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Angina & Dysrhythmias
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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.
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ANGINA PECTORIS
Definitions Signs and Symptoms Stable vs Unstable Silent Ischemia Precipitating factors Diagnostic studies
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Lewis Page 812
Precipitating
Factors of Angina
PRECIPITATING FACTORS OF ANGINA
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CARDIAC DRUGS
Nitrates
Beta Blockers
Calcium Channel blockers
Ace inhibitors
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Lewis fig 33-13
Decision tree
Collaborative care
Coronary Artery Disease Collaborative care decision tree
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MYOCARDIAL INFARCTION
Definition Signs and Symptoms Complications Diagnostics PTCA (Percutaneous Coronary
Angioplasty) CABG (Coronary Artery Bypass)
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MYOCARDIAL INFARCTION
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NURSING DIAGNOSIS
Acute pain Ineffective Tissue perfusion (cardiac) Anxiety Activity intolerance Ineffective Therapeutic regimen
management
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PTCA
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CORONARY ARTERY BYPASS GRAFT
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CARDIOMYOPHATHY
Dilated (congestive)
Hypertrophic
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Types of cardiomyopathies
See differences in ventricle muscles
Types of Cardiomyopathies
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CARDIAC TRANSPLANT
Drug therapies
Lifestyle changes
Support Systems
Teaching
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INFLAMMATORY HEART DISEASE NURSING DIAGNOSIS
Hyperthermia Decreased Cardiac Output Activity Intolerance Ineffective Health Maintenance Pain Anxiety
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Layers of the heart Page 886
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INFLAMMATORYHEART DISEASES
Infective EndocarditisClinical
manifestationsDiagnostic
studies
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INFLAMMATORY HEART DISEASE
ACUTE PERICARDITISEtiology and PathophysiologyClinical ManifestationsComplicationsCollaborative Care
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MYOCARDITIS
Etiology
Clinical Manifestations
Diagnostic Studies
Nursing Management
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VALVULAR DISEASE
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NURSING DIAGNOSIS
Activity Intolerance Excess Fluid Volume Decreased Cardiac
Output Ineffective
Therapeutic Regimen Management
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MITRAL VALVEStenosis and Regurgitant
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MITRAL VALVE STENOSIS
Etiology Clinical Manifestations Teaching Diagnostic findings
ECGEchocardiogramCardiac Catheterization
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RELATIONSHIP OF ECG TO CARDIAC CYCLE
Page 767, Chapter 31
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ATRIAL STENOSIS & REGURGIATION
Etiology Clinical Manifestation Diagnostic Findings
ECGEchocardiogramCardiac Catheterization
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VALVULAR HEART DISEASECOLLABORATIVE CARE (PTBV) Percutaneous transluminal balloon
valvuplasty
Surgical therapy
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TYPES OF PROSTHETIC AND TISSUE VALVES
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ARRHYTHMIAS
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Chapter 31, pages 758 & 759
Normal sinus rhythm
NORMAL SINUS RHYTHM
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NORMAL SINUS RHYTHMTIMING
Page 865
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Normal Sinus Rhythm in Lead II
Artifact, loose leads or movement
Rate of conduction systems
NSR, ARTIFACT, CONDUCTION SYSTEM RATES
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Calculating Rhythm and RateUsing 6 second cardiac strip
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REGULAR RHYTHM & RATE
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Sinus bradycardia
Sinus Tachycardia
Premature Atrial Contraction (PAC)
Paroxysmal SVT
SINUS BRADYCARDIATACHYCARDIA, PAC, SVT
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HEART BLOCKS PAGE 871
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Atrial Flutter
Atrial Fibrillation
Page 870What medications would you anticipate the patient to be taking chronically for this rhythm? Why?
ATRIAL FLUTTER AND FIBRILLATION
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Multifocal PVC
PVC’s couplets, runs
PVC bigeminy
PVC Trigeminy
What would you assess first?
PVC, BIGEMINY, TRIGEMINY
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Ventricular Tachycardia
Ventricular
Fibrillation
Page 873
V-TACH, V-FIB
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Pulseless Electrical Activity
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PORTABLE MONITOR
Contains Monitor,
Defibrillator,
Transcutaneous
Pacemaker,
Page 875
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Placement of defibrillation pads
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Implantable Defibrillator (ICD) and Dual Chamber Pacemaker
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Temporary Pacemaker Insertion
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