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Medical-Surgical Nursing, 9th Ed., Ignatavicius & Workman, 2018/
35 - Care of Patients With Cardiac ProblemsAce Your Medical-Surgical Nursing, 9th Ed., Ignatavicius & Workman, 2018 Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Registered Nurse (RN) Students
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Medical-Surgical Nursing, 9th Ed., Ignatavicius & Workman, 2018 | Registered Nurse (RN) School Study Aid
Types of Heart Failure
- Left Sided
- Pulmonary Congestion
- Right Sided
- Peripheral Edema
- High Output
- Unable to Meet Metabolic Needs
1 min
Left Heart Failure Assessment
- Pulmonary Assessment
- Pulmonary Congestion
- Pink Frothy Sputum
- Wheezing or Crackles
- Dyspnea with Exertion
- Cough
- Systemic Assessment
- Fatigue
- Tachycardia
- Weak Peripheral Pulse
- S3, S4 Heart Sounds
1 min
Right Heart Failure Assessment
- Jugular Venous Distention (JVD)
- Peripheral Edema
- Hepatosplenomegaly
- Nocturia
- Weight Gain
- Ascites
- Fatigue
1 min
Lung Sounds - Crackles
- Location
- Lower Lobes
- Description
- Fine/Coarse
- Sounds Like
- Fine: Twisting Hair through Fingers
- Coarse: Velcro
- Cause
- Collapsed Small Airways and Alveoli "Popping Open"
1 min
Heart Failure Interventions
- Diagnostic Tests
- Echocardiogram
- Invasive Hemodynamic Monitoring
- Improve Gas Exchange
- High Fowler's Position
- Oxygen
- Advanced Airway
- Drugs and Devices
- Diuretics
- Beta Blockers
- Angiotensin II Receptor Blockers (ARBs)
- ACE Inhibitors
- Digoxin (Lanoxin)
- Pacemaker
2 mins
Angiotensin-Converting Enzyme (ACE) Inhibitors
- "-pril" Suffix
- Mechanism of Action
- Block Renin Angiotensin-Aldosterone System (RAAS)
- Indications
- Hypertension
- Heart Failure
- Side Effects
- Dry Non-productive Cough
- Hypotension
- Dizziness
- Possible Hyperkalemia
- Angioedema
- Nursing Considerations
- Slowly Change Position
- Do Not Stop Abruptly
2 mins
Angiotensin II Receptor Blockers (ARBs)
- Ends in "-sartan"
- Mechanism of Action
- Blocks Angiotensin II Receptor
- Indications
- Hypertension
- Side Effects
- Angioedema
- Contraindications
- Renal Artery Stenosis
- Pregnancy
1 min
Morphine
- Mechanism
- Opioid Receptor Agonist
- Indications
- Pain
- Myocardial Infarction
- Side Effects
- Nausea and Vomiting
- CNS Depression
- Biliary Colic
- Constipation
- Increased Intracranial Pressure (ICP)
- Pupillary Constriction
- Hypotension
2 mins
Loop Diuretics
- Mechanism of Action
- Thick Ascending Limb of Loop of Henle
- Inhibits Na+-K+-2Cl-
- Sulfa Drug
- Drug Names
- Furosemide
- Lasix
- Side Effects
- Ototoxicity from Rapid Injection
- Gout
- Dehydration
- Hypocalcemia
- Hypokalemia
- Orthostatic Hypotension
2 mins
Loop Diuretic Education
- Furosemide (Lasix)
- Indications
- Heart Failure
- Pulmonary Edema
- Acute Renal Failure (ARF)
- Edema
- Education
- Notify the provider of weakness, dizziness, or muscle cramping
- Increase Potassium Intake
- Check BP Daily
- Daily Weights and Monitor IandOs
1 min
Hydrochlorothiazide HCTZ
- Mechanism of Action
- Inhibits Reabsorption NaCl and H2O
- Indications
- Edema
- Mild to Moderate Hypertension
- Side Effects
- Hypokalemia
- Hyponatremia
- Dehydration
- Hyperglycemia
- Gout
- Contraindications
- Sulfa Allergy
- Pregnancy and Breastfeeding
1 min
Hypokalemia
- Assessment
- < 3.5 mEq/L
- Muscle Weakness
- Arrhythmia
- U Wave
- Ileus
- Hyporeflexia
- Interventions
- IV K+ Infusion at 5-10 mEq/hr
- Give Orally with Food
- Nursing Considerations
- Monitor Respiratory Status
3 mins
Spironolactone (Aldactone)
- Mechanisms
- Inhibition of Aldosterone
- Potassium Retention
- Indications
- Hypertension
- Edema
- Heart Failure
- Side Effects
- Hyperkalemia
- Endocrine Effects
- Consideration
- Avoid Potassium Supplements
2 mins
Nitroglycerin
- Mechanism of Action
- Decreases Preload
- Indications
- Angina
- Up to 3 doses q 5 mins
- Side Effects
- Headache
- Hypotension
- Contraindications
- Viagra (Sildenafil)
- Nursing Considerations
- Assess Blood Pressure
- Protect From Light
- Use Glass Bottle and Special Tubing
- Gloves for Applying Topically
2 mins
Acetaminophen
- Indications
- Fever
- Pain
- Mechanism of Action
- Reversibly Inhibits COX
- Acts Primarily in CNS
- Side Effect
- Hepatic Necrosis
- N-acetylcysteine Antidote
51 secs
Digoxin (Lanoxin)
- Mechanism of Action
- Increases Inotropy
- Indications
- Heart Failure
- Atrial Fibrillation
- Side Effects
- Bradycardia
- Fatigue
- Contraindications
- Heart Block
- Nursing Considerations
- Heart Rate Below 60
- Hypokalemia
- Monitor for Toxicity and Visual Changes
- Digibind
2 mins
Acute Digoxin Toxicity
- Clinical Symptoms
- Hyperkalemia
- Cholinergic (Nausea, Vomiting, Diarrhea)
- Blurry Yellow Green Vision with Halo of Light
- Arrhythmia
- Bradycardia
- EKG Changes
- Prolonged PR interval
- Decreased QT
- Scooping on EKG
- T Wave Inversion
2 mins
Digoxin Toxicity Treatment
- Activated Charcoal
- Slowly Normalize K+
- Digibind (Anti-Digoxin Fab)
- Magnesium Sulfate
- Lidocaine
- Cardiac Pacing
2 mins
Beta-1 Agonists
- Dobutamine
- Heart Failure
- Cardiac Stress Test
- Isoproterenol
- Bradyarrhythmias
- Torsades de Pointes
58 secs
Dobutamine
- Mechanism
- Beta-1 Agonist
- Inotropic
- Indications
- Heart Failure
- Side Effects
- Tachycardia
- Arrhythmias
- Considerations
- Closely Monitor Patients
- Other Meds May Increase Potency
1 min
Beta Blockers
- "-olol" suffix
- Mechanism
- Decreases Heart Rate and Contractility
- Decreases Peripheral Vascular Resistance
- Decreases Renin Release
- Indications
- Hypertension
- Heart Failure
- Angina Pectoris
- Contraindications
- Asthma and Heart Block Patients
- Nursing Considerations
- Assess Blood Pressure and Heart Rate
- Masking Signs of Hypoglycemia
- Do Not Stop Abruptly
2 mins
Cardiovascular Effects of Beta-Blockers
- Cardiac Myocytes and Vasculature
- Decrease cAMP
- Decreases SA and AV Node Conduction Velocity
- Lower Blood Pressure
- Decrease O2 Consumption
- Decreases Mortality Post-MI
2 mins
Systemic Effects of Beta-Blockers
- Respiratory
- Bronchoconstriction
- Metabolic
- Decreased Insulin
- Decreased Glycolysis and Lipolysis
- Eye
- Reduces Intraocular Pressure
1 min
Mitral Stenosis
- Characteristics
- Murmur Follows Opening Snap
- Late Diastolic Murmur
- Enhanced by Expiration
- Low-Pitched Rumbling
- Dilation of Left Atrium (LA)
- Recurrent Attacks of Rheumatic Fever
2 mins
Mitral Regurgitation
- Characteristics
- Holosystolic
- Blowing Murmur
- Loudest at Apex
- Radiates toward Axilla
- Louder by Squatting
- Hand Grip
- Expiration
1 min
Aortic Stenosis
- Characteristics
- Age-related Calcifications
- Bicuspid Aortic Valve
- Crescendo-decrescendo Murmur
- Systolic Murmur
- Ejection Murmur
- Ejection Click
- Radiates to Carotids and Apex
- Pulsus Parvus et Tardus
- Syncope
- Helmet Cells
2 mins
Aortic Regurgitation
- Auscultation
- Diastolic Murmur
- Immediate High-pitched
- Blowing Murmur
- Clinical Findings
- Wide Pulse Pressure
- Water Hammer Pulse
- Head Bobbing
- Pulsating Nail Bed
- Considerations
- Can Cause Austin Flint Murmur
1 min
Calcium Channel Blockers (Verapamil and Diltiazem)
- Mechanism of Action
- Slows AV Conduction
- Indications
- Angina Pectoris
- Arrhythmias
- Essential Hypertension
- Side Effects
- Bradycardia
- Hypotension
- Constipation
- Peripheral Edema
- Gingival Hyperplasia
- Nursing Consideration
- Medication Education
2 mins
Warfarin (Coumadin)
- Mechanism of Action
- Inhibits Clotting Factors
- Indications
- Atrial Fibrillation
- Venous Thrombosis
- Pulmonary Embolism
- Assessment
- PT/INR Levels
- Observe for Bleeding
- Contraindications
- Pregnancy
- Nursing Considerations
- Vitamin K and Fresh Frozen Plasma
- Prolonged Therapeutic Onset
- Maintain Same Diet
2 mins
Endocarditis Assessment
- Infection of Inner Layer and Valves
- Assessment
- Fever
- Fatigue
- New or Changed Murmurs
- Roth's Spots
- Splinter Hemorrhages
- Janeway Lesions
- Osler's Nodes
- Considerations
- Heart Failure
- Embolization
2 mins
Endocarditis Interventions
- Interventions
- IV Antibiotics
- 4-6 Weeks
- Anticoagulants
- Good Hygiene
- Considerations
- Closely Monitor
- Antibiotic Prophylaxis
- Dental Procedures
- Invasive Procedures
1 min
Penicillin
- Mechanism of Action
- Weakens Cell Wall
- Indications
- Gram-Positive Infections
- Prophylaxis
- Side Effects
- Pain at IM Injection Site
- Allergic Reaction
- Considerations
- Skin Tests
- Allergy ID
- Medication Education
2 mins
Cephalosporins
- Starts with "Cef-"
- Mechanism of Action
- Bactericidal
- Indications
- Gram-Positive and Gram-Negative Infections
- Side Effects
- Allergic Reactions
- Thrombophlebitis
- Bleeding
- Contraindications
- Renal Impairment
- Considerations
- Avoid IV Calcium with Ceftriaxone
- No Alcohol
2 mins
Acute Pericarditis Causes
- Idiopathic
- Infection
- Trauma
- Cardiac
- Myocardial Infarction
- Autoimmune Diseases
- Uremia
- Tumor
- Radiation
2 mins
Acute Pericarditis Assessment
- Pericardial Sac Inflammation
- Assessment
- Sharp Chest Pain
- Increased with Inspiration
- Pain Decreased by Leaning Forward
- Pericardial Friction Rub
- Diffuse ST-Elevation
- T Wave Inversion
- Fever
- Considerations
- May Be Asymptomatic
- Cardiac Tamponade
2 mins
Acute Pericarditis Interventions
- Interventions
- Treat Underlying Disorder
- Antibiotics
- Colchicine + NSAIDs
- Corticosteroids
- Place Patient Upright with Head of Bed at 45°
- Pericardiocentesis
- Pericardial Window
2 mins
Rheumatic Fever Assessment
- Mechanism
- Aschoff Bodies
- Signs and Symptoms - Major
- Carditis
- Subcutaneous Nodules
- Polyarthritis
- Chorea
- Erythema Marginatum
- Signs and Symptoms - Minor
- Fever
- Arthralgia
- Elevated ESR and C-reactive Protein
- Complications
- Rheumatic Heart Disease
2 mins
Rheumatic Fever Interventions
- Antibiotics
- Prophylactic Treatment
- Relieve Joint Pain
- Prevent Cardiac Complications
- Educate Chorea is Temporary
1 min
Hypertrophic Cardiomyopathy Mechanisms
- Pathophysiology
- 2/3 Autosomal-Dominant
- 1/3 Sporadic Type
- Mutation in Gene for Sarcomere Protein
- Cardiac Myosin Binding Protein C
- Asymmetric Septal Hypertrophy
- Outflow Tract Obstruction
- Diastolic Dysfunction
2 mins
Hypertrophic Cardiomyopathy Signs, Symptoms and Treatment
- Signs and Symptoms
- Sudden Death Of Young Athlete
- Heart Failure
- Angina
- Arrhythmias
- Syncope
- Harsh Systolic Ejection Murmur
- S4 Heart Sound
- Treatment
- Beta Blocker
- Non-dihydropyridine Calcium Channel Blocker
2 mins
Cardiac Tamponade
- Mechanism
- Fluid in the Pericardial Sac
- Pericarditis
- Decreased Cardiac Output
- Signs/Symptoms
- Beck's Triad
- Hypotension
- Jugular Venous Distention (JVD)
- Distant Heart Sounds
- Pulsus Paradoxus
- Electrical Alternans
- Treatment
- Pericardiocentesis
1 min
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