CARDIO VASCULAR SYSTEM DISORDER IMPORTANT POINTS

• Tablet metformin should be withhold before 24 hour and for 48 Hour after cardiac catheterization. 

• • Hypotension and Dizziness are signs of decreased cardiac output.
  • Stridor is a Crowning sound associated with laryngospasm and edema of upper Airway. 

• When the heart rate decreases and patient complaints of dizziness and hypotension then patient should be prepared for Transcutaneous pacing.

• Classic sign of cardiogenic shock include low BP and tachycardia .dysrhythmia commonly results in cardiogenic shock example ventricular dysrhythmia.

• The patient undergoing cardiac surgery is at risk for renal injury from poor perfusion , low cardiac output etc.

• Renal injury is signalled by decreased urine output and increased blood urea nitrogen and creatinine level.

• Sudden loss of electrocardiographic complexes on system the nurse should assess the client and electrode placement.

• Ventricular tachycardia can developed into ventricular fibrillation at anytime.

• Premature ventricular contraction can cause hemodynamic compromise therefore the priority is to monitor BP and oxygen saturation.

• Anticoagulant are contraindicated with active bleeding except for disseminated intravascular coagulation disseminated intravascular coagulation DIC.

• The patient who developed arterial fibrillation the nurse should assess associated sign and symptoms like hypotension and dizziness.

• On ECG,  when there is no P wave and fibrilatory wave before each QRS COMPLEX is present it represents ATRIAL FIBRILLATION.

• In monophasic defibrillator 360 joules of energy is used.

• In biphasic defibrillator 120 to 200 joules of energy  is used.

• Nursing responsibility after cardio version include maintenance of patent Airway and then oxygenation.

• Expected outcome of of aortoiliac bypass graft surgery is warmth redness and edema in surgical extrimity because of increase blood flow.

• After pericardiocentesis a rise in BP and fall in CVP  is expected.

• In ventricular fibrillation, there is no measurable rate and no P wave or QRS complex.

• In Unna boot dressing constructed of gauze moistened with zinc oxide and changed weekly

• Antidote of heparin is protamine sulfate.

• Heparin prevents thrombin from converting fibrinogen to fibrin.

• Normal aPTT( activated partial thromboplastin) is 20 to 36 sec.

• Patient receiving heparin therapy aPTT level should be 1.5 to 2.5 times normal value

• aPTT level longer than 80 sec. Dosage should be lowered.

• aPTT level less than 60 sec dosage should be incresed.

• Heparin is administered subcutaneous into the abdomen with 5/8 inch needle at 90 degree angle do not aspirate or rub the injection site.

• Warfarin sodium is anticoagulant and is given normally orally.

• When warfarin sodium therapy it started partial thrombin time and INR are monitored.

• NORMAL PT(partial thrombin) is 9.6 to 11.8 sec.

• INR IS 1.3 TO 2.0

• THE therapeutic range of PT is 1.5 to 2 times the normal value.

• Antidote of warfarin sodium is vitamin K(phytonadione).

• Thromobolytic medication includes Alteplase, Reteplase .

• Antidote of thrombolytic medication is Aminocarpoic acid.

• Bleeding is the primary concern for patient taking anticoagulants or antiplatelets medication.

• Antiplatelet medication includes aspirin, clopidogrel etc.

• Dubatamine is used for short-term management of heart failure it increases myocardial contractility that improving cardiac performance.

• Milrinone Lactate is given before  heart transplant.

• Dopamine is used as short term measure for severe acute heart failure.

• Inamrinone should not be mixed with glucose containing solution.
• Early sign of digoxin toxicity is anorexia nausea vomiting and diarrhoea.

• Therapeutic digoxin range is is 0.5 to 2ng/ml

• Digoxin should be withheld if heart rate is is less than 60 beat per minute and notify the doctor.

• Hypokalemia can cause digoxin toxicity.

• Loop diuretics includes furosemide and torsemide.

• Side effect of loop diuretics includes ototoxicity and deafness.

• Iv frusomide should be given very slowly because hearing loss can occur if injected rapidly.

• Potassium retaining diuretic is spironolactone and primary concern is hyperkalemia.

• ACE INHIBITORS includes ramipril, captopril etc.

• Side effect of ACE inhibitors includes persistent dry cough.

• Diminished taste is also side effect of ACE inhibitors

• Nitroglycerine tablet is given for 3 doses with interval of 5 min and then notify doctor. Check bp before each dose

• Beta Adrenergic Blocker includes lebatalol, propranolol etc.

• Side effects includes agranulocytosis( low wbc).

• Brochospasm is serious side effect of betablockers

• Direct acting vasodilators like Sodium nitroprusside or nitro glycerine diazoxide are used in acute hypertensive emergency.

• Sodium nitroprusside it should be protected from light while administration it   should be covered with dark bag and it is stable for 24 hrs

• Discard medication if it is red, green or blue.

• Adenosine injection is used in proximal supraventricular tachycardia and it should be injected very fast less than 1 second because its half life is very less.

• Adreneline or epinephrine is used for cardiac stimulation

• It produces mydriasis(pupil dilation).

• Norepinepherine stimulates heart rate in cardiac arrest.

• Antilipedemics includes Atoverstatin, lovastatin etc

pdf file download here :- Cardiac disorders important points pdf