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Copyright 2009 by Saunders, an imprint of Elsevier Inc.
Chapter 19 CareofPatientswithCardiacDisorders
CHAP
TER 19 CareofPatientswithCardiacDisorders
TERMINOLOGY
Cardiac Pathology
Directions: Match the pathology on the left with the disorder on the right.
1. ______ Structural defect in which chambers, septum, or large vessels are not normal (463)
a. Congestive heart failure
2. ______ Diseased valve is unable to close properly and blood flows backward into heart chamber (479)
b. Endocarditis
3. ______ Disturbance in hearts conduction system (464) c. Congenital heart disease
4. ______ Weakening and exhaustion of hearts pumping action (479)
d. Pericarditis
5. ______ Inflammation of inner lining of heart (470) e. Arrhythmias
6. ______ Excessive fluid restricts the filling and pumping of the heart (481)
f. Cardiomyopathy
7. ______ Inflammation of the sac surrounding the heart (483) g. Cardiogenic shock
8. ______ Causes left atrium to work harder to pump blood through the narrowed valve into the left ventricle (479)
h. Cardiac tamponade
9. ______ Circulatory failure due to the failure of the heart to pump sufficient blood (482)
i. Valvular insufficiency
10. ______ Cardiac degeneration unrelated to CAD, hypertension, structural disorders, or pulmonary disease (482)
j. Mitral stenosis
Copyright 2009 by Saunders, an imprint of Elsevier Inc.
Chapter 19 CareofPatientswithCardiacDisorders
LABELING
Identifying Parts of an EKG Pattern
Directions: Divide and label the waves in the EKG pattern below. Then answer the related questions. (471-473)M
illivo
lts
1. The normal P-R interval is ___________ seconds.
2. The normal QRS time is ______________ seconds.
3. Normal heart rate is ______________ beats per minute.
COMPLETION
Cardiac Disorders
Directions: Fill in the blanks to complete the statements.
1. When a synthetic valve is used (i.e., porcine or bovine) the patient must be on _____________________
therapy for the rest of his life. (481)
2. If the heart rate rises above ___________________ beats per minute, the patient has a dysrhythmia
known as tachycardia. (472)
3. Atrial fibrillation also predisposes the patient to _________________ formation in the atria. (472)
From Aehlert, B. (2002). EKGs Made Easy (2nd ed.). St. Louis: Mosby.
Copyright 2009 by Saunders, an imprint of Elsevier Inc.
Chapter 19 CareofPatientswithCardiacDisorders
TABLE ACTIVITY
Drugs Used for Heart Failure
Directions: Fill in the table below with at least one example of the drug and briefly state the pharmacologic action of the drug. The first classification, betaadrenergic blockers, is done for you. (474-477)
Drug Classification Example Action
Beta-adrenergic blockers
metoprolol (Toprol XL) Used to slow the heart rate if tachycardia is causing the heart failure, thereby decreasing oxygen demand.
Angiotensin-converting enzyme (ACE) inhibitors
Loop diuretics
Digitalis
Venous vasodilators
NCLEX-PN EXAM REVIEW
Directions: Choose the best answer(s) for the following questions.
1. A patient reports being punched with a fist in the mid-sternal area during an assault. He is currently asymptomatic. Which of following complications is most likely to be associated with this type of blunt chest trauma? (483)1. Hemothorax2. Cardiac dysrhythmias3. Cardiogenic shock4. Cardiomyopathy
Copyright 2009 by Saunders, an imprint of Elsevier Inc.
Chapter 19 CareofPatientswithCardiacDisorders
2. The physiologic problem associated with atrial fibrillation is that the heart rate: (472)1. is too slow to supply oxygen to the body effectively.2. can be too fast to allow for adequate ventricular filling.3. is so irregular that it is difficult to count.4. is very erratic and can cause ventricular fibrillation.
CRITICAL THINKING ACTIVITIES
Scenario
Mr. Lee goes into cardiogenic shock 8 hours after surgery. (483)
1. How would you know that this complication is occurring? ____________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
2. Describe the usual treatment for cardiogenic shock. __________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
MEETING CLINICAL OBJECTIVES
1. Ask to be assigned to a cardiac step-down or telemetry unit. Obtain telemetry tracings of several EKG patterns. Interpret whether each EKG pattern is normal or abnormal. What is the rhythm? (Ask another nurse to assist you with abnormal patterns.)
2. Make a pocket diagram of the telemetry lead placements for the most common leads used on the unit. Practice hooking patients up to the telemetry monitor.
3. Learn how to set and reset the telemetry monitor units.
4. Care for a patient on digoxin (Lanoxin). Review the dosage, nursing implications related to administra-tion, and check the lab values for digoxin level and for serum potassium.