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Cardiac Disorders - Teach Back
Transcript of Cardiac Disorders - Teach Back
Danielle Glover - CAD
Harpreet Kaur - HTN
Shweta Mehra - mi
Heart Disease is the
#1 Killer in the U.S.
What is it?
Normal BP is when the heart contracts and puts pressure on blood vessels so blood can flow freely.
Hypertension is the increase in CO plus the increase in PR.
-Lab tests: urinalysis, blood chemistry
-GOAL: Prevent complications by keeping BP at 140/90 or less
-Goal for diabetics and kidney disease" 130/80
What is it?
-Definition: constricted arterial blood vessels increase the resistance to blood flow, causing an increase in
pressure against vessel walls
-Expressed as two numbers: S/D
Systolic pressure= heart contracts
Diastolic pressure= heart relaxes
HTN from unidentified cause
HTN from an identified cause
-Increased SNS activity
-Increased renal reabsorption
-Increased RAAS system
-Resistance to insulin
-Impaired renal function
-Ethnicity: High in African Americans
-Lifestyle: Inactivity, Obesity
-Heart Disease (more later)
Signs and Symptoms
(Thiazide, loop, K-sparing)
-Ca Channel Blockers
-Careful monitoring of BP
-Collect complete health history
-Lowering and controlling blood pressure
-Provide educational materials
CAD: Coronary Artery Disease
What is it?
Coronary artery disease is the narrowing or blockage of the coronary arteries, usually caused by atherosclerosis.
-Exposure to tobacco smoke
-High LDL cholesterol
-Being overweight (BMI >25)
-Uncontrolled stress or anger
-Diet high in sat. fat
-Too much alcohol
-Family history of heart disease
-Race: African Americans, Mexican Americans, Indian Americans, Native Hawaiian, and some Asian Americans
Signs and Symptoms
-Angina – most common
-ECG or EKG
-Exercise stress tests
-Catheter is inserted into the right or left side of the heart
-D/c Metformin 48 hours prior
-Lie flat for 3-6 hours
-Check site q15 min
-Check distal extremity circulation
-Encourage fluid intake
-Teach pt to check for infection
-No tub baths or exercise for 2-3 days
Angioplasty, Stent Replacement
-Insert catheter into narrow part of artery.
-A wire with a balloon in inflated, compressing the deposits against the artery walls.
-Stent is often left in the artery to help keep the artery open.
Coronary artery bypass graft (CABG)
A graft is created to bypass blocked coronary arteries
using a vessel from another part of your body.
Provides blood flow beyond the stenosis. This surgery is reserved for multiple narrowed coronary arteries.
Cholesterol modifying meds, (Statins, Niacin, Bile acid sequestrants), Nitroglycerin, Aspirin, BB, ACE, ARBs, and CCB
-Reduce risk factors
-Diet changes to reduce
cholesterol, sodium, and fat
limit alcohol intake.
-Increase exercise and
Unstable plaque buildup in the coronary arteries can cause a...
What is a MI?
Ischemia, Injury, Infarction
1. Thallium scans
-Assesses for ischemia
-“Cold spots” =
decreased or absent perfusion
2. Plasma biochemical markers
-CK-MB – levels not evident after 24 hr
-Myoglobin – levels not evident after 3 days
-Troponin I – levels not evident after 7 days
-Troponin T – levels not evident after 14-21 days
3. Cardiac Cath
What is happening?
When the blood vessel walls are damaged due to HTN, cholesterol will start to accumulate there and lead to...
-Analgesics – Morphine sulfate
-Beta-blockers – Lopressor
-Thrombolytic agents – Streptokinase (Streptase) and alteplase (Activase)
-Antiplatelet agents – Aspirin and Plavix
-Anticoagulants – Heparin and Lovenox
*MONA - is the wrong order
-Monitor vital signs every 15 mins until stable, then every hour
-Hourly urine output
-Lab data (cardiac enzymes, electrolytes, ABGs)
-Administer oxygen (2-4L)
-Obtain and maintain IV access
-Promote energy conservation (cluster nursing interventions)
Severe MI can lead to...
-Explain drug therapy
-Control diabetes and hypertension
Heart fails to act as a pump-->
Dec CO, backward flow, workload increased
*Primary cause: HTN
Signs and Symptoms
-Digoxin - Normal level: 0.05-2 ng/mL
-Diuretics - Lasix - decreases preload
-Ace inhibitors - decreases afterload
-B- blockers decreases afterload
-Treat cause: Valvular Surgery, CABG, Pacemaker,
-Low Na diet
-I&O/daily wt delegate!
-Daily weight logs
-Self care discharge
(Brunner & Suddarth, 2011)
Retrieved from: http://yeehoo224.wordpress.com/2012/01/28/
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Retreived from: http://www.walgreens.com/marketing/library/contents.html?docid=000003&doctype=10
Retrieved from: http://www.pennmedicine.org/health_info/cholesterol/000235.html
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Retrieved fromL http://www.health-medicine.ch/doctor Myocardial_infarction.html
Retrieved from http://www3.telus.net/emergency/mi/zones.htm
Warning Signs Of A Heart Attack. (n.d.). Retrieved September 20, 2013, from http://t2.gstatic.com/ images?q=tbn:ANd9GcT0PuQEiNLcL6eTFGGW9ZwcC2-s2cYfc3pQxsQmbZigpVyoknH3LQ
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Swan Ganz Cathether or PA Cath
Retrieved from: www.onxlti.com
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Retrieved from: http://spectra.com.pe/edwards/specialy/Cardiology/swan_ganz_catheters_3.html
Retrienved from: http://healthportal.ca/homepage-products/cardiac-medications-and-nursing-series.html
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Retrieved from American Heart Association
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DASH diet AND Exercise = better outcomes
Blumenthal, J. A., Babyak, M. A., Hinderliter, A., Watkins, L. L., Craighead, L., Lin, P. H., ... & Sherwood, A. (2010). Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study. Archives of Internal Medicine, 170(2), 126.
Retrieved from: Blumenthal, J. A., Babyak, M. A., Hinderliter, A., Watkins, L. L., Craighead, L., Lin, P. H., ... & Sherwood, A. (2010). Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study. Archives of Internal Medicine, 170(2), 126.
(Brunner & Suddarth, 2013 (pg894)
Retrived from: http://www.lifefitness.com/home/cardio/treadmills/f1-smart-treadmill.html
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(Retrieved from CDC)
Who - Is NOT a test of the patient but rather a test of how well you explained a concept
When - Start early
Why - Improves patient outcomes *pic
Closed communication loop
Do not say, "Do you understand?" or "Do you have any questions?"
Retrieved from: http://www.serenabydesign.com/wp-content/uploads/2012/03/Einstein.jpg
Retrieved from: www.ihconline.org
Retrieved from: http://www.allanwolf.com/visits/active-voice-workshop/teaching-poetry/