Study Guide Cardio: Nursing Care, Signs, and Symptoms - PDF

**Study Guide Cardio** **Terminology** Hyperlipidemia = "high cholesterol" high levels of fat and lipids in the blood PMM PMH = past medical history **Roles of Organs and Structures** Respiratory System - Work together with the cardiovascular system to supply O2 and dispose CO2 Cardiov...

**Study Guide Cardio** **Terminology** Hyperlipidemia = "high cholesterol" high levels of fat and lipids in the blood PMM PMH = past medical history **Roles of Organs and Structures** Respiratory System - Work together with the cardiovascular system to supply O2 and dispose CO2 Cardiovascular system - Transports blood, carries oxygen and nutrients to all the cells in the body Arteries - Transport **OXYGEN RICH** blood to the body cells Veins - Transport **OXYGEN POOR** blood back to the heart to be pumped to the lungs Aorta - Carry **OXYGEN RICH** blood from the heart to the rest of the body **Vital Signs** Temperature - Normal = 36-38 - \> 38 = hyperthermia - \< 36 = hypothermia Pulse - Normal = 60-100 bpm - \> 100 bpm = tachycardia - \< 60 bpm = bradycardia Respirations - Normal = 12-20 bpm - \> 24 tachypnea - \< 10 bradypnea Blood Pressure - Normal = systolic 100 -139 mmHg, diastolic 60-89 mmHg - \> 140/90 mmHg = hypertension - \< 100/60 mmHg = hypotension 02 Sat - Normal = 95-100% - 90 -- 95% = mild hypoxia - \< 90% = severe hypoxia **Conditions/ Disorders** **ON EXAM 1 OR 2 NURSING CARE INTERVENTIONS (choose the best ones)** **[CANNOT SAY] VS IN S&S** Anemia Decrease the number of quality red blood cells Laxck of iron *Signs & Symptoms* a. Pallor b. Sensitivity to cold c. Fatigue d. Dizziness e. Weakness (asthenia) f. Tachycardia g. Dyspnea (SOB) h. Paresthesia (numbness & tingling) i. Decreased hemoglobin and hematocrit *Nursing Interventions* For tachycardia: - Regularly monitor HR and RR - Raise HOB to facilitate breathing For decreased Hb, pale skin, asthenia, dizziness, paresthesia: - Iron rich diet - Vitamin C rich diet - Antianemics as prescribed - Alternating periods of activity and rest - Getting up slowly - Ensure safe environment Angina Pain in the chest Arteries increases blood supply Pain that will be relieved with nitro, temporary blockage *Signs & Symptoms* a. Retrosternal pain b. Severe pain/ tightness in the chest that may radiate c. Indigestion is the 1^st^ complaint d. Nausea e. Pallor f. Diaphoresis g. Dyspnea h. Anxiety *Nursing Interventions* Immediate treatment: - Have pt stop activity and sit or lie down - Stay with pt. to reassure them (reduce anxiety) - Check VS and O2 sat - Administer nitro as prescribed For retrosternal pain: - Keep pt at rest - Assess PQRST - Administer nitroglycerin as prescribed (every 5 mins MAX 3 doses) To increase oxygenation: - Administer oxygen as prescribed To facilitate breathing: - Place pt in semi -- high fowlers position Myocardial Infarction Sudden blockage/ obstruction of one or many coronary arteries Pain will continue, permanent blockage *Signs & Symptoms* a. Sudden, sharp, crushing retrosternal chest pain b. Pain/ numbness that may radiate c. Nausea ad vomiting d. Panic, confusion, feeling of doom e. Dyspnea f. Cold, clammy ashy skin or cyanosis g. Rapid, thready, irregular pulse h. Diaphoresis *Nursing Considerations* - Stool softeners - Antiembolic stockings For retrosternal pain: - Keep pt at rest - Assess PQRST - Administer nitroglycerin as prescribed (every 5 mins MAX 3 doses) To increase oxygenation: - Administer oxygen as prescribed To facilitate breathing: - Place pt in semi -- high fowlers position Hypertension High blood pressure *Signs & symptoms* a. SOB b. Headaches c. Flushed face (red) d. Dizziness e. Tinnitus (ringing in ears) f. Epistaxis (nose bleeds) Nursing Considerations To relieve pain and discomfort: - Administer analgesics as prescribed To allow the heart to rest: - Limit prolonged exertion - Rest periods during the day General care: - Monitor BP regularly - Administer antihypertensives as prescribed Congestive Heart Failure Heart has lost it's pumping efficiency *Signs & Symptoms* a. Excessive fatigue b. Pitting edema c. Decreased urine output d. Dyspnea e. JVD (swollen, pulsing neck veins) f. Persistent cough with thin whitish sputum that can be frothy or blood streaked *Nursing Considerations* - Strict I/O - Daily weights - 02 - Elevate legs - Check CTSM - Monitor edema and skin integrity - Monitor sputum (colour, amount) - Elevate HOB - Pursed lip breathing - Decrease fluids and Na - Foley catheter - IV KVO (keep vein open) DVT Clot that develops in a deep vein & affects normal blood flow *Signs & Symptoms* a. Pain in affected leg b. Redness c. Warmth d. Pitting edema e. Fever f. Positive Homan's Sign *Nursing Considerations* - Slightly elevate leg - Check neurovascular signs - Measure leg edema - Complete bed rest as ordered - Anti-embolism stockings - Immobilize affected part - Tell pt. to avoid long periods of standing or immobility Pneumonia Inflammation of the lung with air sacs filling with exudate *Signs & symptoms* a. Severe sharp pain in chest b. Chills c. high fever d. painful cough e. purulent (green) sputum f. pain with breathing g. rapid pulse & respiration h. expiration is difficult i. cyanosis j. delirium k. anxiety l. high WBC count *Nursing considerations* - adequate fluid intake - elevate HOB to aid breathing - DB & C COPD Chronic Bronchitis Inflammation of the bronchial tubes, often follows a resp infection *Signs & Symptoms* a. Productive hacking cough b. Constant SOB c. Hypoventilation (shallow breathing) d. Hypoxia e. Reddish/ blue colour *Nursing Considerations* - Raise HOB - Promote hydration - Pursed lip breathing - Coughing exercises - Monitor O2 sat - High fiber, high calorie diet - Advise pt. to stop smoking - AAT - Small frequent meals COPD Emphysema Permanent enlargement of alveoli & alveolar ducts which results in a lack of elasticity *Signs & Symptoms* a. 1^st^ difficulty breathing after exertion leading to persistent dyspnea b. Wheezing c. Cyanosis d. Pale & drawn e. Fear of choking f. Use of abd. & accessory muscles to breathe g. Afraid to lie down h. Barrel-shaped chest *Nursing Considerations* - Raise HOB - Promote hydration - Pursed lip breathing - Coughing exercises - Monitor O2 sat - High fiber, high calorie diet - Advise pt. to stop smoking - AAT - Small frequent meals Asthma (NOT ON EXAM) Chronic lung disease with reversible airway obstruction & inflammation Airways will close down and create secretions inside and make it difficult to breathe *Signs & Symptoms* a. Wheezing b. SOB c. Cough (worse at night) *Nursing Considerations* - Raise HOB with arms on bedside table if needed - Monitor O2 sat - Pursed lip breathing - Increased fluid intake - Have pt. rest **Nursing Care** Poor appetite a. Small frequent meals b. High protein & high calorie Warmth a. Monitor NVS Sputum a. Monitor consistency b. Encourage coughing c. Give Ventolin if ordered Fever a. Monitor temp b. Antipyretic as ordered c. Increase fluids SOB a. Oxygen as needed b. Elevate HOB c. Pursed lip breathing d. Monitor O2 sat Edema a. Measure leg b. Elevate leg skightly c. Anti-embolic stockings as ordered Redness a. Monitor temp b. Monitor colour c. Monitor PQRST Dizziness a. Safety b. Maintain bed rest Anxious a. Calm environment b. Remain calm c. Stay with patient Headache a. PQRST b. Medicate as needed