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Angina & Dysrhythmias

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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Angina & Dysrhythmias

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  1. Angina & Dysrhythmias

  2. 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.

  3. ANGINA PECTORIS • Definitions • Signs and Symptoms • Stable vs Unstable • Silent Ischemia • Precipitating factors • Diagnostic studies

  4. PRECIPITATING FACTORS OF ANGINA Lewis Page 812 Precipitating Factors of Angina

  5. CARDIAC DRUGS • Nitrates • Beta Blockers • Calcium Channel blockers • Ace inhibitors

  6. Coronary Artery Disease Collaborative care decision tree Lewis fig 33-13 Decision tree Collaborative care

  7. MYOCARDIAL INFARCTION • Definition • Signs and Symptoms • Complications • Diagnostics • PTCA (Percutaneous Coronary Angioplasty) • CABG (Coronary Artery Bypass)

  8. MYOCARDIAL INFARCTION

  9. NURSING DIAGNOSIS • Acute pain • Ineffective Tissue perfusion (cardiac) • Anxiety • Activity intolerance • Ineffective Therapeutic regimen management

  10. PTCA

  11. CORONARY ARTERY BYPASS GRAFT

  12. CARDIOMYOPHATHY • Dilated (congestive) • Hypertrophic

  13. Types of Cardiomyopathies Types of cardiomyopathies See differences in ventricle muscles

  14. CARDIAC TRANSPLANT Drug therapies Lifestyle changes Support Systems Teaching

  15. INFLAMMATORY HEART DISEASE NURSING DIAGNOSIS • Hyperthermia • Decreased Cardiac Output • Activity Intolerance • Ineffective Health Maintenance • Pain • Anxiety

  16. Layers of the heart Page 886

  17. Infective Endocarditis Clinical manifestations Diagnostic studies INFLAMMATORYHEART DISEASES

  18. INFLAMMATORY HEART DISEASE • ACUTE PERICARDITIS • Etiology and Pathophysiology • Clinical Manifestations • Complications • Collaborative Care

  19. MYOCARDITIS • Etiology • Clinical Manifestations • Diagnostic Studies • Nursing Management

  20. VALVULAR DISEASE

  21. NURSING DIAGNOSIS • Activity Intolerance • Excess Fluid Volume • Decreased Cardiac Output • Ineffective Therapeutic Regimen Management

  22. MITRAL VALVE Stenosis and Regurgitant

  23. MITRAL VALVE STENOSIS • Etiology • Clinical Manifestations • Teaching • Diagnostic findings • ECG • Echocardiogram • Cardiac Catheterization

  24. RELATIONSHIP OF ECG TO CARDIAC CYCLE Page 767, Chapter 31

  25. ATRIAL STENOSIS & REGURGIATION • Etiology • Clinical Manifestation • Diagnostic Findings • ECG • Echocardiogram • Cardiac Catheterization

  26. VALVULAR HEART DISEASECOLLABORATIVE CARE • (PTBV) Percutaneous transluminal balloon valvuplasty • Surgical therapy

  27. TYPES OF PROSTHETIC AND TISSUE VALVES

  28. ARRHYTHMIAS

  29. NORMAL SINUS RHYTHM Chapter 31, pages 758 & 759 Normal sinus rhythm

  30. NORMAL SINUS RHYTHM TIMING Page 865

  31. NSR, ARTIFACT, CONDUCTION SYSTEM RATES Normal Sinus Rhythm in Lead II Artifact, loose leads or movement Rate of conduction systems

  32. Calculating Rhythm and Rate Using 6 second cardiac strip

  33. REGULAR RHYTHM & RATE

  34. SINUS BRADYCARDIATACHYCARDIA, PAC, SVT Sinus bradycardia Sinus Tachycardia Premature Atrial Contraction (PAC) Paroxysmal SVT

  35. HEART BLOCKS PAGE 871

  36. 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

  37. PVC, BIGEMINY, TRIGEMINY Multifocal PVC PVC’s couplets, runs PVC bigeminy PVC Trigeminy What would you assess first?

  38. V-TACH, V-FIB Ventricular Tachycardia Ventricular Fibrillation Page 873

  39. Pulseless Electrical Activity

  40. PORTABLE MONITOR Contains Monitor, Defibrillator, Transcutaneous Pacemaker, Page 875

  41. Placement of defibrillation pads

  42. Implantable Defibrillator (ICD) and Dual Chamber Pacemaker

  43. Temporary Pacemaker Insertion

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