Term
Defintion of Dysrhythmias |
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Definition
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Term
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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 |
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Term
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Definition
electrical impulse through atrium-causes atrial depolarization |
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Term
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Definition
time for the impulse to spread through the atria-right before ventricular contraction |
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Term
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Definition
ventricular depolarization |
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Term
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Definition
ventricular repolarization |
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Term
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Definition
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Term
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Definition
time b/t ventricular depolarization and repolarization |
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Term
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Definition
entire time taken for electrical repolarization and depolarization of ventricles (on strip, it is the R to R interval) |
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Term
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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. |
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Term
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Definition
Boxed b/t R intervals (each is 10) Take the number of boxes X 10 |
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Term
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Definition
Rate 60-100 P wave-.06-.12 PR-.12-.2 QRS-.04-.12 T wave upright |
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Term
Systematic approach to assess Cardiac Rhythm |
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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 |
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Term
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Definition
Waves flutter Atrial rate 250-350 BPM Patterned waves before (Called F-waves)QRS |
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Term
Risks with Atrial Flutter |
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Definition
Thrombus AV not completely emptying, lots of times on blood thinners |
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Term
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Definition
Atrial rate: 350-600 BPM F-waves present QRS complex .04-.12 |
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Term
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Definition
tooth shaped waves before QRS in A-Flutter |
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Term
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Definition
High stroke risk, compermised CO2, VTAC |
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Term
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Definition
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Term
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Definition
No P waves Ventricular rate-150-250 PR interval not measurable QRS wide and distorted |
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Term
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Definition
Premture ventricular contraction 3 or more PVC=VTAC |
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Term
Nursing Interventions Ventricular Tachycardia |
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Definition
Need pulse (stable)-if pulse absent-patient not perfusing If no pulse-patient not perfusing-unstable |
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Term
S/S of Ventricular Fibrillation |
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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. |
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Term
Nurs. Interventions Ventricular Fibrillation |
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Definition
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Term
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Definition
Electronic devices used to pace the heart when normal conduction pathway is damaged |
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Term
Pacing Circuit Components |
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Definition
Power source, leads, myocardium |
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Term
Indications for Pacemaker |
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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 |
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Term
Patient Teaching - Pacemakers |
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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 |
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Term
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Definition
(Implantable Cardioverter-defribillator) |
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Term
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Definition
Non-dominant side Leads can become misplaced |
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Term
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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 |
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Term
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Definition
Inflammatory disease of heart; inside perameter of the heart |
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Term
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Definition
Pre-existing valve disease. Course extends over months |
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Term
Acute Inefective Endocarditis |
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Definition
Healthy valves, rapidy progressive illness |
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Term
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Definition
Endocardium infected; most likely valves are to |
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Term
Etiology/Patho of Inefective Endocarditis |
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Definition
Strep/staph infections; bacteria in blood grown on heart valves or endothelial surface previously damaged, lesions, embolization |
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Term
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Definition
R side - Lung L side - brain kidney |
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Term
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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 |
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Term
Prophylactic Antibiotics-Endocarditis |
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Definition
Dental procedures, tonsillectomy, bronchoscopy, upper/lower GI, cystoscopy, laparoscopy, prostate surgery |
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Term
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Definition
Hyperthermia-fever, chills, stress on heart, administer antibiotics, pyretic, watch peaks/troughs, monitor VS, decreased CO, activity intolerance, knowledge deficit |
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Term
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Definition
The sack that the heart is in |
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Term
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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) |
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Term
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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 |
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Term
COMPLICATIONS-Pericarditis |
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Definition
Effusion-fluid around the heart, distant heart sounds Cardia Tamponade-rapidly increasing fluid around the heart, abnormal pulse rate during inspiration |
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Term
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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) |
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Term
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Definition
Caused by virus-most common can be bacterial, fungal, radiation therapy, chemothereapy. linked to dialated cardiomyopathy |
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Term
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Definition
Looks like S/S of viral infection, fever, fatigue, malaise, myalgias, N/V; heart failure, SCD |
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Term
Avoid what? With Myocarditis |
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Definition
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Term
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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 |
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Term
Nursing Care Cont-Myocardititis |
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Definition
Watch S/S heart failure, semi-fowlers, space activities with lots of rest, quiet environment. KEEP ANXIETY DECREASED |
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Term
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Definition
RF is complication of strep infections |
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Term
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Definition
Cardiac lesions & valve deformitites |
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Term
Which valve is primarily affected by RF? |
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Definition
Mitral most of the time. Other valves-tricuspid and aortic can be affected also |
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Term
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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 |
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Term
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Definition
Best rest, antibiotics, corticosteroids, non steroid anti-inflammatory drugs |
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Term
What are the two semilunar valves? |
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Definition
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Term
What are the two atrio-ventricular valves? |
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Definition
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Term
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Definition
Constriction or narrowing of the valves-manifested by increased pressure |
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Term
Definition of Regurgitation |
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Definition
Incomplete closure of the valves causing the backflow of blood |
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Term
CL. Manifestations of Mitral Valve STENOSIS |
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Definition
DOE, palpitations, load accentuated S1, low pitched, rumbling diastolic murmur, atrial fib on ECG |
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Term
CL. Man of Mitro Valve REGURGITATION CAN BE ACUTE OR CHRONIC |
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Definition
Acute-pulmonary edema, shock, new systolic murmur Chronic-weakness, fatigue, palpitations, S3 gallop |
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Term
CL. Man. Mitro Valve PROLAPSE |
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Definition
Palpitations, dyspnea, chest pain, activity intolerance, midsystolic click |
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Term
CL. Man. of Aortic Valve STENOSIS |
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Definition
Angina, syncope, dyspnea on exertion, heart failure |
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Term
CL. man of Aortic Regurgitation Can be ACUTE or CHRONIC |
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Definition
Acute-abrupt onset of dyspnea, chest pain, L ventricular failure and shock Chronic-Fatigue, extertional dyspnea, orthopnea, systolic ejection click |
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Term
Cl. Man of Tricuspid Valve |
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Definition
Peripheral edema, ascites, diastolic low-pitched murmur w/decreased intensity during inspiration |
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Term
Valve disease and collaborative care |
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Definition
CXR, ECG, Echo, cardiac cath |
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Term
Non-surgical methods of treatment for valve disease |
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Definition
prophylactic antibiotics, NA restrictions, meds--nitrates, ace inhibitors, diuretics, B-blockers, anticoagulants, antidysrhythmics |
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Term
Surgical Therapy for Valve Disease |
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Definition
Commissurotomy, valvuloplasty, prosthetic valves |
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Term
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Definition
Increased risk of thrombo-embolism, LT anticoagulant therapy, mechanical/biological valves. |
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Term
Nursing DX: Valvular Heart Diseased Patients |
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Definition
Activity intolerance, excess fluid volume, decreased cardiac output, knowledge deficit |
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Term
Definition of Cardiomyopathy |
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Definition
Group of diseases that affect the structural and functional ability of the myocardium |
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Term
3 types of Cardiomyopathy |
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Definition
Dilated, Hypertrophic, restrictive |
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Term
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Definition
Seen with alcohol/cocaine abuse, genetic, hypertension, ischemia, muscular dystrophy, myocarditis, pregnancy, valvular heart disease |
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Term
S/S Dilated Cardiomyopathy |
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Definition
Fatigue, weakness, palpitations, dyspnea, cardiomegaly, decreased contractility, mitral valve incompetence, tachycardia, atrial & ventricular dysrhythmias |
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Term
S/S hypertrophic cardiomyopathy |
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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 |
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Term
S/S Restrictive Cardiomyopathy |
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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 |
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Term
Nursing Care & Cardiomyopathy |
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Definition
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Term
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Definition
Nitrates (increase profusion), B-blockers, antidysrhythmics, Ace inhibitors, diuretics, anticoagulants (thrombosis) |
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Term
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Definition
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Term
Focus/Goal of dilated Cardiomyopathy |
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Definition
Palliation of symptoms; decrease afterload, treat dysrhythmias, prevent thrombi formation. May require docutamine, ventricular assist |
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Term
Cure for Dilated Cardiomyopathy |
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Definition
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Term
Goal Hypertrophic Cardiomyopathy |
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Definition
Decrease ventricular contractility and relieve left ventricular outflow obstruction |
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Term
MEDS for Hypertrophic Cardiomyopathy |
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Definition
B-blockers, calcium channel blockers, amiodarone, ICD |
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Term
What med do you not give for Hypertrophic Cardiomyopathy |
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Definition
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Term
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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) |
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Term
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Definition
Low blood flow Mal-distribution |
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Term
What shock is low blood flow shock |
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Definition
cardiogenic, hypovolemic, relative hypovolemic |
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Term
What kind of shock is mal-distributive flood flow shock |
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Definition
Neurogenic, anaphylactic, septic |
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Term
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Definition
tachycardia, tachypnea, hypotension, narrowed pulse pressure, crackles, cool clammy skin, cyanosis, pallor, decreased cap refill, decreased urine output |
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Term
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Definition
Hypotension, tachycardia, tachypnea, decreased urine output |
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Term
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Definition
bradycardia, hypotension, hyperthermia at first then hypothermia, dry skin, loss of bowel and bladder tone |
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Term
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Definition
facial flushing, swelling of the lips, tongue, dizziness, edema, wheezing, stridor, severe bronchospasms and chest pain |
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Term
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Definition
Hypotension with widening of the pulse pressure-then crashing BP, tachycardia/tachypnea, respiratory arrest, does not respont to fluid resuscitation |
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Term
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Definition
compensatory, progressive, refractory |
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Term
S/S Compensatory Stage of Shock |
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Definition
tachycardia, tachypnea, pale cool skin, decreased uring output, hypoactive bowel sounds, decreased pO2, decreased O2 stats |
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Term
S/S of progressive stage of shock |
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Definition
decreased LOC, hypotension, tachycardia, pulmonary edema, cool clammy skin, thrombin clots in micro-circulation |
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Term
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Definition
unresponsiveness, hypotension, bradycardia, respiratory failure, ischemic bowel, third spacing, mottled cyanotic skin |
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Term
Collaborative Care for Shock patient |
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Definition
O2 and ventilatory support; continuous monitoring of VS, mechanical ventilation, fluid resuscitation |
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Term
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Definition
Gender, ethnic group, lifestyle choices, diet, access to healthcare |
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Term
End organ damage in HTN affect...... |
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Definition
MI, heart failure, stroke, renal failure |
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Term
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Definition
Cardiac-the heart rate Renal-fluid volume Sympathetic Nervous System-vasoconstriction and increased HR |
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Term
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Definition
The force opposing the movement of blood within the vessels |
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Term
Three factors that affect SVR |
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Definition
Vasoconstrictors (angiotensin & norepinephrine) local regulators (prostaglandins=vasodilation endothelin=vasoconstriction SNS stimulation |
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Term
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Definition
increase HR, increase myocardial contractility, wide spread vasoconstriction, increased release of renin from the kidneys Net Effect-increase CO and SVR |
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Term
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Definition
Controls sodium excretion and extracellular fluid volume. If sodium level is high=H2O retention |
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Term
Job of endocrine system and HTN |
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Definition
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Term
What is the job of NE r/t HTN |
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Definition
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Term
Job of epinephrine in HTN |
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Definition
Increase HR and myocardial contractility and causes vasoconstruction of peripheral arterioles |
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Term
Risk Factors for Primary HTN |
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Definition
age >50, diabetes, high lipids, high sodium diet, obesity, smoking, seditary lifestyle |
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Term
Definition of primary HTN |
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Definition
Increased BP without a cause Associated with increased SNS activity and over production of aldosterone |
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Term
Characteristics of Pre HTN |
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Definition
Systolic-120-139 Diastolic-80-89 |
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Term
Characteristics of Stage I HTN |
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Definition
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Term
Characteristics of Stage II HTN |
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Definition
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Term
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Definition
Narrowing of aorta, renal and hepatic disease, endocrine disorders, head injury, sleep apnea, pregnancy |
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Term
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Definition
Increased CO, increased system vascular resistance, heredity, high sodium western diet, insulin resistance |
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Term
4 Organs that damage occurs from HTN |
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Definition
Heart, peripheral and cerebral vasculature, kidneys, retina |
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Term
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Definition
HBP flow injures vascular endothelium...it becomes thick and has places for plaque to get stuck |
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Term
Relationship b/t HTN and Cerebrovascular disease |
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Definition
Stroke risk increased by 4x; TIA and stroke are due to plaque formation and embolization |
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Term
Left Ventricular Hypertrophy |
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Definition
Increased left vascular resistance causes the LV to work harder, so it gets thick, stretched and boggy. |
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Term
How does HTN affect the kidneys? |
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Definition
causes nephrosclerosis; increased pressure causes narrowing of the arteries and arterioles ---death of nephrons |
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Term
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Definition
Damage to retinal vessels indicate damage to other blood vessels-heart, kidney & brain. Leads to blurred vision, retinal hemorrhage and loss of vision |
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Term
What studies are done to diagnose HTN |
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Definition
BP-two or more readings (supine and sitting up), BUN, creatine, blood glucose, EKG, hx of stroke? Tia? pulses-all present? bruits? |
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Term
Collaborative care for HTN |
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Definition
weight reduction, DASH eating, sodium restriction, moderate alcohol, regular aerobic exercise, avoid tobacco and caffine |
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Term
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Definition
Low sodium, decreased calories, increased fiber |
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Term
What is the Goal of DASH eating |
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Definition
Decrease sodium to 2g p/day. Teach patient how to read labels |
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Term
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Definition
Diuretics, adrenergic inhibitors, direct vasodilators, angiotensin inhibitors, calcium channel blockers |
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Term
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Definition
First line of therapy for mgmt of HTN. Inhibit sodium reabsorption in distal tubial. |
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Term
Use of Adrenergic Inhibitors in HTN |
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Definition
diminishing the SNS that increase BP |
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Term
Use of Vasodilators for HTN |
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Definition
Decrease BP by relaxing vascular smooth muscle and reducing systemic vascular resistance. |
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Term
Nursing interventions for Adrenergic Inhibitors |
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Definition
monitor BP, urine output, orthostatic hypertension |
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Term
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Definition
block the conversion of angiotensin I to angiotensin II |
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Term
Nursing Interventions for Ace Inhibitors |
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Definition
monitor BP, kidney function, creatin, BUN, potassium, diet...avoid high potassium foods |
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Term
MOA calcium channel blockers |
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Definition
increase sodium excretion and cause vasodilation |
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Term
Nursing Implications of calcium channel blockers |
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Definition
decreased HR, decreased contractility, bradycardia, N/V, HA, dizziness, peripheral edema |
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Term
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Definition
diuretics and lifestyle modifications; 2 or more antihypertensive meds |
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Term
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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 |
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Term
Patient teaching HTN Meds |
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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 |
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Term
Cl. Man. of Orthostatic HTN |
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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 |
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Term
HTN is associated with......in the older adult |
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Definition
loss of tissue elasticity, myocardial stiffness, increased peripheral vascular resistance, decreased adrenergic receptor, sensitivity, blunting of the baroreceptors, decreased renin function. |
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Term
Characteristics of HTN Crisis |
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Definition
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Term
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Definition
Can be deadly and cause organ damage, seizure, shock, MI and encephalopathy; could see acute confussion |
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Term
Cl. Man of Hypertensive crisis |
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Definition
HA, N/V, seizure, confusion, coma, blurred vision |
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Term
Tx of Hypertensive Crisis |
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Definition
vasodilators, nitropress, apresoline, vasotec. Do not lower blood pressure too quickly |
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Term
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Definition
fat sticks to inside of arteries and harden; hardening of the arteries, endothelial damage caused by inflammation r/t tobacco, HTN, DM |
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Term
Modifiable risk factors for CAD |
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Definition
serum lipids, HTN, smoking, physical inactivity, obesity, metabolic syndrome, stress, homocystine levels |
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Term
Non-modifiable risk factors for CAD |
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Definition
age, gender, ethnicity, family hx, genetics, more women than men, more caucasions than AA |
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Term
Nursing Interventions for CAD |
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Definition
maintain healthy weight, reduce salt, low fat, low cholesterol diet, increase exercise, avoid tobacco & alcohol, encourage plant proteins, high fiber diet |
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Term
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Definition
exercise 30 min 5x p/w; encourage relaxation, controlled anxiety/depression, obesity-encourage change in eating, diabetes, smoking cessation |
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Term
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Definition
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Term
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Definition
Stable and Chronic Stable |
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Term
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Definition
Precipitating events; quality of pain; radiation of pain; severity of pain; timing |
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Term
Cl. Man of Chronic Stable Angina |
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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 |
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Term
Precipitating factors for Angina |
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Definition
Increased HR, decreased time spent in diastole, temperature extremes, strong emotions, tobacco and drug use, sexual activity |
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|
Term
|
Definition
Administer O2, aspirin to thin blood, nitrates to dilate the coronary arteries |
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|
Term
|
Definition
increase O2 supply and decrease O2 demand |
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|
Term
Tx of Chronic Stable Angina ****ABCDEF**** |
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Definition
Antiplatelet, B-blockers, cigarette smoking and cholesterol, diet and diabetes, educate and exercise, flu shot |
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|
Term
Angina Diagnostic Studies |
|
Definition
12 lead ECG, echo cardiogram, exercise stress test, coronary angiography |
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|
Term
Characteristics of chronic stable |
|
Definition
pain lasts 5-15 min, provoked by exertion, relieved by rest/nitroglycerin |
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|
Term
Characteristics of stable angina |
|
Definition
new onset, increasing frequency, duration or severity, occurs with rest or minimal exertion, not relieved by nitro |
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|
Term
Characteristics of unstable angina |
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Definition
change in pattern of pain, occurs w/o excertion-during sleep-pain at rest, more pain, fatigue and SOB |
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|
Term
|
Definition
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|
Term
|
Definition
pain, sns stimulation, cardiovascular, N/V, fever. No change with nitro or position changes. |
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|
Term
|
Definition
skin is cool and clamy, BP and HR initially increase, as heart decompensates, BP drops. |
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|
Term
|
Definition
dysrhythmias, heart failure-crackles, cardiogenic shock, MV regurgitation, ventricular aneurism, pericardial friction rub |
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|
Term
|
Definition
O2 2-4L per nasal cannula, VSQ15m, bed rest (decreases cardio demand) |
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|
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 |
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|
Term
Impaired cardiac pump caused by...... |
|
Definition
anything affecting preload, afterload, myocardial contractility, HR or metabolic rate |
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|
Term
Heart failure is associated with...... |
|
Definition
Cardiovascular disease, long standing HTN, CAD, MI |
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|
Term
|
Definition
CAD, HTN, rheumatic heart, congenital HD, cor pulmonale, cardiomyopathy, bacterial endocarditis, valvular disorders |
|
|
Term
|
Definition
MI, dysrhythmias, PE, anaphylaxis, VSD, ruptured papillary muscle, myocarditis |
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|
Term
Precipitating conditions of HF |
|
Definition
anemia, infection, hypothyroidism, dysrhythmia, bacterial endocarditis, pulmonary disease and hypervolemia |
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|
Term
HF is classified into....... |
|
Definition
Systolic and diastolic failure |
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|
Term
|
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 |
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|
Term
|
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. |
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|
Term
|
Definition
Patient is really in trouble, have decreased BP and decreased HR, impaired renal profusion, poor activity tolerance |
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|
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. |
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|
Term
What does the patient look like with LHF |
|
Definition
sleeping on lots of pillows (6), going to bathroom many times per night. |
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|
Term
Characteristics of Right side heart failure |
|
Definition
blood backs up into the right atria and venous circulation |
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|
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 |
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|
Term
How to care for Pulmonary Edema |
|
Definition
high fowlers position, O2 by mask, VS q1h, continuous telemetry monitoring, drug therapy |
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|
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 |
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|
Term
Care of the ptnt with Chronic heart failure |
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Definition
O2 therapy, rest periods (keeping O2 demand low), drug therapy, daily weights, sodium restrictions, ventricular assist devices |
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