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Anaphylactic Shock - CORRECT ANSWER: Hallmark sx:
-laryngeal edema
-bronchospasm
-hypotension
-dysrhythmias
Get rid of "problem"
-disconnect IV
-maintain airway with meds (diphenhydramine, IM ep, albuterol, IV steroids)
-prepare for intubation/CPR
-RRT
-education
Aneurysms - CORRECT ANSWER: Risk factors: HTN, atherosclerosis, genetics, trauma,
infection, smoking, age, male gender
Treatment:
-Monitor or surgical repair
,-Lots of TEACHING
Dissection: emergency situation where aorta tears (surgery, fluids, blood, BP control)
Aortic Regurgitation - CORRECT ANSWER: -Caused by non RHD: endocarditis, congenital,
HTN, Marfan's syndrome
-Creates dilation of LV
Sx:
-asymptomatic for years before Sx of LV failure occur
-DOE, orthopnea and PND
PE:
-Diastolic murmur
Aortic stenosis - CORRECT ANSWER: Increased resistance to to ejection during systole-->LV
failure-->RV failure
Common in elderly
Sx:
-dyspnea, angina and syncope
PE:
-systolic crescendo/decrescendo murmur
Arterial Line - CORRECT ANSWER: To monitor BP and draw blood
-in radial or femoral artery
-Minimally invasive
,Nurse must:
-monitor hemodynamics
-monitor bleeding
-skin protection (on wrist)
-monitor pulses/perfusion
-monitor infection
Cardiac Index CI normal value - CORRECT ANSWER: Relates heart performance to the size of
the body
CO/BSA
4-8 L/min
Cardiac tamponade - CORRECT ANSWER: Fluid accumulates rapidly in pericardium--
>increase pressure on heart-->decrease in CO
Cause:
-myocardial rupture after an MI or during cardiac surgery
Sx (Beck's Triad):
-JVD
-Muffled heart sounds
-Hypotension, tachycardia
-Pulsus paradoxus
-narrowed pulse pressure <30 mmHg
Cardiogenic Shock - CORRECT ANSWER: AKA heart failure
, -ineffective pumping; decreased CO
Sx:
-tachycardia
-hypotension
-decreased urine output
-cold, clammy skin
-mental changes
-s/sx of HF, CP, tachypnea
Tx:
-Intra-aortic Balloon pump (IABP)
-Treat sx to help perfusion
*DO NOT give fluids, heart cant handle it*
Cardiogenic shock - CORRECT ANSWER: aka Pump failure
1. Coronary: MI
2. Non-coronary
-cardiomyopathy
-valve damage
-cardiac tamponade
-dysrhythmias
Criteria:
-SBP<90 for 30 mins or more