Nursing Tips: Cardiovascular

Blood: Components

Blood is composed of plasma and formed elements. The plasma contains water, ions, protein, nutrients, wastes, gasses, and clotting factors. The formed elements include red blood cells, white blood cells, and platelets.

Clopidogrel

Cardiovascular Pharmacology

Clopidogrel, a platelet aggregate inhibitor, helps to prevent myocardial infarction and stroke in patients with acute coronary syndrome.

Hypoplastic Left Heart Syndrome

1 Comment

Cardiovascular Pediatrics

For Hypoplastic Left Heart Syndrome a surgery in three stages is required: First the Norwood procedure, then the Glenn Shunt, and finally the Fontan procedure.

Atrial Fibrillation (A-Fib)

Cardiovascular Med-Surg

A patient with atrial fibrillation (A-Fib) experiences rapid but disorganized depolarization of the atria, causing them to quiver instead of fully squeezing.

Abdominal Aortic Aneurysm

Cardiovascular Med-Surg

A patient with an Abdominal Aortic Aneurysm may have a pulsating abdominal mass with a bruit. Do NOT palpate this due to the risk for rupture!

Sinus Bradycardia

Cardiovascular Med-Surg

A patient with sinus bradycardia will likely require no treatment. However, if they are symptomatic, treatment with atropine or a pacemaker may be indicated.

Cardiac Tamponade

Cardiovascular Med-Surg

A patient with paradoxical pulse and an EKG showing electrical alternans should be evaluated for cardiac tamponade.

Because atropine has anticholinergic side effects, it is often administered during surgery to decrease secretions.

Atropine: Nursing Care

1 Comment

Cardiovascular Pharmacology

Because atropine has anticholinergic side effects, it is often administered during surgery to decrease secretions.

Elevated hBNP

Cardiovascular Med-Surg

A patient with elevated hBNP (> 100 pg/mL) should be evaluated for Heart Failure.

Adenosine

Cardiovascular Pharmacology

Adenosine (Adenocard) is a Class V antiarrhythmic medication used for supraventricular tachycardia.

Calcium (Ca) expected range: 9 - 10.5 mEq/L.

Calcium Ranges

Cardiovascular Lab Values Med-Surg

Calcium (Ca) expected range: 9 - 10.5 mEq/L HINT: California (CA) is due for a big earthquake that may measure 9 - 10.5 on the Richter scale.

Filgrastim

Cardiovascular Pharmacology

Filgrastim is a medication used to stimulate the growth of neutrophils in patients with neutropenia.

A patient who experiences prolonged standing (like nurses!) is at risk for developing varicose veins. Educate patients with this risk factor to wear compression stockings and elevate the legs when possible.

Varicose Veins: Patient Teaching

Cardiovascular Med-Surg

A patient who experiences prolonged standing (like nurses!) is at risk for developing varicose veins. Educate patients with this risk factor to wear compression stockings and elevate the legs when possible.

Because hypokalemia increases a patient's risk of digoxin toxicity, be sure to closely monitor the potassium levels for patients taking digoxin!

Digoxin and Hypokalemia

Cardiovascular Pharmacology

Because hypokalemia increases a patient's risk of digoxin toxicity, be sure to closely monitor the potassium levels for patients taking digoxin!

Atropine

Cardiovascular Pharmacology

Atropine is a medication that can be administered to patients with sinus bradycardia or heart block in order to increase heart rate.

Cardiac Enzymes

Cardiovascular Med-Surg

Cardiac Enzymes are released in response to cardiac ischemia. They include CK-MB, Myoglobin, Troponin T, and Troponin I. Troponin is the most specific!

Disseminated Intravascular Coagulopathy (DIC)

Cardiovascular Med-Surg

A client experiencing shock is at risk for Disseminated Intravascular Coagulopathy (DIC). Monitor for signs of clotting/bleeding and report any of these findings promptly.

A child with Sickle Cell Anemia experiencing vaso-occlusive crisis should be treated with scheduled opioid analgesia (non-opioid analgesia will not be sufficient!).

Sick Cell Anemia and Vaso-occlusive Crisis

Cardiovascular Pediatrics

A child with Sickle Cell Anemia experiencing vaso-occlusive crisis should be treated with scheduled opioid analgesia (non-opioid analgesia will not be sufficient!).

A child with infective endocarditis will require IV antibiotics via PICC line for 2 - 6 weeks, and may require a valve repair or replacement.

Infective Endocarditis in Children

Cardiovascular Pediatrics

A child with infective endocarditis will require IV antibiotics via PICC line for 2 - 6 weeks, and may require a valve repair or replacement.

A child with Hemophilia A is deficient in Factor VIII. In Hemophilia B the deficiency is with Factor IX. Treatment of these conditions will include replacement of the missing factor, desmopressin, and aminocaproic acid.

Hemophilia in Children: Signs and Treatment

Cardiovascular Pediatrics

A child with Hemophilia A is deficient in Factor VIII. In Hemophilia B the deficiency is with Factor IX. Treatment of these conditions will include replacement of the missing factor, desmopressin, and aminocaproic acid.

Key Symptoms of Coarctation of the Aorta

Cardiovascular Pediatrics

KEY symptoms of Coarctation of the Aorta: elevated BP and bounding pulses in the arms, decreased BP and pulses in the legs.

Key Symptoms of a Patent Ductus Arteriosus

Cardiovascular Pediatrics

KEY symptoms of a Patent Ductus Arteriosus: machine-hum murmur, bounding pulses, and wide pulse pressure.

DASH diet & hypertension

Cardiovascular Nutrition

The DASH diet (for patients with hypertension) emphasizes low sodium, high potassium, and high calcium foods.

Calcium Channel Blockers

Cardiovascular Pharmacology

Calcium channel blockers are Very Nice Drugs: Verapamil, Nifedipine, Diltiazem.

Calcium Gluconate

Cardiovascular Pharmacology

Calcium gluconate is used for emergency treatment of hyperkalemia and hypermagnesemia!

Iron supplements can cause dark green/black stools. This is expected and harmless.

Iron supplements and stool

Cardiovascular Pharmacology

Iron supplements can cause dark green/black stools. This is expected and harmless.

Orthostatic Hypotension

Cardiovascular Fundamentals Health Assessment

A patient is POSITIVE for orthostatic hypotension if: The SBP decreases more than 20mmHg when changing position AND/OR the DBP decreases more than 10mmHg

ACE Inhibitors

Cardiovascular Pharmacology

ACE inhibitors typically end in -pril. Remember the key side effects.

Non-selective beta blockers are used for hypertension, angina, arrhythmias, and MIs. However, they should NEVER be used in patients with asthma, as they can cause bronchospasm.

Key Information: Beta Blockers

Cardiovascular Pharmacology

Non-selective beta blockers are used for hypertension, angina, arrhythmias, and MIs. However, they should NEVER be used in patients with asthma, as they can cause bronchospasm.