MS Midterm PDF

Pneumothorax (Collapsed Lung) Arterial blood gases (ABGs): Measure - Pneumothorax is a condition where air collects in oxygen and carbon dioxide levels. the space around the lungs, making it difficult for...

Pneumothorax (Collapsed Lung) Arterial blood gases (ABGs): Measure - Pneumothorax is a condition where air collects in oxygen and carbon dioxide levels. the space around the lungs, making it difficult for Thoracentesis: Fluid or blood in the pleural the lung to expand normally. space confirms hemothorax. Treatment: Types: Chest tube: To drain air and re-expand the 1. Simple/Spontaneous Pneumothorax: lung. Occurs when air leaks into the space due Surgical intervention: In severe cases, to a tear in the lung. such as large amounts of blood or air. 2. Traumatic Pneumothorax: Happens when Oxygen therapy: To address low oxygen an injury (like a rib fracture or stab wound) levels. causes air to escape into the pleural Antibiotics: To prevent infection. space. 3. Tension Pneumothorax: A more serious Nursing Care: form where air builds up and can’t escape, Monitor breathing, chest expansion, and causing the lung to collapse and pushing oxygen levels. the trachea to one side. Provide pain relief. Causes: Ensure the chest tube is functioning Rupture of a small air sac (bleb) properly. Trauma to the chest Teach the patient to help re-expand their Medical procedures that accidentally lung through breathing exercises. puncture the lung Goals: Pathophysiology: Pain relief 1. Negative Pressure in Pleural Space: The Improved breathing pleural space around the lungs normally Reduced anxiety has negative pressure, which keeps the Restored oxygen levels lungs expanded. 2. Breach in Pleura: When the parietal or Cardiogenic Shock (Pump Failure) visceral pleura (the membranes - Cardiogenic shock occurs when the heart cannot surrounding the lungs) is breached, air pump enough blood to the body, leading to poor enters the pleural space. cardiac output and reduced tissue perfusion. It 3. Air in Pleural Space: As air enters, the typically stems from severe left-sided heart failure. pleural space loses its negative pressure and becomes positive, which prevents the Pathophysiology: lung from expanding properly. 1. Decreased Heart Contraction: The heart 4. Lung Collapse: The buildup of air in the can’t pump enough blood, leading to a pleural space pushes against the lung, drop in stroke volume and reduced causing it to partially or completely cardiac output. collapse, reducing its ability to function. 2. Pulmonary Congestion: Blood backs up in Symptoms: the lungs, causing congestion. Sudden chest pain 3. Compensation: The heart beats faster to Difficulty breathing (dyspnea) try and maintain output, but it doesn’t help Rapid breathing (tachypnea) enough. Cyanosis (bluish skin due to lack of 4. Decreased Stroke Volume: Less blood oxygen) reaches the coronary arteries, reducing Decreased breath sounds on the affected oxygen supply to the heart. side 5. Increased Workload: This causes more Trachea may shift away from the strain on the heart, worsening heart collapsed lung in tension pneumothorax failure. 6. Final Outcome: Low oxygen to the heart Diagnosis: leads to further reduced cardiac output Chest X-ray and CT scans detect air in the and triggers compensatory mechanisms pleural space and lung collapse. to prevent death.  - Monitor arterial lines and fluid therapy. Causes: - Adjust balloon pump for heart rhythm. 1. Coronary Causes: Most commonly due to - Provide medications to relieve pain and a heart attack (myocardial infarction). monitor oxygen and acid-base levels. 2. Non-Coronary Causes: Conditions like cardiomyopathy or stress on the heart Lifestyle Changes for Prevention: muscle. Control blood pressure, avoid smoking, Symptoms: maintain a healthy weight, eat a low-fat Cool, clammy skin diet, and exercise regularly to lower risk Low blood pressure factors for heart disease. Rapid heart rate (tachycardia) Expected Outcomes: Fast, shallow breathing Stable heart function, relief of symptoms, Decreased urine output and successful treatment of cardiogenic Confusion and cyanosis (bluish skin) shock. Diagnosis: Heart failure, or congestive heart failure Auscultation: Detects abnormal heart - is a condition where the heart cannot pump sounds. enough blood to meet the body’s needs. It can Pulmonary Artery Pressure (PAP): involve problems with either the heart’s ability to Measures increased pressure. contract (systolic dysfunction) or to fill with blood Arterial Pressure Monitoring: Shows low (diastolic dysfunction). The main goal of treatment blood pressure. is to manage symptoms and prevent further heart ABGs: Detects metabolic acidosis and low damage. oxygen. ECG & Echocardiography: Confirms heart Types of Heart Failure: damage. Left-Sided Heart Failure: This Enzyme Tests: Confirms heart attack. causes fluid buildup in the lungs, leading to breathing problems. Treatment: Right-Sided Heart Failure: This 1. Medical Management: causes fluid buildup in the body, Oxygen therapy leading to swelling in areas like Angioplasty and stenting (open the legs. blocked arteries) Stages of Heart Failure: Balloon pump (helps blood flow) 1. Stage A: High risk of heart failure IV medications: Dopamine but no symptoms. (increases heart output), 2. Stage B: Heart damage without Dobutamine (increases symptoms. contraction), Nitroprusside 3. Stage C: Heart damage with (decreases vascular resistance) symptoms like fatigue or 2. Surgical Management: Intra-aortic balloon shortness of breath. pump (IABP) to assist heart function. 4. Stage D: Advanced heart failure with severe symptoms. Causes: Nursing Management: Coronary Artery Disease: 1. Assessment: Monitor vital signs, Narrowing of heart arteries due to especially blood pressure and watch for atherosclerosis. signs of fluid overload. Hypertension: High blood 2. Diagnosis: Includes decreased cardiac pressure increases heart output, impaired gas exchange, and ineffective tissue perfusion. workload. Valvular Heart Disease: Problems 3. Goals: Prevent recurrence of shock, with heart valves increase monitor hemodynamics, and manage pressure on the heart. fluids. 4. Interventions: Symptoms: 1. Reduce blood pressure by 25% in the first Left-Sided Heart Failure: hour. Shortness of breath, cough, and 2. Lower to 160/100 mm Hg within 6 hours. lung crackles. 3. Gradually reduce further over several Right-Sided Heart Failure: days. Swelling in the legs and abdomen, Medications: IV vasodilators like sodium loss of appetite. nitroprusside, nicardipine, or nitroglycerin are used for quick action. Fluid status is Diagnosis: monitored to prevent a sudden drop in ECG and Chest X-ray: Check pressure. heart size and function. Echocardiogram: Measures heart Hypertensive Urgency: chambers and ejection fraction. Blood pressure is very high, but no organ Blood Tests: Look for kidney damage is seen. Symptoms may include function and electrolyte levels. headaches, nosebleeds, or anxiety. Treatment: Oral medications like Treatment: labetalol, captopril, or clonidine can lower Medications: ACE inhibitors, blood pressure over 24-48 hours. beta-blockers, and diuretics reduce strain on the heart and Monitoring: Blood pressure is checked frequently—every 5 control fluid buildup. minutes if it’s changing quickly, or every 15-30 minutes in Lifestyle: Low-sodium diet, stable situations. Sudden drops in blood pressure may regular exercise, and quitting smoking. require immediate intervention. Nursing Care: Cardiomyopathy Monitor symptoms like breathing - is a disease of the heart muscle that affects its difficulty and weight changes. ability to pump blood. It is classified into different Encourage activity in manageable types based on how the heart muscle is affected: amounts. Teach self-care: how to manage Dilated cardiomyopathy (DCM) (most diet, medication, and recognize common) worsening symptoms. Hypertrophic cardiomyopathy (HCM) Prevention: (rare, often inherited) Restrictive cardiomyopathy (RCM) Maintain a healthy diet, regular Arrhythmogenic right ventricular exercise, and avoid smoking. cardiomyopathy (ARVC) Unclassified cardiomyopathies (with HYPERTENSIVE EMERGENCES AND URGENCY: features of multiple types) - Hypertensive emergencies and urgencies happen when blood pressure is dangerously high, often Pathophysiology due to poor control or stopping medications abruptly. Cardiomyopathies lead to decreased heart function and reduced blood output. Hypertensive Emergency: This triggers responses in the body that Blood pressure is extremely high (above increase fluid retention and place extra 180/120 mm Hg) and must be lowered stress on the heart, often leading to heart immediately to prevent organ damage. failure. Conditions linked include: Pregnancy-related hypertension Heart attack Symptoms: Aortic aneurysm Heart failure signs: shortness of breath, Brain hemorrhage fatigue, and fluid retention. Treatment goals:  Other symptoms: chest pain, dizziness, causing symptoms like low blood pressure, palpitations, and fainting during activity. dizziness, or fainting. Diagnosis is made using an HCM may cause sudden cardiac arrest, Electrocardiogram (ECG), which records the especially in young people. electrical activity of the heart. Diagnosis: Types of Dysrhythmias: Diagnosis is done through patient history, imaging tests like echocardiograms, MRIs, 1. Sinus Tachycardia: Heart rate >100 bpm, and ECGs, as well as possibly a biopsy. often asymptomatic. Treatment involves Treatment: addressing the cause (e.g., fever, exercise). Treatment includes medications to 2. Sinus Bradycardia: Heart rate