MDC III Final Exam 1. Caring for the patient with cardiovascular disorders includes general nursing interventions such as: - Monitoring vital signs Continuous cardiac monitoring Assessment of the cardiovascular and respiratory system Monitoring laboratory/other diagnostic study and reporting results Monitoring intake and output Assessment for signs and symptoms of complications of the disease or treatment Monitoring of daily weight Implement hemodynamic monitoring Administration of prescribed medication Consult a dietician for dietary requirements based on disorder Allow ample rest periods 2. Cardiovascular post-op care: - Monitoring vital signs. Continuous cardiac monitoring to detect dysrhythmias. Implementation of early ambulation to avoid the formation of a deep vein thrombosis. Encouraging coughing and deep breathing to prevent respiratory complications. 3. Heart Failure Nursing Interventions - Administration of continuous positive airway pressure (CPAP) to maintain oxygenation and ventilation Assist patient and family in advanced directive planning Assist in preparation of the patient for cardiac resynchronization therapy (CRT) to restore normal rhythm Prepare the patient for surgical intervention if indicated Provide patient and family education for home care to include: Dietary requirements Daily weight Fluid restriction Signs and symptoms of worsening heart failure and when to follow-up with provider Importance of adhering to medication regimen Teach the patient how to take their heart rate 4. S/S Heart Failure - edema, tachypnea, tachycardia, fatigue, cough, dyspnea 5. Normal ejection fraction? - 55-70% 6. Causes of Heart Failure - Hypertension Coronary artery disease Cardiomyopathy Substance abuse (drugs and alcohol) Valvular disease Congenital defects Cardiac infections Dysrhythmias Diabetes Smoking Family history Obesity Severe lung disease Sleep apnea Metabolic disorders 7. Left-sided heart failure symptoms - Pulmonary edema, orthopnea, crackles in lungs, pink/frothy sputum 8. Right-sided heart failure symptoms - peripheral edema, JVD, abdominal growth (ascites, hepatomegaly, splenomegaly) 9. Left-sided heart failure causes - post-heart attack, ischemic heart disease, low oxygen to heart muscles-CAD, ACS 10. Right-sided heart failure causes - HTN, Pulmonary HTN, Stiff fibrotic lungs, left-side HF can cause the other 11. Causes of mitral stenosis - congenital abnormalities, rheumatic fever 12. Medications for Valvular Disorders - "ABCD" ACE inhibitors, ARbs, anticoagulants Beta-blockers Calcium channel blocker Diuretics, Digoxin, 13. Patients who have had valve replacements with prosthetic valves require lifetime ____________ therapy - anti-coagulant therapy (like Warfarin, aspirin is indicated too) 14. Pt with mechanical valve should be educated to take what prior to invasive surgery/dental procedures? - prophylactic abx 15. How are "pump" disorders of the heart diagnosed? - Echocardiogram (non-invasive test, performed to evaluate cardiac structures/abnormalities consistent with valvular disease) Endocardiogram (used to visualize structures) TEE (Invasive) TTE Exercise tolerance test Chest X-ray ECG Cardiac Cath (invasive) 16. If pt has low platelets, what should be the nursing priority? - bleeding precautions 17. The difference between stable and unstable angina is? - Stable angina pain goes away with rest, pain meds, whereas unstable it does not 18. Medication class for PAD? - antiplatelets 19. This lab test is specific for cardiac damage - troponin 20. A patient recently diagnosed with leukemia asks what is a definitive treatment for their condition. the RN responds with this procedure. - stem cell transplant