Cardiovascular Disorders

Front 1

Explain the rationale for the following lab tests: CK, LDH, AST, troponin and lipid levels

Back 1

Enzymes; these diagnostic markers are released into the bloodstream when muscle damage occurs, as in myocardial infarction. The lab tests are done
to measure the amount of the particular enzyme; the levels help determine what is wrong. Levels of these enzymes rise and fall at specific times

Front 2

Differentiate: Angiocardiogram and Arteriogram; include three nursing considerations for each procedure

Back 2

angiocardiogram (angiogram) is an x-ray study of the heart and major vessels performed after injection of aradiopaque dye into a vessel. The angiogram shows the movement of the dye from the heart to the lungs, back to the heart, then out through the aorta. This procedure provides information about structural abnormalities and calcifications within the vascular system. An arteriogram is an x-ray study of an artery. NURSING CON: no breakfast, sedative 30 min before and prepare groin area if used.

Front 3

Describe the role of the nurse during and after the following procedures: (a) echocardiogram, (b) ECG stress test, (c) electrophysiology study

Back 3

The client must sign an informedconsent and can having nothing to eat or drink (NPO) aftermidnight. A sedative is sometimes ordered for relaxationbefore and during the procedure.After the procedure, the catheter insertion site is coveredwith a 4×4 bandage or Band-Aid. The client will be on bedrest for 1 to 2 hours after the procedure. Check the client’svital signs every 15 minutes initially and less frequently oncethey have stabilized. This procedure may be done on an out-patient basis.

Front 4

Identify at least four nursing considerations before and after a cardiac catherization.

Back 4

(1) Explain that it is not painful, although it maybe slightly uncomfortable. A local anesthetic is given during the procedure. Warn the client that during the procedure, he or she may feel a sensation of warmth and a “fluttering” in the heart, as the catheter passes through the blood vessels. (2) check for signed informed consent is required, (3) the client is NPO for at least 6 hours before the procedure. Exceptions to the NPO order are specific medications ordered by the physician. Cardiac catheterization usually has no complications, but it is not entirely without danger. AFTER:(1) Assess the insertion site for bleeding or hematoma. (2) Check the client’s peripheral pulses every 15 minutes for an hour after the test and then fre-quently thereafter for up to 8 hours, depending upon the insertion site used. (3) check vital signs BP, RESP (4) change the TV station while client relaxes and provide a blanket if client is cold.

Front 5

Identify the rationale for performing a PTCA.

Back 5

In percutaneous transluminal coronary angioplasty
(PTCA) a surgeon inserts a balloon-tipped catheter into a client’s narrowed coronary artery Injection of a radiopaque dye allows clear visibility of the coronary arteries by x-ray study so that the surgeon can see the vessels a/k/a angioplasty.
Angioplasty widens the artery’s opening (lumen) and improves blood flow to the heart muscles. Another type of angioplasty, called atherectomy, involves use of a cutting device (roto-blator) with a rotating shaver (burr)at the tip of the catheter.This is used to shave away plaque from the coronary artery. Laser angioplasty has also been used either alone or in conjunction with the balloon. The laser beam of light vaporizes the plaque in the coronary artery.

Front 6

Compare and contrast the following surgical procedures: (a) closed-heart surgery (b) open-heart surgery (c) heart valve replacement (d) heart transplantation. List 5 post-op nursing interventions for each

Back 6

Closed-heart surgery refers to surgical procedures that are done without stopping the heart. Open-heart surgery involves opening or operating on the heart in such a way that the heart must be stopped and the circulated blood is oxygenated by a device, such as a pump oxygenator (heart–lung pump). Use of such a device is called extracorporeal (outside the body) circulation.Congenital defects or diseases can damage the heart valves. In some cases, artificial or mechanical valves are transplanted for valve replacement. In other cases, human heart valves are used. Human heart valves have several advantages: (1) they do not need to be replaced as soon (artificial valves last about 10 years); (2) they better control pressures within the heart;(3) they are quiet (some artificial valves click); and (4) they can be preserved until needed. In addition, human heart valves grow with children who receive them. However, because human valves are foreign tissue, recipients must receive more antirejection drugs

Front 7

Compare and contrast the following surgical procedures: (a) closed-heart surgery (b) open-heart surgery (c) heart valve replacement (d) heart transplantation. List 5 post-op nursing interventions for each

Back 7

Many problems are associated with heart transplantation, the greatest of which is rejection by the body of any foreign object or protein substance. This normal defense mechanism fights infection. However, with transplantation, it works against the person’s well-being. Drugs must offset the body’s normal antibody response or the new heart will be rejected.
POST OP: Registered nurses are usually responsible for immediate postoperative nursing care; lpn may assist. The
first 2 days after surgery are the most critical to survival. After surgery, nursing care focuses on the following: •Providing adequate tissue oxygenation• Assessing cardiac function • Maintaining fluid and electrolyte balance • Controlling chest drainage with suction • Monitoring body temperature • Relieving pain

Front 8

Explain the role of each of the following conditions as they contribute to cardiovascular disease: arteriosclerosis, atherosclerosis, hypertention, hypotension.

Back 8

Arteriosclerosis applies to several pathologic conditions in which the walls of the arteries thicken, harden, and lose elasticity. Sometimes it is referred to as “hardening of the arteries.”
Atherosclerosis, the most common type of arteriosclerosis, is characterized by fatty deterioration of the arterial smooth muscle walls. These diseases may affect the heart valves and may lead to hypertension or CAD.

Hypertension can lead to MI, kidney damage, congestive heart failure, and CVA. Consistent HTN leads to heart damage. With advancing age, blood pressure tends to rise, although the exact reason is unclear. One thing is certain: the condition of the heart and blood vessels has the greatest effect on blood pressure. Although HTN cannot be cured, treatment can usually bring blood pressure to within the normal range. High blood pressure is predominantly due to a spasm of the small arterioles.

Low Blood Pressure: causes of hypotension can be classified under one of three mechanisms: a heart rate problem,

Front 9

Differentiate the following cardiac rhythm abnormalties: sinus tachycardia, sinus bradycardia, PVC heart block and fibrillation

Back 9

x

Front 10

Discuss the rationale for the use of external and internal defibrillation devices

Back 10

x

Front 11

Describe congestive heart failure, including possible causes, signs and symptoms, diagnsotic tests, treatment and nursing care

Back 11

x

Front 12

Define the following infectious and inflammatory heart disorders: myocarditis, endocarditis and pericarditis

Back 12

x

Front 13

Identify four major causes of coronary artery disease

Back 13

x

Front 14

Describe three signs and symptoms for angina pectoris and mycardial infarction and four nursing interventions for each condition

Back 14

x