NSG 4100 E3 CARDIAC NEW UPDATE WITH COMPLETE
SOLUTIONS 100% VERIFIED!!
Pulmonary artery pressure(Swan-Ganz) - ANSWER>>Pressure sensor via catheter in
the artery b/w heart and lungs
Dx HF, shock etiology, response to medical interventions
CVP (central venous pressure) - ANSWER>>Normal: 2-6 mmHg (or 8-12cm H2O)
Measure of pressure in vena cava/R. Atrium.
Estimation of preload and R. Atrial pressure
>6 = Fluid overload = lasix tx
<2 = Hypovolemia = Infuse volume/blood
Heart block treatment - ANSWER>>- TX: increase HR to maintain cardiac output
- Cardiac Monitoring
- Pacemaker
- Transcutaneous pacing- when atropine fails to work
- No symptoms: no treatment or decreasing the cause (i.e.
withhold medication or treatment)
- With symptoms: IV bolus atropine
pacemaker implantation - ANSWER>>electrical device that substitutes for the natural
pacemaker of the heart
when a pt has a permanent or temporary bradycardia <60BPM
On demand = PRN
,Fixed = set at constant rate b/c no comm. b/w atrium and ventricle
Transcutaneous = emergent situation through skin
Complications:
• Dislodgement of pacing electrode
• Pacemaker malfunction -> bradycardia -> decreased CO (diaphoresis, postural
hypotension, syncope)
• Dx through ECG
• Fix: change settings, replace generator or leads
Pacemaker Meds - ANSWER>>Atropine (anticholinergic) = Increase HR if pacemaker
is not sufficient
Not effective in 2nd degree type 2 or 3rd degree
For symptomatic bradycardia
Pacemaker Education - ANSWER>>Monitor for infection, bleeding, hematoma
Restrict arm movement until incision heals; do not raise arm
above head for 2 weeks
Can use microwaves, household electronic appliances
Place digital cellphones at least 6-12 in away from generator;
don't carry in shirt pocket
May trigger antitheft devices in stores and security at airports;
will not interfere with pacemaker
Implantable Cardioverter Defibrillator - ANSWER>>For V. tach/V.fib & MI survivor
w/<35% EF
• Detects and terminates life threatening tachycardia or fibrillation through shock
,• May need temporary vest until implantation:
Worn at all times except when showering
Change battery every day; low battery = V.Fib/V.Tach sx present
Delivers shock within 1 minute after rhythm detected; vest
vibrates and alarm to warn shock imminent
• Must continue with meds
Acute Coronary Syndrome - ANSWER>>Prolonged or complete interruption of blood
flow to the myocardium via rupture of coronary plaque -> acute thrombus
"Code STEMI"
Ischemia of cardiac cells occurs when oxygen supply is not
adequate to meet metabolic needs = Angina, diaphoretic, "elephant on my chest",
indigestion
-can be asymptomatic/unrelated signs
Can present as unstable angina (partial occlusion where clot dissolved before tissue
death), MI, or sudden cardiac arrest
Unstable Angina - ANSWER>>Unstable Angina preinfarction angina /crescendo
infarction)
• Occlusion is partial, or the clot is dissolved before the
death of myocardial tissue: REDUCED blood flow
Sx increase in frequency and severity
Nito/rest does not relieve sx
MI, or myocardial infarction, is a condition wherein there is irreversible damage to a
segment of heart muscle secondary to prolonged ischemia. The narrowings of the
coronary arteries produced by atherosclerotic occlusion, as well as the poor coronary
perfusion due to hemorrhage and occlusion of one of major coronary arteries, will result
in mi.
, COMPLETE occlusion
Men x6 more likely to get MI than women at 45 y/o
NSTEMI = less damage
STEMI
Etiology
Coronary Heart Disease CHD
-Over 125,000 deaths yearly in the US.
- Atherosclerosis: narrowing of the coronary artery → decreased myocardial blood flow
+ lipid/fat/fibrous tissue deposition in the arterial blood vessel wall.
MI (myocardial infarction) Prevention - ANSWER>>Important:
• Low-Density Lipoprotein (LDL) < 100mg/dl
• High-Density Lipoprotein (HDL) >40 mg/dl
• Total Cholesterol <200 mg/dl
• Triglyceride < 150 mg/dl
• Cholesterol Control
• Dietary Measures: Low Saturated Fats and High Fiber
• Weight Loss and Physical Activity
• Smoking Cessation
• Managing Hypertension
• Controlling Diabetes
MI (myocardial infarction) Interventions - ANSWER>>MONA = ONMA
• Oxygen
• 12 Lead EKG= determine where problem is
• Labs= Troponin
SOLUTIONS 100% VERIFIED!!
Pulmonary artery pressure(Swan-Ganz) - ANSWER>>Pressure sensor via catheter in
the artery b/w heart and lungs
Dx HF, shock etiology, response to medical interventions
CVP (central venous pressure) - ANSWER>>Normal: 2-6 mmHg (or 8-12cm H2O)
Measure of pressure in vena cava/R. Atrium.
Estimation of preload and R. Atrial pressure
>6 = Fluid overload = lasix tx
<2 = Hypovolemia = Infuse volume/blood
Heart block treatment - ANSWER>>- TX: increase HR to maintain cardiac output
- Cardiac Monitoring
- Pacemaker
- Transcutaneous pacing- when atropine fails to work
- No symptoms: no treatment or decreasing the cause (i.e.
withhold medication or treatment)
- With symptoms: IV bolus atropine
pacemaker implantation - ANSWER>>electrical device that substitutes for the natural
pacemaker of the heart
when a pt has a permanent or temporary bradycardia <60BPM
On demand = PRN
,Fixed = set at constant rate b/c no comm. b/w atrium and ventricle
Transcutaneous = emergent situation through skin
Complications:
• Dislodgement of pacing electrode
• Pacemaker malfunction -> bradycardia -> decreased CO (diaphoresis, postural
hypotension, syncope)
• Dx through ECG
• Fix: change settings, replace generator or leads
Pacemaker Meds - ANSWER>>Atropine (anticholinergic) = Increase HR if pacemaker
is not sufficient
Not effective in 2nd degree type 2 or 3rd degree
For symptomatic bradycardia
Pacemaker Education - ANSWER>>Monitor for infection, bleeding, hematoma
Restrict arm movement until incision heals; do not raise arm
above head for 2 weeks
Can use microwaves, household electronic appliances
Place digital cellphones at least 6-12 in away from generator;
don't carry in shirt pocket
May trigger antitheft devices in stores and security at airports;
will not interfere with pacemaker
Implantable Cardioverter Defibrillator - ANSWER>>For V. tach/V.fib & MI survivor
w/<35% EF
• Detects and terminates life threatening tachycardia or fibrillation through shock
,• May need temporary vest until implantation:
Worn at all times except when showering
Change battery every day; low battery = V.Fib/V.Tach sx present
Delivers shock within 1 minute after rhythm detected; vest
vibrates and alarm to warn shock imminent
• Must continue with meds
Acute Coronary Syndrome - ANSWER>>Prolonged or complete interruption of blood
flow to the myocardium via rupture of coronary plaque -> acute thrombus
"Code STEMI"
Ischemia of cardiac cells occurs when oxygen supply is not
adequate to meet metabolic needs = Angina, diaphoretic, "elephant on my chest",
indigestion
-can be asymptomatic/unrelated signs
Can present as unstable angina (partial occlusion where clot dissolved before tissue
death), MI, or sudden cardiac arrest
Unstable Angina - ANSWER>>Unstable Angina preinfarction angina /crescendo
infarction)
• Occlusion is partial, or the clot is dissolved before the
death of myocardial tissue: REDUCED blood flow
Sx increase in frequency and severity
Nito/rest does not relieve sx
MI, or myocardial infarction, is a condition wherein there is irreversible damage to a
segment of heart muscle secondary to prolonged ischemia. The narrowings of the
coronary arteries produced by atherosclerotic occlusion, as well as the poor coronary
perfusion due to hemorrhage and occlusion of one of major coronary arteries, will result
in mi.
, COMPLETE occlusion
Men x6 more likely to get MI than women at 45 y/o
NSTEMI = less damage
STEMI
Etiology
Coronary Heart Disease CHD
-Over 125,000 deaths yearly in the US.
- Atherosclerosis: narrowing of the coronary artery → decreased myocardial blood flow
+ lipid/fat/fibrous tissue deposition in the arterial blood vessel wall.
MI (myocardial infarction) Prevention - ANSWER>>Important:
• Low-Density Lipoprotein (LDL) < 100mg/dl
• High-Density Lipoprotein (HDL) >40 mg/dl
• Total Cholesterol <200 mg/dl
• Triglyceride < 150 mg/dl
• Cholesterol Control
• Dietary Measures: Low Saturated Fats and High Fiber
• Weight Loss and Physical Activity
• Smoking Cessation
• Managing Hypertension
• Controlling Diabetes
MI (myocardial infarction) Interventions - ANSWER>>MONA = ONMA
• Oxygen
• 12 Lead EKG= determine where problem is
• Labs= Troponin
