Angina & Dysrhythmias

A & P OF THE CARDIAC SYSTEM

Cardiac output CO=SV(stroke volume) X HR(heart rate)

Preload Volume of blood in the ventricles at the end of

diastole Afterload

Peripheral resistance against which the left ventricle must pump. Affected by the size of the ventricle, wall tension and arterial blood pressure.

ANGINA PECTORIS

Definitions Signs and Symptoms Stable vs Unstable Silent Ischemia Precipitating factors Diagnostic studies

Lewis Page 812

Precipitating

Factors of Angina

PRECIPITATING FACTORS OF ANGINA

CARDIAC DRUGS

Nitrates

Beta Blockers

Calcium Channel blockers

Ace inhibitors

Lewis fig 33-13

Decision tree

Collaborative care

Coronary Artery Disease Collaborative care decision tree

MYOCARDIAL INFARCTION

Definition Signs and Symptoms Complications Diagnostics PTCA (Percutaneous Coronary

Angioplasty) CABG (Coronary Artery Bypass)

MYOCARDIAL INFARCTION

NURSING DIAGNOSIS

Acute pain Ineffective Tissue perfusion (cardiac) Anxiety Activity intolerance Ineffective Therapeutic regimen

management

PTCA

CORONARY ARTERY BYPASS GRAFT

CARDIOMYOPHATHY

Dilated (congestive)

Hypertrophic

Types of cardiomyopathies

See differences in ventricle muscles

Types of Cardiomyopathies

CARDIAC TRANSPLANT

Drug therapies

Lifestyle changes

Support Systems

Teaching

INFLAMMATORY HEART DISEASE NURSING DIAGNOSIS

Hyperthermia Decreased Cardiac Output Activity Intolerance Ineffective Health Maintenance Pain Anxiety

Layers of the heart Page 886

INFLAMMATORYHEART DISEASES

Infective EndocarditisClinical

manifestationsDiagnostic

studies

INFLAMMATORY HEART DISEASE

ACUTE PERICARDITISEtiology and PathophysiologyClinical ManifestationsComplicationsCollaborative Care

MYOCARDITIS

Etiology

Clinical Manifestations

Diagnostic Studies

Nursing Management

VALVULAR DISEASE

NURSING DIAGNOSIS

Activity Intolerance Excess Fluid Volume Decreased Cardiac

Output Ineffective

Therapeutic Regimen Management

MITRAL VALVEStenosis and Regurgitant

MITRAL VALVE STENOSIS

Etiology Clinical Manifestations Teaching Diagnostic findings

ECGEchocardiogramCardiac Catheterization

RELATIONSHIP OF ECG TO CARDIAC CYCLE

Page 767, Chapter 31

ATRIAL STENOSIS & REGURGIATION

Etiology Clinical Manifestation Diagnostic Findings

ECGEchocardiogramCardiac Catheterization

VALVULAR HEART DISEASECOLLABORATIVE CARE (PTBV) Percutaneous transluminal balloon

valvuplasty

Surgical therapy

TYPES OF PROSTHETIC AND TISSUE VALVES

ARRHYTHMIAS

Chapter 31, pages 758 & 759

Normal sinus rhythm

NORMAL SINUS RHYTHM

NORMAL SINUS RHYTHMTIMING

Page 865

Normal Sinus Rhythm in Lead II

Artifact, loose leads or movement

Rate of conduction systems

NSR, ARTIFACT, CONDUCTION SYSTEM RATES

Calculating Rhythm and RateUsing 6 second cardiac strip

REGULAR RHYTHM & RATE

Sinus bradycardia

Sinus Tachycardia

Premature Atrial Contraction (PAC)

Paroxysmal SVT

SINUS BRADYCARDIATACHYCARDIA, PAC, SVT

HEART BLOCKS PAGE 871

Atrial Flutter

Atrial Fibrillation

Page 870What medications would you anticipate the patient to be taking chronically for this rhythm? Why?

ATRIAL FLUTTER AND FIBRILLATION

Multifocal PVC

PVC’s couplets, runs

PVC bigeminy

PVC Trigeminy

What would you assess first?

PVC, BIGEMINY, TRIGEMINY

Ventricular Tachycardia

Ventricular

Fibrillation

Page 873

V-TACH, V-FIB

Pulseless Electrical Activity

PORTABLE MONITOR

Contains Monitor,

Defibrillator,

Transcutaneous

Pacemaker,

Page 875

Placement of defibrillation pads

Implantable Defibrillator (ICD) and Dual Chamber Pacemaker

Temporary Pacemaker Insertion