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ability of the heart to pump hard |
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Means starts in the SA node. |
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Normal rythm but just slow, asses and if tx needed, then give atropeine. may need pacmaker |
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Gosts holding hands, pulse???? if pulsess defib!!! |
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Fast sinus, give fluid (dehydrated, painfull or anxious), possible beta blocerks... |
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vitals o2, iv, montor, EKG, labs |
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big jello wavy line, have to shock now!!! Rate is, none, grossly irregular, no PR ration, no PR intervil No QRS, patiet is pulsless and apenic! |
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NO p waves just flutter waves!!!! wil have QRS's and will be irregular, (but P waves will look organized) depends on rate for what we do, maybe do adenosine, may cardiovert, try beta blocers or CC bockers, |
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No P wave, jiggly line, has QRS's, |
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long pr intervil, monitor nothing... |
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longer and longer PR then non, possible pacemaker, |
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Normal PR intervil, but dropped qrs's and reguraly, possible pacemaker, possible atropine, |
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P's and qrs's dont talk to eacother, will posibly hve wider QRS's, will need Pacmaker, and possible temp pacing. |
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Ca-channel blockers – (diltiazem, cardiazem, verapamil) |
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Slows down heart rate, and lowers BP, cna convert a=fib, (cartazem) |
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Tx for bradycardia, only works on atria!!!! |
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anti arythmic. for v-tach, v-fib. |
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for a VERY-fast hart lol, |
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inceases contractility, decreased hr, |
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like lidocaine, is anti artymic. |
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Ace-inhibitors (ACE-I) (ie Lisinopril, enalapril, captopril) |
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decreases BP, give for heart attacks, |
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Give for torsades de pointers, |
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Stops heart and fixes tachycardia, GIVE FAST!!! |
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beta Blockers –(ie Metoprolol, Atenolol) |
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decrease BP, and HR, and workload, |
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Angiotensin Receptor Blockers (ARBS – Losartin (Cozaar) |
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Nitroglycerin (oral, paste and drip) |
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vasodilator, give q 5 min, x3 call after 2nd, BP problem, dont give whit viagra, |
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vasoconstrictor, workes like epinephrine, |
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Vasoconstrictor, and increases contractility of heart. |
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Nitroprusside sodium (Nipride) |
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Thrombolytic agents Retaplase, Tenecteplase (TNKase), and Streptokinase |
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Vasodilators (Nesiritide) |
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Arginine Vasopressin (AVP) |
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Definition
increases water retention |
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AVP antagonists (tolvaptan, conivaptan (Vaprisol) |
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decreases water retention |
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stunning heart into normal rythm. |
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What is synchronized cardioversion and when is it used? |
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Used for stable tachycardic rythms. |
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When do you use, and describe a temporary pacemaker? |
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use for symptomatic bradycardia, is an extrnal power source for heart. can be external or internal, |
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When do you use, and describe a synchronous (demand) pacemaker? |
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Beat when needed. heart blocks or sinus brady |
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When do you use, and describe transvenouse pacing? |
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When do you use, and describe noninvasive temporary pacing? |
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External pads that regulate a brady rythm. |
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What is the nursing management of a patient with a pacemaker? |
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Definition
montor, if they go home, watch for magnets, |
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What is the nursing management of a patient with an ICD? |
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Definition
they may be shocked when it works. |
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What is the nursing management of a patient undergoing radio freqency ablation? |
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Definition
kils cardiac cells that are being bad. |
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What is the nursing management of a patient with and intraaortic ballon pump? |
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Definition
basic an artificial heart, asisting blood flow, in aortia, |
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What is the nursing management of a patient with ventricualr asistit devices and artificial hearts? |
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heart muscle breakdown (myocardial band)has quick decline.But rises second! |
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Has slower decline, for angina,but rises FIRST |
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What is C-reactive protein? |
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Definition
tests for inflammation... |
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What is homycysteine level? |
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Definition
if hi they have highr rate of heart atak or stroke. |
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What are the S/S of an MI in women, elderly, and men? |
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Definition
woemn have vague symtpoms, and abdomen s/s |
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Describe pericarditis and what we do for them? |
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describe cardiac tamponade and what we do for it? |
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blut trauma and fluid around the heart. |
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describe cardiogenic shock and what we do for it? |
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heart is not beating and no BP, or ineffectiv like from cardiac tampanode |
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pulseless arest in asystole/PEA |
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Definition
Give epi, or vasopression. consider atropene, then check rythm again and continue |
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Pulseless aresest with Vf/VT |
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Definition
give 1 shock, check rythm, give another cshock, then give epi or vasopresin, check rythm, shock, then possible amiodarone, lidocane or magnesium. then after 5 cycles of CPR do more shocks. |
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For bradycardia with poor profusion do what? |
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Definition
prep for transcutaneous pacing, consider atropeine, consider epi or dopamine, then consider transvenous pacing |
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Tachycardia that is unstable do what? |
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Definition
Perform immediate synchronized cardioversion. |
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Stable tachycardiai that is wide do what? |
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ask if reg or ireg, if reg give amiodarone prepare for elecitve synch cardioversion, if svt with abberancy give adensoine. BUT if irreg, maybe amiodarone,can be torsades, |
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Tachycardia that is stable and narrow? |
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Definition
Attemp vegal manuvers, give adenosene RAPID!, if it is not fixed suspecte atrial flutter, ectopic atrial tachycardia or junctional tachycardia, then give betblocers or diltiazem (CCblocker) |
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For chest pain with probable ischemia. |
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Definition
MONA, VOIMEL, then look @ EKG.... LOOK FOR FOLLOWING SLIDE! |
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Sugesstive ichmia with ST elevation or new LBBB, |
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means they are having cardiac event, give beta blocerks, heparin, clopidogrel (antiplatlet) ask when s/s started then start reprofusion strategy if less than 12 hrs. |
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Definition
Give meds TPA like stuff. Clottbuster!!! |
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Sugestiv ischmia with ST Depression |
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Definition
possible ichmia, start more nitro and same as with ST elevation, also glyoprotein inhibitor, send to seattle to get invasive treatment (CABG Stents) |
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ichmia with normal nondiagnostic changes in ST segment or T wave. |
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Definition
if there at risk or they are troponin positive give them the (St depression way) then admit if nothing wrong. |
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triponin 1 time and CK-MB time |
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Triponin Rises first, ckmb rises later |
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if QRS is normal size qhere does impulse come from? |
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Above the ventricles, likethe atrum ;) |
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12-20 or no more than 1 BOX! |
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4-10 no less than one little box and less than 3 boxes |
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