Cardiovascular Disorders Worksheet-1 PDF

Cardiovascular Disorders Disease Pathophysiology Signs and Symptoms Nursing Medications Interventions/treatments Heart Failure Inability to pump blood...

Cardiovascular Disorders Disease Pathophysiology Signs and Symptoms Nursing Medications Interventions/treatments Heart Failure Inability to pump blood to Depending on which side of Respiratory- rate and ACE if cough ARBs they meet the metabolic the heart rhythm, lung sounds, block aldosterone demands of the body Right sided- periphery sob, pulse ox, incentive Diuretics (edema, swelling) spirometer, pulmonary (spironolactone) Left sided- pulmonary/ lung edema Morphine would be issues used for vasodilation Cardiac- pre and which decreases the afterload reduction, vital workload of the heart signs, heart sounds, Nitroglycerin- edema, skin turgor, i&o, fatigue, chest pain, jvd, activity tolerance Dietary- limit sodium intake, more fiber, fresh fruits and vegetables (no canned foods) Weight- same clothing and time of the day Skin- cold, clammy and cyanotic skin or poor perfusion Lifestyle changes ADL’s tolerant  Cardiovascular Disorders Disease Pathophysiology Signs and Symptoms Nursing Medications Interventions/treatments Valvular Disease There are two types: Mitral Stenosis- Respiratory If patient is Diuretics to control Stenosis- narrowing of the symptoms due to asymptomatic- no volume SASMR valve pulmonary congestion: interventions needed Systolic murmur Regurgitation- back flow of dyspnea, tachypnea, dry just monitor the valve Digoxin if force of (aortic stenosis, the blood cough, coughing blood, contraction needs to be mitral regurgitation) pulmonary edema Activity restriction to improved decrease stress DARMS Mitral regurgitation- If respiratory issues- Diastolic murmur asymptomatic (respiratory Dietary changes (fluid supplemental oxygen (aortic regurgitation, if any) restriction/ no added mitral stenosis) salt) If develops an Aortic stenosis- respiratory arrythmia- calcium symptoms, activity Surgery- reconstructive channel blocker or a intolerance and fatigue or valve replacement beta blocker Aortic regurgitation- If develops AFIB- respiratory symptoms coumadin to prevent clot Aneurysms Dilation of an artery- HYPERTENSION is Non-surgical: monitor for Antihypertensive meds enlarges up to 2 times its important to control growth, pain Location: diameter management, frequent Abdominal Aortic Other risk factors: ultrasound to monitor Aneurysm (AAA) Middle of the arterial atherosclerosis, for growth. Thoracic Aortic weakened producing hyperlipidemia, smoking, Aneurysm (TAA) stretching effect. As the age, gender, genetic Surgical: elecetive/ tension increases, it causes emergent vessel to enlarge and could Assessment: usually cause Has to be at least 5cm lead to rupture by pressure in the diameter in able to be candidate for surgery or  Cardiovascular Disorders Disease Pathophysiology Signs and Symptoms Nursing Medications Interventions/treatments surrounding organs or if the patient becomes when it ruptures symptomatic Procedure: AAA: abdominal, flank, back aneurysmectomy pain. Steady pain. Indigestion, n&v, Post-operative care: icu constipation. to monitor bp, cardiac It can be asymptomatic if monitor, assess pulses, aneurysm is too small. temp and sensation AUSCULTATE BUT DON’T PALPATE Complication: hypovolemia, TAA: ascending: hypotensiton asymptomatic. If its close to the valve, TAA: chest tube murmur can be heard assessment tomake sure If it’s in the arch of the its not bleeding, monitor aorta where great vessels UO. GOAL: 50ml/hr branch off, could have s/sx BUN/ creatinine of neuro changes d/t decrease blood flow to the Respiratory CNS complication: Descending: back pain, supplemental o2/ SOB, wheezing, hoarse ventilator for a short voice, difficulty swallowing, period of time numbness and tingling Complication: paralytic ileus  Cardiovascular Disorders Disease Pathophysiology Signs and Symptoms Nursing Medications Interventions/treatments Peripheral Arterial Part or all of an artery is Common cause: Assessment: pain, Trental: increases the Disease occluded or blocked causing atherosclerosis location, severity with or flexibility of RBC, decreased perfusion to distal Other cause: compression without activity, hair loss decreases viscosity tissue. of the vessels (tumor, lower calf and ankle, foot Antiplatelet agent: Tissue below the blockage structural defects, skin dry, scaly, dusky, aspirin/ Plavix/ cannot live without vasospasm) pale or mottled, thick clopidogrel adequate oxygen or toenails. Patient who takes Plavix nutrients causing ischemia/ Risk factor: age, pregnancy, With severe: cold and should be not eat necrosis smoking, dm, obese, gray, blue or darkened. grapefruit sedentary lifestyle, diet- If you elevate: pale Control hypertension: to high is saturated fat, Lowered: red improve perfusion cholesterol, trans fat), Palpate pulses in both Beta blockers: sugar and salt, genetic legs and compare contraindicated in PAD Ulcer formation- usually because it increases Risk for developing: chronic painful claudication agina or chest pain, Segment SBP: lower for If patient has myocardia infarction and ankle than brachial hyperlipidemia, take stroke statins Management: exercise, Nondiabetic patient: positioning, vasodilation, femoral popliteal collateral circulation. Severe pain: rest Diabetic patient: usually Educate patient to avoid occurs below the knee elevating feet, instead dangle them Promote vasodilation by providing warm blanket but do not use direct heat it may cause burn!  Cardiovascular Disorders Disease Pathophysiology Signs and Symptoms Nursing Medications Interventions/treatments Avoid cold weather, stress, nicotine, caffeine Venous Formation of thrombus in a Contributing factor: A duplex ultrasound (non anticoagulant (heparin Thromboembolism vein. Most common is deep Virchow’s Triad invasive) to visualize the drip) with lovenox (VTE) vein. 1. Vessel damage vein and see if there’s Coumadin 2. Blood stasis/pooling thrombus present Heparin- APTT Formation of thrombus is 3. Hypercoagulation Veinography (invasive) associated with uses dye, risk for Pain relief: inflammation of the vein Assessment: hx of complications. Used with acetaminophen thromboembolism, surgery, patient who have clinical Should suffice pregnancy, afib, tumor, evidence of DVT but a obese, myocardial negative ultrasound Severe pain: narcotic infarction, heart failure Two kinds: Lab test: d-dimer Superficial thromboembolic :palpable cord-like vein. Patient should not Painful around the area, massage the area warm to touch, tender or Measure the painful, may or may not circumference of the have edema extremity daily if not a Deep thromboembolic: few times a day unilateral edema Gradually increase If emboli is in the inferior ambulation vena cava: bilateral edema Elevate legs If emboli is in the superior Compression socks vena cava: edema in the SCD face, neck and back area.  Cardiovascular Disorders Disease Pathophysiology Signs and Symptoms Nursing Medications Interventions/treatments Typically edema is Monitor for s/sx of unilateral. pulmonary embolism: Tenderness/ pain in the SOB, chest pain and area acute confusion If pt has a hx of multiple DVT: they may have inferior vena cava filter placed After procedure: watch for bleeding/ signs of infection Deep breaths Stop smoking and weight loss Arteriosclerosis and Arteriosclerosis- thickening It can take 20-40 years for Change diet to lower LDL If lipoprotein levels Atherosclerosis or hardening of the arterial an individual to exhibit and increase HDL don’t improve with wall. Often associated with symptoms More vegetables, whole lifestyle changes- bile aging, arteries lose elasticity grain, limiting sweets acid sequential Atherosclerosis- plaque and sugary drinks and (cholestyramine) should build up withing the arterial red meat take other meds 1 hour wall. Narrowing of the Low-fat dairy intake prior or 4 hours after arterial lumen. Leading risk Eat poultry, fish, factor of CVD, CAD, PVD and legumes, nuts and Fibric acid (gemfibrozil)- CVD. reducing trans fat lower triglyceride levels  Cardiovascular Disorders Disease Pathophysiology Signs and Symptoms Nursing Medications Interventions/treatments Saturated fat- 5-6% of Nicotinic acid (niacin)- their calories inhibits VLDL synthesis Increase fiber to 30g/day used in conjunction with Stop smoking bile acid sequential and Manage weight, exercise reduces risk of CAD. Don’t drink grape juice Common adverse effect Liver function test, niacin flush—check for monitor for AST, ALT orthostatic hypotension, levels if it rise to 3 times educate to change their normal- STOP! position slowly Omega three fatty acid (fish oil)- reduce Hyperlipidemia triglycerides synthesis treatment (atorvastatin, simvastatin)- inhibits cholesterol synthesis, reduces LDL. Most effective when taken at night Hypertension Increases the workload of Usually, asymptomatic Lifestyle changes to **garlic has been shown the left ventricle by lower bp to reduce cholesterol increasing the afterload and bp (pressure) causing Limit sodium intake hypertrophy and remodeling Initial tx for HTN of the left ventricle. Lose weight-regular 1. Thiazide exercise at least 40 diuretics- take in It can lead to stroke, minutes, 3-4 times a the morning myocardial infarction, week than at night kidney failure and death  Cardiovascular Disorders Disease Pathophysiology Signs and Symptoms Nursing Medications Interventions/treatments Don’t drink too much 2. Calcium channel alcohol/ stop smoking blockers- don’t eat grapefruit Relaxation to reduce with it stress 3. ACE inhibitors- if experience dry cough call pcp and switch to 4. ARB’s Hypertensive crisis Severe elevation of bp. Severe headache, Putting patient on a Antihypertensive IV Greater than 180/120. It can extremely high pressure, semi-fowlers position (nitrous oxide/ beta cause damage to kidney/ dizziness, blurred vision, blockers). heart sob, nosebleed, severe Administer oxygen anxiety Starting an antihypertensive IV (nitrous oxide/ beta blockers). Once patient is stable change medication to oral Monitor bp frequently- every 5-15 mins from when IV med started until below 90 but not less than 75 of diastolic.  Cardiovascular Disorders Disease Pathophysiology Signs and Symptoms Nursing Medications Interventions/treatments Then monitor bp every 30 minutes to make sure pressure isn’t dropping to quickly Monitor neurologic complications: seizure, numbness, weakness or tingling of the extremities Monitor cardiovascular complications: dysrhythmia or chest pain Infective Endocarditis Pericarditis  Cardiovascular Disorders Disease Pathophysiology Signs and Symptoms Nursing Medications Interventions/treatments Cardiac Tamponade Coronary Artery Disease Acute Coronary Syndrome Angina - Stable Angina - Unstable  Cardiovascular Disorders Disease Pathophysiology Signs and Symptoms Nursing Medications Interventions/treatments Myocardial Infarction