Whole Blood Composition
- Plasma
- Electrolytes And Other Solutes
- Proteins
- Albumin
- Fibrinogen
- Globulins
- Water
- Formed Elements
- Buffy Coat
- White Blood Cells (WBC)
- Platelets
- Red Blood Cells (RBC)
Types of Heart Failure
- Left Sided
- Pulmonary Congestion
- Right Sided
- Peripheral Edema
- High Output
- Unable to Meet Metabolic Needs
Right Heart Failure Assessment
- Jugular Venous Distention (JVD)
- Peripheral Edema
- Hepatosplenomegaly
- Nocturia
- Weight Gain
- Ascites
- Fatigue
Left Heart Failure Assessment
- Pulmonary Congestion
- Pink Frothy Sputum
- Wheezing or Crackles
- Dyspnea with Exertion
- Cough
- Fatigue
- Tachycardia
- Weak Peripheral Pulse
- S3, S4 Heart Sounds
Heart Failure Interventions
- Echocardiogram
- Invasive Hemodynamic Monitoring
- High Fowler's Position
- Oxygen
- Advanced Airway
- Diuretics
- Beta Blockers
- Angiotensin II Receptor Blockers (ARBs)
- ACE Inhibitors
- Digoxin (Lanoxin)
- Pacemaker
Digoxin (Lanoxin)
- Increases Inotropy
- Heart Failure
- Atrial Fibrillation
- Bradycardia
- Fatigue
- Heart Block
- Heart Rate Below 60
- Hypokalemia
- Monitor for Toxicity and Visual Changes
- Digibind
Acute Digoxin Toxicity
- Hyperkalemia
- Cholinergic (Nausea, Vomiting, Diarrhea)
- Blurry Yellow Green Vision with Halo of Light
- Arrhythmia
- Bradycardia
- Prolonged PR interval
- Decreased QT
- Scooping on EKG
- T Wave Inversion
Digoxin Toxicity Treatment
- Activated Charcoal
- Slowly Normalize K+
- Digibind (Anti-Digoxin Fab)
- Magnesium Sulfate
- Lidocaine
- Cardiac Pacing
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
Calcium Channel Blockers (Verapamil and Diltiazem)
- Slows AV Conduction
- Angina Pectoris
- Arrhythmias
- Essential Hypertension
- Bradycardia
- Hypotension
- Constipation
- Peripheral Edema
- Gingival Hyperplasia
- Medication Education
Stable Angina
- Chest Pain with Exertion
- Relieved within 15 Minutes
- ST Depression
- Nitroglycerin
- Up to 3 Doses q 5 Minutes
- Rest
- Antiplatelet Medication
- CABG
- Angioplasty
Unstable Angina
- Chest Pain with Rest or Exertion
- Limits ADLs
- > 15 Minutes
- Less Likely Relieved by Nitroglycerin
- ST Depression
- Fatigue
- Acute Coronary Syndrome (ACS) Treatment
- Emergency Treatment
Adenosine (Adenocard)
- Slows AV Conduction
- Supraventricular Tachycardia (Paroxysmal)
- Bradycardia
- Flushing
- Dyspnea
- Rapid IV Push
- Caffeine and Theophylline Decrease Effectiveness
- Dipyridamole May Intensify Effects