Med-Surg Final
CARDIOVASCULAR
Dsyrhythmias * Etiology * Disturbances in automaticity – initiation of impulse is altered * Disturbances in conduction – alteration in the speed the impulse travels * Reentry of impulses – cardiac tissue is depolarized multiple times by the same impulse * Speed, distance and location can be changed or affected (blockages cause change in heart rhythm) * Risk factors * Cardiovascular disease, MI * MI – death of tissue – no electricity can conduct through it, so it has to alter the pathway of the impulse after an MI * Hypoxemia * Electrolyte imbalance * Spiked T waves from potassium imbalance * Drug use or toxicity * Beta blockers can slow heart too much * Hypovolemia * Shock
Labs and Diagnostic Tests * Labs * Electrolytes * K (important) and Na * Hemoglobin and hematocrit * BUN and creatinine * Kidneys – your kidneys help your pH balance (increase puts more stress on heart because there is more Cr in the blood) * Type and cross match * Cardiac markers * Urinalysis * PT, PTT, INR platelet counts * Because of blood thinners (PT and Coumadin & PTT and heparin) * Diagnostic tests * Chest x-ray – enlargement of the heart and congestion of the lungs * Arterial blood gas (ABG) * pH * show you what your O2 level is * how well your heart and lungs are working together to supply body with oxygen * EKG – electrical impulse of the heart * Echocardiogram – details of how the chambers are working * Stress test – can the O2 demand by met by the body * Nuclear * Treadmill
Normal Intervals * PR interval – 0.12 to 0.20 seconds * QRS interval – 0.06 to 0.12 seconds * QT interval – 0.34 to 0.43 seconds
Normal Sinus Rhythms * Uniform P wave for every QRS with normal PR
Dsyrhythmias * Etiology * Disturbances in automaticity – initiation of impulse is altered * Disturbances in conduction – alteration in the speed the impulse travels * Reentry of impulses – cardiac tissue is depolarized multiple times by the same impulse * Speed, distance and location can be changed or affected (blockages cause change in heart rhythm) * Risk factors * Cardiovascular disease, MI * MI – death of tissue – no electricity can conduct through it, so it has to alter the pathway of the impulse after an MI * Hypoxemia * Electrolyte imbalance * Spiked T waves from potassium imbalance * Drug use or toxicity * Beta blockers can slow heart too much * Hypovolemia * Shock
Labs and Diagnostic Tests * Labs * Electrolytes * K (important) and Na * Hemoglobin and hematocrit * BUN and creatinine * Kidneys – your kidneys help your pH balance (increase puts more stress on heart because there is more Cr in the blood) * Type and cross match * Cardiac markers * Urinalysis * PT, PTT, INR platelet counts * Because of blood thinners (PT and Coumadin & PTT and heparin) * Diagnostic tests * Chest x-ray – enlargement of the heart and congestion of the lungs * Arterial blood gas (ABG) * pH * show you what your O2 level is * how well your heart and lungs are working together to supply body with oxygen * EKG – electrical impulse of the heart * Echocardiogram – details of how the chambers are working * Stress test – can the O2 demand by met by the body * Nuclear * Treadmill
Normal Intervals * PR interval – 0.12 to 0.20 seconds * QRS interval – 0.06 to 0.12 seconds * QT interval – 0.34 to 0.43 seconds
Normal Sinus Rhythms * Uniform P wave for every QRS with normal PR