Famous Nursing Knowledge

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Famous Cardiac Knowledge

Famous NCLEX knowledge about Myocardial Infarction and Heart Failure

  • Reduce pain and myocardial oxygen demand.
  • How? Bedrest and Morphine
  • Also, Pain= insufficient oxygen reaching the heart muscle
  • Headache common due to vasodilation
  • Monitor blood pressure
  • Goal: Coronary vasodilation to decrease chest pain.
  • Yes, they will ask you. Must be given with an infusion pump and requires frequent BP monitoring
  • Give the morphine first is the answer most of the time (EKG, chest x-ray, labs can wait)
  • Intended effect:
    • Reduce myocardial oxygen consumption
    • Treat the chest pain
    • Reduce blood pressure and heart rate
    • Reduce anxiety and fear.
  • Monitor for Confusion (decrease oxygen to brain)
  • Urine output (acute kidney failure from decrease blood flow)
  • Orthopnea, Dyspnea (pulmonary edema)
  • Do not give Metoprolol or any other beta blocker (depresses myocardial contractility)
  • Beta blockers only for stable cardiac patients.
  • Cardiogenic shock watch for oliguria (low urine output). It’s an expected finding.
  • Small, easily digested meals.
  • tPA (Alteplase) breaks down (lysis) the clot in blocked coronary arteries.
  • Watch for reperfusion cardiac arrhythmias
  • Contraindications: Hx of Cerebral hemorrhage
  • Fluid-filled alveoli
  • Seen in left sided heart failure.
  • Troponin
  • Myoglobin
  • CK-MB
  • Did you now that it causes gingival hyperplasia
  • Monitor gums daily
  • Can cause hyperkalemia
  • The -prils  Captopril, enalapril, lisinopril
  • Coumadin to prevent thrombus formation
  • Causes Stasis of blood in the atria (Leading to clots)
  • Blurred vision, nausea, headache, weakness, any visual disturbances.
  • Think visual disturbances. Yellow spots
  • Hypokalemia increases risk of digoxin toxicity.
  • You know what digoxin does right? Increases myocardial contractility.
  • High fowler’s position
  • Best lung expansion
  • Decreases venous return to decrease myocardial workload
  • Notify your MD if
    • Gain 2 or more lbs in a day
    • Have to sit upright to sleep
    • Become increasing SOB at rest
  • Left look for lung symptoms: crackles, dyspnea, orthopnea.  Left and Lungs both start with L
  • Right look for swelling: peripheral edema, hematomegaly (swollen liver), enlarged spleen (swollen liver), jugular vein distension (swollen jugular)