Post on 20-Jan-2016
transcript
Angina & Dysrhythmias
A & P OF THE CARDIAC SYSTEM
Cardiac output CO=SV(stroke volume) X HR(heart rate)
Preload Volume of blood in the ventricles at the end of
diastole Afterload
Peripheral resistance against which the left ventricle must pump. Affected by the size of the ventricle, wall tension and arterial blood pressure.
ANGINA PECTORIS
Definitions Signs and Symptoms Stable vs Unstable Silent Ischemia Precipitating factors Diagnostic studies
Lewis Page 812
Precipitating
Factors of Angina
PRECIPITATING FACTORS OF ANGINA
CARDIAC DRUGS
Nitrates
Beta Blockers
Calcium Channel blockers
Ace inhibitors
Lewis fig 33-13
Decision tree
Collaborative care
Coronary Artery Disease Collaborative care decision tree
MYOCARDIAL INFARCTION
Definition Signs and Symptoms Complications Diagnostics PTCA (Percutaneous Coronary
Angioplasty) CABG (Coronary Artery Bypass)
MYOCARDIAL INFARCTION
NURSING DIAGNOSIS
Acute pain Ineffective Tissue perfusion (cardiac) Anxiety Activity intolerance Ineffective Therapeutic regimen
management
PTCA
CORONARY ARTERY BYPASS GRAFT
CARDIOMYOPHATHY
Dilated (congestive)
Hypertrophic
Types of cardiomyopathies
See differences in ventricle muscles
Types of Cardiomyopathies
CARDIAC TRANSPLANT
Drug therapies
Lifestyle changes
Support Systems
Teaching
INFLAMMATORY HEART DISEASE NURSING DIAGNOSIS
Hyperthermia Decreased Cardiac Output Activity Intolerance Ineffective Health Maintenance Pain Anxiety
Layers of the heart Page 886
INFLAMMATORYHEART DISEASES
Infective EndocarditisClinical
manifestationsDiagnostic
studies
INFLAMMATORY HEART DISEASE
ACUTE PERICARDITISEtiology and PathophysiologyClinical ManifestationsComplicationsCollaborative Care
MYOCARDITIS
Etiology
Clinical Manifestations
Diagnostic Studies
Nursing Management
VALVULAR DISEASE
NURSING DIAGNOSIS
Activity Intolerance Excess Fluid Volume Decreased Cardiac
Output Ineffective
Therapeutic Regimen Management
MITRAL VALVEStenosis and Regurgitant
MITRAL VALVE STENOSIS
Etiology Clinical Manifestations Teaching Diagnostic findings
ECGEchocardiogramCardiac Catheterization
RELATIONSHIP OF ECG TO CARDIAC CYCLE
Page 767, Chapter 31
ATRIAL STENOSIS & REGURGIATION
Etiology Clinical Manifestation Diagnostic Findings
ECGEchocardiogramCardiac Catheterization
VALVULAR HEART DISEASECOLLABORATIVE CARE (PTBV) Percutaneous transluminal balloon
valvuplasty
Surgical therapy
TYPES OF PROSTHETIC AND TISSUE VALVES
ARRHYTHMIAS
Chapter 31, pages 758 & 759
Normal sinus rhythm
NORMAL SINUS RHYTHM
NORMAL SINUS RHYTHMTIMING
Page 865
Normal Sinus Rhythm in Lead II
Artifact, loose leads or movement
Rate of conduction systems
NSR, ARTIFACT, CONDUCTION SYSTEM RATES
Calculating Rhythm and RateUsing 6 second cardiac strip
REGULAR RHYTHM & RATE
Sinus bradycardia
Sinus Tachycardia
Premature Atrial Contraction (PAC)
Paroxysmal SVT
SINUS BRADYCARDIATACHYCARDIA, PAC, SVT
HEART BLOCKS PAGE 871
Atrial Flutter
Atrial Fibrillation
Page 870What medications would you anticipate the patient to be taking chronically for this rhythm? Why?
ATRIAL FLUTTER AND FIBRILLATION
Multifocal PVC
PVC’s couplets, runs
PVC bigeminy
PVC Trigeminy
What would you assess first?
PVC, BIGEMINY, TRIGEMINY
Ventricular Tachycardia
Ventricular
Fibrillation
Page 873
V-TACH, V-FIB
Pulseless Electrical Activity
PORTABLE MONITOR
Contains Monitor,
Defibrillator,
Transcutaneous
Pacemaker,
Page 875
Placement of defibrillation pads
Implantable Defibrillator (ICD) and Dual Chamber Pacemaker
Temporary Pacemaker Insertion