Heart Failure
Heart Failure Complex clinical syndrome resulting in insufficient blood supply/oxygen to tissues and organs Involves diastolic or systolic dysfunction Ejection fraction (EF) is amount of blood pumped by LV with each heart beat Associated with CVDs Increase in incidence and prevalence Most common cause for hospital admission in adults over age 65 Risk factors Primary […]
Role of Nursing Personnel
Role of Nursing Personnel Registered Nurse (RN) Pre-procedure Assess for allergies, especially to contrast dye. Perform baseline assessment, including vital signs, pulse oximetry, heart and breath sounds, neurovascular assessment of extremities (e.g., distal pulses, skin temperature, skin color, sensation). Assess baseline laboratory values (e.g., cardiac biomarkers, creatinine). Teach patient and caregiver about procedure and post-procedure […]
Sudden cardiac death
Sudden cardiac death Nursing/Interprofessional care Diagnostic workup to rule out or confirm MI Cardiac biomarkers ECGs Treat accordingly Cardiac catheterization PCI or CABG 24-hour Holter monitoring Exercise stress testing Signal-averaged ECG Electrophysiologic study (EPS) Implantable cardioverter-defibrillator (ICD) Antidysrhythmic drugs LifeVest
Coronary revascularization: PCI – Coronary revascularization: CABG
Coronary revascularization: PCI Monitor for recurrent angina Frequent VS, including cardiac rhythm Monitor catheter insertion site for bleeding Neurovascular assessment Bed rest per institutional policy Coronary revascularization: CABG ICU for first 24–36 hours Pulmonary artery catheter Intra-arterial line Pleural/mediastinal chest tubes Continuous ECG ET tube with mechanical ventilation Epicardial pacing wires Urinary catheter NG tube […]
Nursing diagnoses : Decreased cardiac output
Nursing diagnoses Decreased cardiac output related to altered contractility and altered heart rate and rhythm Acute pain related to an imbalance between myocardial O2 supply and demand Anxiety related to perceived or actual threat of death, pain, and/or possible lifestyle changes Activity intolerance related to general weakness secondary to decreased cardiac output and poor lung […]
Acute coronary syndrome : Nursing management
Nursing management Nursing Assessment: Subjective Data Health history CAD/chest pain/angina/ MI Valve disease Heart failure/cardiomyopathy, Hypertension, diabetes, anemia, lung disease, hyperlipidemia Drugs Use of anti-platelets or anticoagulants Nitrates Angiotensin-converting enzyme inhibitors β-blockers Calcium channel blockers Antihypertensive drugs Lipid-lowering drugs Over-the-counter drugs (e.g., vitamin and herbal supplements) History of present illness Description of events related to […]
Acute coronary syndrome
Acute coronary syndrome Minimally invasive direct coronary artery bypass (MIDCAB) For patients with disease of left anterior descending or right coronary artery Does not involve a sternotomy and CPB Off-pump coronary artery bypass (OPCAB) Sternotomy but no CPB Robotic or totally endoscopic coronary artery bypass (TECAB) Transmyocardial laser revascularization Indirect revascularization High-energy laser creates channels […]
Interprofessional care : Acute Coronary Syndrome
Interprofessional care Acute Coronary Syndrome Initial interventions 12-lead ECG Upright position Oxygen – keep O2 sat > 93% IV access Nitroglycerin (SL) and ASA (chewable) Statin Morphine Ongoing monitoring Treat dysrhythmias Frequent vital sign monitoring Bed rest/limited activity for 12–24 hours UA or NSTEMI Dual antiplatelet therapy and heparin Cardiac catheterization with PCI once stable […]
Nursing management : Hypertension
Nursing management Nursing Assessment Subjective Data Important Health Information Past health history: Known duration and past workup of high BP; cardiovascular, cerebrovascular, renal, or thyroid disease; diabetes mellitus; pituitary disorders; obesity; dyslipidemia; menopause or hormone replacement status Medications: Use of any prescription or over-the-counter, illicit, or herbal drugs or products; previous use of antihypertensive drug […]
Hypertension in older persons
Hypertension in older persons BP goal for people > 60 is < 150/90 Preferred antihypertensive drugs Thiazide diuretic Calcium channel blockers ACE inhibitors or ARBs Caution use of NSAIDS Hypertensive crisis SBP >180 mmHg and/or DBP >110 mmHg Hypertensive urgency Develops over hours to days May not require hospitalization Hypertensive emergency Very severe problems can […]