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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
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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.
ANGINA PECTORIS • Definitions • Signs and Symptoms • Stable vs Unstable • Silent Ischemia • Precipitating factors • Diagnostic studies
PRECIPITATING FACTORS OF ANGINA Lewis Page 812 Precipitating Factors of Angina
CARDIAC DRUGS • Nitrates • Beta Blockers • Calcium Channel blockers • Ace inhibitors
Coronary Artery Disease Collaborative care decision tree Lewis fig 33-13 Decision tree Collaborative care
MYOCARDIAL INFARCTION • Definition • Signs and Symptoms • Complications • Diagnostics • PTCA (Percutaneous Coronary Angioplasty) • CABG (Coronary Artery Bypass)
NURSING DIAGNOSIS • Acute pain • Ineffective Tissue perfusion (cardiac) • Anxiety • Activity intolerance • Ineffective Therapeutic regimen management
CARDIOMYOPHATHY • Dilated (congestive) • Hypertrophic
Types of Cardiomyopathies Types of cardiomyopathies See differences in ventricle muscles
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
Infective Endocarditis Clinical manifestations Diagnostic studies INFLAMMATORYHEART DISEASES
INFLAMMATORY HEART DISEASE • ACUTE PERICARDITIS • Etiology and Pathophysiology • Clinical Manifestations • Complications • Collaborative Care
MYOCARDITIS • Etiology • Clinical Manifestations • Diagnostic Studies • Nursing Management
NURSING DIAGNOSIS • Activity Intolerance • Excess Fluid Volume • Decreased Cardiac Output • Ineffective Therapeutic Regimen Management
MITRAL VALVE STENOSIS • Etiology • Clinical Manifestations • Teaching • Diagnostic findings • ECG • Echocardiogram • Cardiac Catheterization
RELATIONSHIP OF ECG TO CARDIAC CYCLE Page 767, Chapter 31
ATRIAL STENOSIS & REGURGIATION • Etiology • Clinical Manifestation • Diagnostic Findings • ECG • Echocardiogram • Cardiac Catheterization
VALVULAR HEART DISEASECOLLABORATIVE CARE • (PTBV) Percutaneous transluminal balloon valvuplasty • Surgical therapy
NORMAL SINUS RHYTHM Chapter 31, pages 758 & 759 Normal sinus rhythm
NORMAL SINUS RHYTHM TIMING Page 865
NSR, ARTIFACT, CONDUCTION SYSTEM RATES Normal Sinus Rhythm in Lead II Artifact, loose leads or movement Rate of conduction systems
Calculating Rhythm and Rate Using 6 second cardiac strip
SINUS BRADYCARDIATACHYCARDIA, PAC, SVT Sinus bradycardia Sinus Tachycardia Premature Atrial Contraction (PAC) Paroxysmal SVT
ATRIAL FLUTTER AND FIBRILLATION Atrial Flutter Atrial Fibrillation What medications would you anticipate the patient to be taking chronically for this rhythm? Why? Page 870
PVC, BIGEMINY, TRIGEMINY Multifocal PVC PVC’s couplets, runs PVC bigeminy PVC Trigeminy What would you assess first?
V-TACH, V-FIB Ventricular Tachycardia Ventricular Fibrillation Page 873
PORTABLE MONITOR Contains Monitor, Defibrillator, Transcutaneous Pacemaker, Page 875