Cardiovascular exam 1 reveiw ❤️

echocardiogram is used to visualize

visualize heart structures and measure ejection fraction

EKG is used to visualize

conduction system and electrical activity of heart

transesophegeal echocardiogram (TEE) is used to visualize

more detailed veiw of cardiac structures. goes into body for clear view.

hemodynamic monitoring is used to

provide direct measurement of pressures in the heart and great vessels. can tell us CO and CVP

a cardiac cath is used to

determine is you have a blockage or narrowing of coronary artery.

cardia cath pre-procedure

NPO for 8+ hours. assess for allergies to iodine and shellfish (because they could interact with the dye). assess kidney function (creatine and BUN) because of dye. assess and mark distal pulses so you can check afterwards aswell.

cardiac cath post procedure

check insertion site for bleeding. check extremity distal to insertion site for pulse, capillary refil, color, and temperature. take VS frequently. increase fluid intake to flush out dye. lay flat for 4-6hrs

pathophysiology of angina

athereosclerosis reduces blood to coronary artery and decreases oxegyn heart is getting.

stable agnina

CP with exercise that is relived with nitro or with rest

unstable angina

occurs with exercise or rest. overtime pain increases.

variant angina

caused by cornary spasm

chest pain not releived by nitroglycerin or rest and lasting more than 30 minutes is indicative of

MI

nitroglycerin instructions

when chest pain occurs put tab under tounge and stop all activity. if pain is not releived in 5 minutes, call 911 and put second tablet under tounge. wait another 5 minutes and put third tablet under tonge if not releived. only do 3

what medications can help with angina

antihypertensives (beta blockers, CCBs), anticoagulants, and statins

calcium channel blocker medications

verapamil, dilatazem, nifidipine

CCBs are used for

HTN, angina,

(nifidipine also for pre-term labor)

CCB’s therepeutic effect

cause vasodilation and decrease HR

CCB side effects

peripheral edema* and hypotension. bradycardia, HA, constipation

CCB paitent teaching

don’t drink grapefruit juice, monitor BP and HR

centrally acting aplha 2 agonist medication

clonidine

clonadine is used for

HTN

clonadine thereputic effects

decreasing sympathtic acitvity to decrease HR and BP

clonadine side effects

dizzines, drowsiness, dry mouth

clonadine client education

can suck on hard candy to help dry mouth

beta 1 blocker (selective) medications

metoprolol and atenolol (you only have 1 MA)

beta 1 blockers used for

HTN, angina, HF, MI

beta 1 blockers thereputic effects

decrease BP and HR

beta 1 blockers side effects

bradycarida, hypotension, fatigue, ereticle dysfunction

BBW* abrupt discontinuation can cause angina or MI

beta 1 blockers client education

change position slowly, monitor BP, can mask signs of hypoglycemia

nonselective beta blockers (beta 2 blockers) medications

propranolol, labetalol, carvedilol

beta 2 blockers used for

HTN, angina, MI, arrythmias,

beta 2 blockers thereputic effects

decrease BP and HR

beta 2 blockers side effects

bronchospasm, bronchoconstriction, fatigue, hypotension, bradycardia, erectile dysfunction

never give beta 2 blockers to someone with

asthma

nitroprusside drug class

vasodilator

nitroprusside use for

hypertensive crisis

nitroprusside mode of action

causes direct vasodilation of arteries and veins so it drops BP FAST. decreases btoh preload and afterload

nitroprusside side effects

hypotension, BBW* dangerous drop in BP, cyanide toxicity, and thyocynate toxicity, dizzines, GI upset

antianginal medications

nitroglycerin, isosorbide mononitrate, isosorbide dinitrate

antianginals work via

vasodilation (decrease preload and oxegyn demand)

nitroglycerin, isosorbide mononitrate, isosorbide dinitrate side effects

orthostatic hypotension, HA, possible reflex tachycardia

(sorbide sorbet causes brainfreeze headache)

sublingual nitroglycerin storage

cool, dark, place

pathophysiology of MI

atherosclerosis build up breaks off and occludes blood flow to heart

MI EKG findings may include

elevated/depressed ST segment, T wave inversion, or abnormal Q wave

PCI is done to

open up coronary arteries. balloon inserted into artery, inflated, stent placed

PCI must be done when

within 2 hours of symptom onset

CABG post precedure

monitor BP (high BP can cause bleeding at graft site, low BP can cause graft to collapse), monitor temp, bleeding, consciousness, electrolytes, donor site,

what symptoms of MI might women experience that men may not

nausea, vomitting, fatigue, pain in back shoulders or jaw

what vein is often used to bypass the blocked coronary artery during a CABG procedure

saphenous

sodium is important for

mainting fluid volume, muscle function, and nerve function

sodium range

135-145

what can cause hypernatremia

excess sodium intake, cushings, DI

hypernatremia signs and symptoms

thrist, agitation, msucle weakness, GI upset

hypernatremia treatment

hypotonic fluids (ex 0.45 saline), slowly correct to prevent cerebral edema and seizures, diuretics (furosemide), increase water intake

hyponatremia causes

diuretics, kidney failure, diaphoresis, SIADH, hyperglycemia, HF

hyponatrremia signs and symptoms

confusion (esp in elderly), fatigue, nausea and vommiting, headache

hyponatremia treatment

hypertonic fluids (3% saline). slowly correct imbalance. restrict fluid intake and eat more sodium

calcium is important for

bone, teeth, nerve, muscle function and clotting

calcium range

9-10.5

(think of a california CA earthquake being 9-10.5 on the rictor scale)

(CAll 911- think calcium is close to 9 and 11)

hypercalcemia causes

hyperparathyroidism, corticosteroids, bone cancer

hypercalcemia signs and symptoms

constipation, decreased DTR, kidney stones, lethargy weakness

hypercalcemia treatment

0.9% NACL, calcitonin, and dialysis in severe cases

hypocalcemia causes

diahrea, vitamin d defincecny, hypoparathyroidism

hypocalcemia signs and symptoms

positive chvostek's sign, positive trousseau's sign (inflated BP cuff causes contraction of hand and fingers), muscle spasms, GI upset, numbness and tingling

hypocalcemia treatment

calcum supplements

potassium is important to

maintaining ICF, nerve and muscle function. cardiac function

potassium range

3.5-5

hyperkalemia causes

DKA*, metabolic acidosis*, salt substitutes, kidney failure

hyperkalemia signs and symptoms

dysrythmias, muscle weakness, numbness, tingling, nausea, vomitting

hyperkalemia treatment

furosemide, insulin (helps bring potassium into the ICF; must give dextrose with insulin to offset hypoglycemia), kayexelate, decreased intake of potassium

hypokalemia causes

diuretics, GI losses, diaphoresis, cushings disease, metabolic alkalosis

hypokalemia signs and symptoms

dysrythmias, muscle spasms or weakness, constipation, ileus (GI system like stops)

hypokalemia treatment

potassium supplement,

magnesium is important for

biochemical reactions in the body, muscle and nerve function

magnesium range

1.3-2.1

(think of little MG car that can only fit 1-2 people in it)

hypermagnesemia causes

kidney disease, excess intake of antacids or laxatives containing MG

hypermagnesemia signs and symtpoms

hypotension, lethargy, muscle weakness, decreased DTR, respirtory and cardiac arrest

(MG too high, everything else goes low)

hypermagnesemia treatment

furosemide, calcium (help reverse cardiac effects)

hypomagnesemia causes

GI losses, diuretics, malnutrition, alchol abuse,

hypomagnesemia signs and symptoms

dysrythmias, toresades de pointes, tachycardia, HTN, increased DTR, tremors, seizures

(MG goes low, everything else goes high)

hypomagnesemia treatment

magnesium supplements

a positive chvosteks sign and trousseaus sign is indicative of what imabalance

hypocalcemia