Week 3 NR341 Notes PDF

Week 3 Notes Dysrhythmias and Their Effect on Perfusion: Dysrhythmias are abnormal heart rhythms that reduce the heart's ability to pump blood effectively. Reduced perfusion can affect vital organs like the brain, kidneys, and heart. Example: In atri...

Week 3 Notes Dysrhythmias and Their Effect on Perfusion: Dysrhythmias are abnormal heart rhythms that reduce the heart's ability to pump blood effectively. Reduced perfusion can affect vital organs like the brain, kidneys, and heart. Example: In atrial fibrillation, patients may experience dizziness, chest pain, or fainting due to poor blood flow. Nursing Assessment, Interventions, and Prevention of Complications in Patients with Dysrhythmias: Assessment: o Monitor heart rhythm via ECG. o Check vital signs (blood pressure, pulse) and assess for symptoms like dizziness and confusion. o Example: A patient with ventricular tachycardia may have low blood pressure and shortness of breath. Interventions: o Administer medications like amiodarone or lidocaine to control heart rhythm. o Use defibrillation for life-threatening rhythms like ventricular fibrillation. o Provide oxygen therapy if the patient is hypoxic. o Educate patients to avoid caffeine, alcohol, and smoking to reduce recurrence. Prevention of Complications: o Administer anticoagulants such as warfarin or apixaban in patients with atrial fibrillation to prevent blood clots and strokes. o Ensure medication adherence to prevent recurrences. o Implement fall prevention strategies for patients experiencing dizziness or hypotension. Review of Evidence-Based Guidelines in Cardiovascular Care: Use beta-blockers (e.g., metoprolol) and ACE inhibitors (e.g., lisinopril) to manage heart failure. Administer anticoagulation therapy (e.g., warfarin, rivaroxaban) to reduce stroke risk in atrial fibrillation.  Enroll patients in cardiac rehabilitation after a heart attack (ACS) to reduce recurrence. Encourage lifestyle changes such as exercise, healthy diet, and smoking cessation for long-term cardiovascular health. Assessment, Interventions, and Prevention of Complications Associated with Fluid Overload: Assessment: o Monitor daily weight and intake/output. o Assess for edema, crackles in the lungs, and shortness of breath. Interventions: o Administer diuretics like furosemide (Lasix) to reduce fluid buildup. o Position patients in semi-Fowler’s or Fowler’s to ease breathing. o Provide oxygen therapy if oxygen levels are low. o Restrict fluid intake and provide a low-sodium diet. Prevention of Complications: o Detect early signs of worsening heart failure or kidney failure. o Regularly monitor fluid balance and adjust as needed. o Manage edema to prevent skin breakdown. Strategies to Improve Communication in Complex Adult Patient Care: Use SBAR (Situation, Background, Assessment, Recommendation) for clear communication with the healthcare team. Hold interdisciplinary team meetings to discuss patient care plans and adjust treatments. Use patient-centered communication by explaining the condition and involving the patient in decision-making. Practice active listening and encourage patient participation in their care. Ensure proper documentation of changes in patient status to maintain smooth transitions between caregivers. Use SBAR (Situation, Background, Assessment, Recommendation) for clear communication with the healthcare team. Encourage interdisciplinary team meetings to discuss patient care plans. Utilize patient-centered communication, ensuring the patient understands their condition and care.  Incorporate active listening and encourage patient participation in decision- making. Ensure proper documentation of changes in patient status to facilitate smooth transitions between care providers. Chapter 37: Coronary Artery Disease (CAD) and Acute Coronary Syndrome (ACS) Coronary Artery Disease (CAD) CAD occurs when the coronary arteries (which supply blood to the heart) become narrowed or blocked due to plaque buildup, causing reduced blood flow. Risk Factors: High cholesterol, smoking, high blood pressure, diabetes, and lack of exercise. Symptoms: Chest pain (angina), shortness of breath, or no symptoms at all. Acute Coronary Syndrome (ACS) ACS refers to any condition caused by the sudden reduction of blood flow to the heart, including: o Unstable Angina: Chest pain that happens suddenly or worsens over time. o Myocardial Infarction (MI): A heart attack occurs when a coronary artery is completely blocked, damaging heart muscle. Medications for CAD & ACS 1. Antiplatelets (e.g., Aspirin, Clopidogrel) – Prevent blood clots. 2. Beta-Blockers (e.g., Metoprolol) – Lower heart rate and blood pressure. 3. Statins (e.g., Atorvastatin) – Lower cholesterol levels. 4. Nitrates (e.g., Nitroglycerin) – Open blood vessels to improve blood flow and relieve chest pain. 5. ACE Inhibitors (e.g., Lisinopril) – Lower blood pressure and decrease heart strain. 6. Heparin/Enoxaparin – Blood thinners used during heart attacks to prevent further clotting. Chapter 38: Heart Failure Heart Failure (HF) Heart failure happens when the heart is too weak to pump blood effectively to meet the body’s needs. It can affect either the left side (more common) or right side of the heart, or both. Causes: Long-standing high blood pressure, coronary artery disease, heart attacks, or diseases that affect the heart muscle. Symptoms: Shortness of breath, fatigue, swelling in the legs (edema), and difficulty sleeping flat. Types of Heart Failure: 7. Systolic Heart Failure – The heart cannot pump effectively. 8. Diastolic Heart Failure – The heart cannot fill with enough blood due to stiffness. Medications for Heart Failure: 9. Diuretics (e.g., Furosemide) – Help remove excess fluid, reducing swelling and lung congestion. 10. Beta-Blockers (e.g., Carvedilol) – Reduce heart rate and blood pressure, improving heart function. 11. ACE Inhibitors/ARBs (e.g., Lisinopril, Losartan) – Lower blood pressure and reduce the heart's workload. 12. Aldosterone Antagonists (e.g., Spironolactone) – Help the body eliminate excess sodium and water. 13. Digoxin – Strengthens the heart's contractions and slows the heart rate. Chapter 39: Dysrhythmias Dysrhythmias (Arrhythmias) Dysrhythmias are abnormal heart rhythms that occur when the electrical signals in the heart don't work properly. Common Types: o Atrial Fibrillation (AFib): An irregular, fast heartbeat in the upper chambers of the heart. o Ventricular Tachycardia (VTach): A fast, abnormal rhythm from the lower chambers, which can be life-threatening. o Ventricular Fibrillation (VFib): A chaotic rhythm that causes the heart to stop pumping blood, leading to cardiac arrest. Symptoms: Palpitations (irregular heartbeats), dizziness, chest pain, shortness of breath, or fainting. Medications for Dysrhythmias: 14. Beta-Blockers (e.g., Metoprolol) – Slow down the heart rate. 15. Calcium Channel Blockers (e.g., Diltiazem) – Help control heart rate and relax blood vessels. 16. Antiarrhythmics (e.g., Amiodarone) – Help restore a normal rhythm. 17. Anticoagulants (e.g., Warfarin, Apixaban) – Prevent blood clots in patients with AFib. 18. Sodium Channel Blockers (e.g., Procainamide) – Stabilize heart electrical activity.