cardiovascular med surg memory notebook of nursing

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Lab to consider with heparin? PTT

Lab to consider with coumadin/warfarin? PT/INR

Pulmonary edema MAD DOG mnemonic M meds (nipride, morphine) A airway D digitalis D diuretics (Lasix) O oxygen G blood gases (ABGs)

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What is preload? Volume of blood in ventricles at end of diastole (end diastolic pressure). Increased in hypervolemia, regurgitation of cardiac valves, HF

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What is afterload? Resistance left ventricle must overcome to circulate blood. Increased in hypertension, vasoconstriction Increased afterload=Increased cardiac workload

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What are desirable LDL (low density lipoprotein) and HDL (high density lipoprotein) levels?

LDL <130 mg/dL HDL >45 mg/dL

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Describe MI pain sudden onset substernal crushing tightness severe UNRELIEVED BY NITRO may radiate to back, neck, jaw, shoulder, arm

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What are signs and symptoms of MI? dyspnea syncope (decreased BP) n/v extreme weakness diaphoresis denial is common increased HR

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What are dietary restrictions of patient with MI? decreased sodium decreased cholesterol decreased caffeine

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What are signs and symptoms of Left Sided Heart Failure?

paroxysmal nocturnal dyspnea elevated pulmonary capillary wedge pressure restlessness confusion orthopnea tachycardia exertional dyspnea fatigue cyanosis pulmonary congestion

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What are signs and symptoms of Pulmonary Congestion? cough crackles wheezes blood-tinged sputum tachypnea

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What are signs and symptoms of Right Sided Heart Failure? (cor pulmonale) fatigue increased peripheral venous pressure ascites enlarged liver and spleen may be secondary to chronic pulmonary problems distended jugular veins anorexia complaints of GI distress

weight gain dependent edema

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What are common adrenergic antagonist BETA BLOCKERS? Propanolol (Inderal) Atenolol (Tenormin) Metoprolol (Lopressor)

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What are SIDE EFFECTS of BETA BLOCKERS? hypotension bradycardia (AV-block) drowsiness depression symptoms of CHF (coughing, SOB, edema, fatigue)

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What are common adrenergic antagonist ALPHA BLOCKERS? Doxazosin (Cardura) Clonidine (Catapress) Methyldopa (Aldomet)

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What are SIDE EFFECTS of ALPHA BLOCKERS? orthostatic hypotension palpitations vertigo sexual dysfunction

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What are some common CALCIUM CHANNEL BLOCKERS? Verapamil Nifedipine Diltiazem

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What is the ACTION of CALCIUM CHANNEL BLOCKERS? Action - blocks calcium access to cells

decreased contractility + decreased conductivity of the heart = decreased demand for oxygen
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What are SIDE EFFECTS of CALCIUM CHANNEL BLOCKERS? decreased BP bradycardia may precipitate A-V Block H/A abdominal discomfort - constipation, nausea peripheral edema

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What are some drugs to treat bradycardia and decreased BP? Isoproterenol dopamine epinephrine atropine

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Classification of ANTIHYPERTENSIVE DRUGS

ACE inhibitors (captopril, enalapril, benzapril) B-blockers (propanolol, atenolol, metoprolol) Calcium antagonists (verapamil, diltiazem, nifedipine)

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What is the ACTION of ACE INHIBITORS? Angiotensin Converting Enzyme inhibitors

Decrease peripheral vascular resistance without increasing CO, HR, or contractility

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What are SIDE EFFECTS of ACE INHIBITORS? dizziness orthostatic hypotension GI distress nonproductive cough H/A

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What is ACTION of BETA BLOCKERS? Blocks beta receptors in heart causing... decreased HR decreased force of contraction decreased rate of A-V conduction

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What are SIDE EFFECTS of BETA BLOCKERS? bradycardia lethargy GI disturbance

CHF decreased BP depression

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When do you see JUGULAR VEIN DISTENTION? Distended when pt at 45 angle

hypervolemia R sided HF pericardial tamponade constrictive pericarditis

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What is the stat treatment for MI? M morphine O oxygen N nitroglycerin A aspirin

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Treating heart failure UNLOAD FAST mnemonic U upright position N nitrates L lasix O oxygen A ACE inhibitors D digoxin

F fluids A afterload

S sodium restriction T test (dig level, ABGs, K level)