Module 4 Part 1 PCW

CARDIAC
OBJECTIVES:

 Analyze the importance of history taking in the cardiac assessment
 Correlate A&P aspects of the cardiac system with the respiratory exam
 Compare etiology and incidence of acute cardiac disease and disorders
 Interpret treatment plans based on the pathophysiology of acute cardiac disease or disorders
 Generate a plan of care for patients with acute cardiac disease and disorders.




CONTENT OUTLINE: Chapters 31 & 32

Supraventricular  Rapid stimulation of atrial tissue
 Rate: 100-280 beats/min
Tachycardia  P waves may not be visible
 Nonsustained – patient may be asymptomatic
Patho Review
 Sustained – symptoms? Weakness, fatigue, shortness of breath, nervousness, anxiety,
hypotension, syncope


Diagnostics  12-Lead EKG
 Eval in the electrophysiology (EP) lab
Nursing Care  Describe some nursing interventions for stimulating a patient’s vagal reflex: carotid
massage and Valsalva maneuvers


Medications  AV nodal blocking agents
 Describe the indication and administration for Adenosine: in a case of poor perfusion,
synchronized cardioversion may be warranted

Complications  Cardiovascular deterioration
 Angina, heart failure, and cardiogenic shock
Ventricular  Three or more successive PVCs
 Repetitive firing of an ectopic focus
Tachycardia  Rate: 140-180 beats/min
 May be caused by increased automaticity or a re-entry mechanism
Patho Review
 Intermittent or non-sustained
 Sustained – lasts longer than 15-30 seconds
Diagnostics  12-Lead EKG
Medications  What are 2 antidysrhythmic agents that may be prescribed to prevent further
episodes of v tach? Magnesium sulfate, amiodarone
Complications  Death
Nursing Care  Assessment:
1
NUR4227 Module 4: Cardiac Part 1
Updated 2/11/2022 4:19:00 PM
This study source was downloaded by 100000849044796 from CourseHero.com on 06-23-2022 14:47:51 GMT -05:00


https://www.coursehero.com/file/135926617/Module-4-Part-1-PCWdocx/

, - Dyspnea
- Palpitations
- Dizziness
 Interventions:
- Assess ABC’s (V. tach may lead to cardiac arrest)
- 12 Lead ECG
- Initiate CPR
 Name at least 3 conditions that can increase a patient’s risk for v tach?...
Hypokalemia, hypomagnesemia, ischemic heart disease


Ventricular  Electrical chaos in the ventricles
 Irritable foci fire impulses in a disorganized manner
Fibrillation  The ventricles do not contract
 No cardiac output
Patho Review
Diagnostics  12 Lead EKG
Medications - Class I:
- Type IA:
- Stabilize the membrane
- Decrease automaticity
- MOA: Slow conduction, prolong QT interval
- Treat/prevent supraventricular and ventricular premature beats and
tachydysrhythmias
- Example: Procainamide
- Type IB:
- MOA: Shorten repolarization
- Treat/prevent ventricular premature beats, v tach, and v fib
- What is an example of a drug in this class? lidocaine

- Type IC:
- MOA: Slow conduction, widen QRS complex
- Treat/prevent recurrent, life-threatening ventricular premature beats, v tach and v
fib
- Example: Flecainide Acetate; Propafenone Hydrochloride
- Class II:
- Treat dysrhythmias associated w/ excessive beta-adrenergic stimulation by
competing with receptor sites = DECREASED heart rate and conduction velocity
- Treat/prevent supraventricular and ventricular premature beats and
tachydysrhythmias
- What is an example of a drug in this class? Propranolol

- Class III:
- MOA: Lengthen absolute refractory period and prolong repolarization and the
action potential of ischemic cells
- Treat/prevent ventricular premature beats, v tach, and v fib
- Example: Amiodarone

2
NUR4227 Module 4: Cardiac Part 1
Updated 2/11/2022 4:19:00 PM
This study source was downloaded by 100000849044796 from CourseHero.com on 06-23-2022 14:47:51 GMT -05:00


https://www.coursehero.com/file/135926617/Module-4-Part-1-PCWdocx/