Cardiac Assessment and Diagnostics Review

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Questions and Answers

What is the primary treatment for atrial fibrillation (Afib)?

Atropine

Warfarin (correct)

Oxygen therapy

Defibrillation

In left-sided heart failure, where does the backup of blood primarily occur?

In the abdomen

In the lungs (correct)

In the liver

In the inferior vena cava

Which medication requires monitoring of potassium levels due to a risk of hypokalemia?

Diltiazem

Furosemide (correct)

Valsartan

Warfarin

What symptom is commonly associated with right-sided heart failure?

Edema in hands and feet Signup and view all the answers

When monitoring a patient post cardiac catheterization, which of the following is essential?

Assess vital signs and pulses distal to the catheter insertion Signup and view all the answers

What symptom indicates potential left-sided heart failure?

Fatigue and confusion Signup and view all the answers

Which action is part of the MAWDS home management teaching for heart failure?

Record daily weights at the same time each day Signup and view all the answers

In the case of a pulseless patient, what is the immediate action required?

Perform defibrillation Signup and view all the answers

What lifestyle change can help Susie manage her hypertension?

DASH diet Signup and view all the answers

Which of the following is a symptom of atherosclerosis that Susie might experience?

Chest pain Signup and view all the answers

What should Susie monitor for as side effects of cholesterol-lowering statins?

Muscle cramping and abdominal pain Signup and view all the answers

What does the absence of hair growth on Susie's legs indicate?

Poor circulation due to atherosclerosis Signup and view all the answers

What is a key sign to watch out for after Susie's stent placement surgery?

Decreased circulation or cold extremity Signup and view all the answers

Which condition is characterized by ischemia to the feet and is linked to smoking?

Buerger's disease Signup and view all the answers

What is the recommended treatment for a patient diagnosed with DVT?

Initiate heparin IV in a hospital setting Signup and view all the answers

What common factor can contribute to high cholesterol levels in Susie's case?

High fat diet Signup and view all the answers

Study Notes

Cardiac Content Review

Head to Toe Cardiac Clues: Assess for brittle/dry hair (possible poor nutrition), vascular changes in eyes, cyanosis or dehydration in lips/tongue, distended jugular veins (hypervolemia, right-sided heart failure), lung crackles (left-sided heart failure), murmurs, fluid accumulation (ascites), enlarged liver (right-sided heart failure), dry/cool skin (poor nutrition), clubbed nails (chronic low O2 saturation), thin skin and lack of hair (poor circulation), edema, and presence of pulses and sensation in lower extremities.

Diagnostics for Chest Pain

Electrolytes, lipids, troponin, CK-MB, EKG, exercise stress test, Holter monitor: Used to diagnose potential cardiac issues.
Cardiac catheterization (cardiac cath): Post-procedure monitoring for bleeding and vital sign assessment, checking pulses distal to insertion site.

Rhythms and Treatments

Sinus Bradycardia: Give O2, stimulate patient, administer atropine, or pacemaker. Assess for signs of distress and address underlying causes.
Atrial Fibrillation (Afib): Administer warfarin, diltiazem. Monitor PT/INR (2-3 if therapeutic). Consider cardioversion.
Other Rhythms: First check for pulse; if no pulse, defibrillation may be necessary.

Left-Sided Heart Failure (LHF)

Blood Back-up: Blood backs up into the lungs from the left atrium causing respiratory symptoms (dyspnea, confusion, crackles, orthopnea, cyanosis, fatigue, weak pulses).

Right-Sided Heart Failure (RHF)

Blood Back-up: Blood backs up into the body from the superior/inferior vena cava causing symptoms of edema in hands/feet, abdominal distention, ascites, JVD, enlarged liver and spleen.

Heart Failure Treatment

General Treatment: Daily weights, low sodium diet, oxygen, furosemide and valsartan for heart failure; monitor for dehydration, hypokalemia (lethargy, decreased GI motility, heart irregularities). Take meds in the morning.
Additional Considerations: Report dizziness, lightheadedness, cough, and monitor electrolytes and renal function.

Hypertension Evaluation and Management

Initial Readings: Patient's blood pressure readings (182/88, 178/86, 180/82). Diagnosis of hypertension.
Management: Teach patient DASH diet, weight loss, alcohol limitation, exercises, and stop smoking. Relaxation techniques for stress. Monitor for side effects of medication (orthostatic hypotension and electrolyte imbalances) and home blood pressure monitoring.

Atherosclerosis

Possible Symptoms: High total cholesterol (300), LDL (220) while HDL is low (80). Symptoms include hypertension, chest pain, decreased or absent pulses in extremities, and cool extremities.
Possible Underlying Causes: Sedentary lifestyle, smoking, diabetes, and high-fat diets are possible underlying causes for increased cholesterol.
Treatment: Statins (for lowering cholesterol). Watch for side effects like abdominal pain, constipation, muscle cramping, and diarrhea.

Peripheral Vascular Disease (PVD)

Symptoms: No hair growth, intermittent claudication, rubor (redness), ulcers.
Treatment: Stent placement to increase blood flow, compression stockings, exercise, and weight loss.

Buerger's Disease

Symptoms: Ischemia to feet, linked to smoking, intermittent claudication, sensitive to cold temps, ulcers. Avoid cold temperatures, stop smoking, and take medications as prescribed.

Raynaud's Disease

Symptoms: Vasospasms of hands, painful when exposed to cold. Same treatment as Buerger's disease.

Deep Vein Thrombosis (DVT)

Symptoms: Symptoms in hip replacement patient (hot, swollen, red, hard calf).
Treatment: Heparin IV in the hospital.

Monitoring and Teaching

Bleeding Time: Monitor activated partial thromboplastin time (aPTT) while patient is on heparin (60-80 seconds). Discuss bleeding risks.
Patient Education: Teach patients about foot care (aches, heaviness, varicose veins), high-impact exercise avoidance, compression stockings, weight loss, and elevation techniques.
Medication adherence: Encourage medication adherence and emphasize monitoring for side-effects.

Myocardial Infarction (MI)

Symptoms: Chest pain, indigestion, weakness, shortness of breath (SOA). Use MONA medication (Morphine, Oxygen, Nitroglycerin, and Aspirin).

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Description

This quiz covers essential cardiac clues, diagnostics for chest pain, and treatments for various rhythms, focusing on assessment strategies and critical interventions. Test your knowledge on identifying signs of heart failure, understanding diagnostic tests, and appropriate responses to heart rhythm irregularities.