathy
Definition
Fatigue, weakness, palpitations, dyspnea, cardiomegaly, decreased contractility, mitral valve incompetence, tachycardia, atrial & ventricular dysrhythmias
Term
S/S hypertrophic cardiomyopathy
Definition
Seen with Aortic stenosis, genetic, HTN, exertional dyspnea, fatigue, angina, syncope, palpitations, moderate cardiomegaly, decreased/increased contractility, mitral valve incompetence, normal to decreased CO
Term
S/S Restrictive Cardiomyopathy
Definition
Seen with amyloidosis, endomyocardial fibrosis, tumors, post radiation therapy, sarcoidosis, ventricular thrombus; dyspnea/fatigue, mild cardiomegaly, normal to decreased contractility, normal to decreased CO
Term
Nursing Care & Cardiomyopathy
Definition
Treat underlying cause.
Term
Cardiomyopathy Meds
Definition
Nitrates (increase profusion), B-blockers, antidysrhythmics, Ace inhibitors, diuretics, anticoagulants (thrombosis)
Term
Dilated Cardiomyopathy
Definition
End stage cardiomyopathy
Term
Focus/Goal of dilated Cardiomyopathy
Definition
Palliation of symptoms; decrease afterload, treat dysrhythmias, prevent thrombi formation. May require docutamine, ventricular assist
Term
Cure for Dilated Cardiomyopathy
Definition
Heart Transplant
Term
Goal Hypertrophic Cardiomyopathy
Definition
Decrease ventricular contractility and relieve left ventricular outflow obstruction
Term
MEDS for Hypertrophic Cardiomyopathy
Definition
B-blockers, calcium channel blockers, amiodarone, ICD
Term
What med do you not give for Hypertrophic Cardiomyopathy
Definition
Digoxin
Term
Definition of SHOCK
Definition
Decreased tissue profusion and impaired cellular metabolism; imbalance b/t supply and demand for O2 and nutrients; may lead to multi-organ syndrome (MOS)
Term
Classifications of Shock
Definition
Low blood flow
Mal-distribution
Term
What shock is low blood flow shock
Definition
cardiogenic, hypovolemic, relative hypovolemic
Term
What kind of shock is mal-distributive flood flow shock
Definition
Neurogenic, anaphylactic, septic
Term
S/S Cardiogenic Shock
Definition
tachycardia, tachypnea, hypotension, narrowed pulse pressure, crackles, cool clammy skin, cyanosis, pallor, decreased cap refill, decreased urine output
Term
S/S Hypovolemic Shock
Definition
Hypotension, tachycardia, tachypnea, decreased urine output
Term
S/S Neurogenic Shock
Definition
bradycardia, hypotension, hyperthermia at first then hypothermia, dry skin, loss of bowel and bladder tone
Term
S/S Anaphylactic Shock
Definition
facial flushing, swelling of the lips, tongue, dizziness, edema, wheezing, stridor, severe bronchospasms and chest pain
Term
S/S Septic Shock
Definition
Hypotension with widening of the pulse pressure-then crashing BP, tachycardia/tachypnea, respiratory arrest, does not respont to fluid resuscitation
Term
3 Stages of shock
Definition
compensatory, progressive, refractory
Term
S/S Compensatory Stage of Shock
Definition
tachycardia, tachypnea, pale cool skin, decreased uring output, hypoactive bowel sounds, decreased pO2, decreased O2 stats
Term
S/S of progressive stage of shock
Definition
decreased LOC, hypotension, tachycardia, pulmonary edema, cool clammy skin, thrombin clots in micro-circulation
Term
S/S of refractory stage
Definition
unresponsiveness, hypotension, bradycardia, respiratory failure, ischemic bowel, third spacing, mottled cyanotic skin
Term
Collaborative Care for Shock patient
Definition
O2 and ventilatory support; continuous monitoring of VS, mechanical ventilation, fluid resuscitation
Term
Risk Factors for HTN
Definition
Gender, ethnic group, lifestyle choices, diet, access to healthcare
Term
End organ damage in HTN affect......
Definition
MI, heart failure, stroke, renal failure
Term
3 Factors that affect CO
Definition
Cardiac-the heart rate
Renal-fluid volume
Sympathetic Nervous System-vasoconstriction and increased HR
Term
What is SVR
Definition
The force opposing the movement of blood within the vessels
Term
Three factors that affect SVR
Definition
Vasoconstrictors (angiotensin & norepinephrine)
local regulators (prostaglandins=vasodilation
endothelin=vasoconstriction
SNS stimulation
Term
Responsibilities of SNS
Definition
increase HR, increase myocardial contractility, wide spread vasoconstriction, increased release of renin from the kidneys
Net Effect-increase CO and SVR
Term
Renal system r/t HTN
Definition
Controls sodium excretion and extracellular fluid volume. If sodium level is high=H2O retention
Term
Job of endocrine system and HTN
Definition
release of NE and E.
Term
What is the job of NE r/t HTN
Definition
increases the heart rate
Term
Job of epinephrine in HTN
Definition
Increase HR and myocardial contractility and causes vasoconstruction of peripheral arterioles
Term
Risk Factors for Primary HTN
Definition
age >50, diabetes, high lipids, high sodium diet, obesity, smoking, seditary lifestyle
Term
Definition of primary HTN
Definition
Increased BP without a cause
Associated with increased SNS activity and over production of aldosterone
Term
Characteristics of Pre HTN
Definition
Systolic-120-139
Diastolic-80-89
Term
Characteristics of Stage I HTN
Definition
SYS-140-159
DYS-90-99
Term
Characteristics of Stage II HTN
Definition
SYS->160
DYS->100
Term
Causes of Secondary HTN
Definition
Narrowing of aorta, renal and hepatic disease, endocrine disorders, head injury, sleep apnea, pregnancy
Term
Patho of Primary HTN
Definition
Increased CO, increased system vascular resistance, heredity, high sodium western diet, insulin resistance
Term
4 Organs that damage occurs from HTN
Definition
Heart, peripheral and cerebral vasculature, kidneys, retina
Term
What is CAD
Definition
HBP flow injures vascular endothelium...it becomes thick and has places for plaque to get stuck
Term
Relationship b/t HTN and Cerebrovascular disease
Definition
Stroke risk increased by 4x; TIA and stroke are due to plaque formation and embolization
Term
Left Ventricular Hypertrophy
Definition
Increased left vascular resistance causes the LV to work harder, so it gets thick, stretched and boggy.
Term
How does HTN affect the kidneys?
Definition
causes nephrosclerosis; increased pressure causes narrowing of the arteries and arterioles ---death of nephrons
Term
HTN and Retinal Damage
Definition
Damage to retinal vessels indicate damage to other blood vessels-heart, kidney & brain. Leads to blurred vision, retinal hemorrhage and loss of vision
Term
What studies are done to diagnose HTN
Definition
BP-two or more readings (supine and sitting up), BUN, creatine, blood glucose, EKG, hx of stroke? Tia? pulses-all present? bruits?
Term
Collaborative care for HTN
Definition
weight reduction, DASH eating, sodium restriction, moderate alcohol, regular aerobic exercise, avoid tobacco and caffine
Term
What is DASH eating?
Definition
Low sodium, decreased calories, increased fiber
Term
What is the Goal of DASH eating
Definition
Decrease sodium to 2g p/day. Teach patient how to read labels
Term
5 HTN Medications
Definition
Diuretics, adrenergic inhibitors, direct vasodilators, angiotensin inhibitors, calcium channel blockers
Term
Use of diuretics for HTN
Definition
First line of therapy for mgmt of HTN. Inhibit sodium reabsorption in distal tubial.
Term
Use of Adrenergic Inhibitors in HTN
Definition
diminishing the SNS that increase BP
Term
Use of Vasodilators for HTN
Definition
Decrease BP by relaxing vascular smooth muscle and reducing systemic vascular resistance.
Term
Nursing interventions for Adrenergic Inhibitors
Definition
monitor BP, urine output, orthostatic hypertension
Term
MOA for Ace Inhibitors
Definition
block the conversion of angiotensin I to angiotensin II
Term
Nursing Interventions for Ace Inhibitors
Definition
monitor BP, kidney function, creatin, BUN, potassium, diet...avoid high potassium foods
Term
MOA calcium channel blockers
Definition
increase sodium excretion and cause vasodilation
Term
Nursing Implications of calcium channel blockers
Definition
decreased HR, decreased contractility, bradycardia, N/V, HA, dizziness, peripheral edema
Term
TX of HTN
Definition
diuretics and lifestyle modifications; 2 or more antihypertensive meds
Term
Patient teaching-HTN
Definition
drug side effects & precautions, S/S orthostatic hypertension, encourage lifestyle changes, BP and meaning, BP monitoring, therapy does not cure-but controls, dangers of uncontrolled HTN
Term
Patient teaching HTN Meds
Definition
Name, dose and SE of all meds, take meds regularly, do not stop abruptly, dont adjust dose by ones self, s/s of orthostatic htn, sexual problems consult dr before taking OTC meds
Term
Cl. Man. of Orthostatic HTN
Definition
drop in SBP of 20 or more
drop in DBP of 10 or more
Increased HR of 20 when patient changes position
Dizziness, faint or light headed, BP will drop, HR will increase to compensate
Term
HTN is associated with......in the older adult
Definition
loss of tissue elasticity, myocardial stiffness, increased peripheral vascular resistance, decreased adrenergic receptor, sensitivity, blunting of the baroreceptors, decreased renin function.
Term
Characteristics of HTN Crisis
Definition
DBP > 140
Term
Effects of HTN crisis
Definition
Can be deadly and cause organ damage, seizure, shock, MI and encephalopathy; could see acute confussion
Term
Cl. Man of Hypertensive crisis
Definition
HA, N/V, seizure, confusion, coma, blurred vision
Term
Tx of Hypertensive Crisis
Definition
vasodilators, nitropress, apresoline, vasotec. Do not lower blood pressure too quickly
Term
Patho of CAD
Definition
fat sticks to inside of arteries and harden; hardening of the arteries, endothelial damage caused by inflammation r/t tobacco, HTN, DM
Term
Modifiable risk factors for CAD
Definition
serum lipids, HTN, smoking, physical inactivity, obesity, metabolic syndrome, stress, homocystine levels
Term
Non-modifiable risk factors for CAD
Definition
age, gender, ethnicity, family hx, genetics, more women than men, more caucasions than AA
Term
Nursing Interventions for CAD
Definition
maintain healthy weight, reduce salt, low fat, low cholesterol diet, increase exercise, avoid tobacco & alcohol, encourage plant proteins, high fiber diet
Term
Patient teaching CAD
Definition
exercise 30 min 5x p/w; encourage relaxation, controlled anxiety/depression, obesity-encourage change in eating, diabetes, smoking cessation
Term
Cl. Man of CAD
Definition
Angina-chest pain
Term
Types of Angina
Definition
Stable and Chronic Stable
Term
What is PQRST?
Definition
Precipitating events; quality of pain; radiation of pain; severity of pain; timing
Term
Cl. Man of Chronic Stable Angina
Definition
ache in the chest (pressure/squeezing), does not change with position or breathing, sub-sternal, often radiates to jaw, shoulder, or arm, EKG shows ST segment depression-not elevation; pleuritic pain may change
Term
Precipitating factors for Angina
Definition
Increased HR, decreased time spent in diastole, temperature extremes, strong emotions, tobacco and drug use, sexual activity
Term
Tx of acute angina
Definition
Administer O2, aspirin to thin blood, nitrates to dilate the coronary arteries
Term
Tx goals of acute angina
Definition
increase O2 supply and decrease O2 demand
Term
Tx of Chronic Stable Angina
****ABCDEF****
Definition
Antiplatelet, B-blockers, cigarette smoking and cholesterol, diet and diabetes, educate and exercise, flu shot
Term
Angina Diagnostic Studies
Definition
12 lead ECG, echo cardiogram, exercise stress test, coronary angiography
Term
Characteristics of chronic stable
Definition
pain lasts 5-15 min, provoked by exertion, relieved by rest/nitroglycerin
Term
Characteristics of stable angina
Definition
new onset, increasing frequency, duration or severity, occurs with rest or minimal exertion, not relieved by nitro
Term
Characteristics of unstable angina
Definition
change in pattern of pain, occurs w/o excertion-during sleep-pain at rest, more pain, fatigue and SOB
Term
MI
Definition
Myocardial infarction
Term
Cl. Man of MI
Definition
pain, sns stimulation, cardiovascular, N/V, fever. No change with nitro or position changes.
Term
Diaphoresis and MI
Definition
skin is cool and clamy, BP and HR initially increase, as heart decompensates, BP drops.
Term
Complications of MI-s
Definition
dysrhythmias, heart failure-crackles, cardiogenic shock, MV regurgitation, ventricular aneurism, pericardial friction rub
Term
Ptnt care with MI
Definition
O2 2-4L per nasal cannula, VSQ15m, bed rest (decreases cardio demand)
Term
Risk factors for SCD
(Sudden cardiac death)
Definition
left ventricular ejection fraction less than 30%, post MI ventricular dysrhythmia, male gender, family hx, smokers, cardiomyopathy, DM, HTN, high cholesterol
Term
Impaired cardiac pump caused by......
Definition
anything affecting preload, afterload, myocardial contractility, HR or metabolic rate
Term
Heart failure is associated with......
Definition
Cardiovascular disease, long standing HTN, CAD, MI
Term
Chronic causes of HF
Definition
CAD, HTN, rheumatic heart, congenital HD, cor pulmonale, cardiomyopathy, bacterial endocarditis, valvular disorders
Term
Acute causes of HF
Definition
MI, dysrhythmias, PE, anaphylaxis, VSD, ruptured papillary muscle, myocarditis
Term
Precipitating conditions of HF
Definition
anemia, infection, hypothyroidism, dysrhythmia, bacterial endocarditis, pulmonary disease and hypervolemia
Term
HF is classified into.......
Definition
Systolic and diastolic failure
Term
Characteristics of SHF
Definition
results from the inability of the heart to pump blood. LV looses its ability to eject blood forward through aorta. LV becomes big and boggy, LVEF is decreased
Term
Characteristics of DHF
Definition
impaired ability of the ventricles to relax and fill during diastole, ventricle can't handle the volume, so blood backs up into pulmonary or systemic vascular systems.
Term
Mixed S/D HF
Definition
Patient is really in trouble, have decreased BP and decreased HR, impaired renal profusion, poor activity tolerance
Term
S/S left sided heart failure
Definition
blood backs up into the left atrium and pulmonary vein, crackles, dyspnea, tachypnea, S3 and S4 heart sounds, mental status change, fatigue, anxiety, orthopnea, dry hacking couph, nocturia. pink tinged frothy sputum in advanced pulmonary edema.
Term
What does the patient look like with LHF
Definition
sleeping on lots of pillows (6), going to bathroom many times per night.
Term
Characteristics of Right side heart failure
Definition
blood backs up into the right atria and venous circulation
Term
What does the patient look like with Right side HF?
Definition
tree trunks for legs, hands/feet swollen, high BP, bloated, weight gain, nausea, fatigue and anxiety
Term
How to care for Pulmonary Edema
Definition
high fowlers position, O2 by mask, VS q1h, continuous telemetry monitoring, drug therapy
Term
Drug therapy for pulmonary edema
Definition
diuretics, nitro, morphine IV, inotropic therapy (increases cardiac output)
Term
Cl. Man of Chronic heart failure
Definition
fatigue, dyspnea, tachycardia, edema, nocturia, skin changes, mental status changes, chest pain
Term
Care of the ptnt with Chronic heart failure
Definition
O2 therapy, rest periods (keeping O2 demand low), drug therapy, daily weights, sodium restrictions, ventricular assist devices
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