Performing Cardiac (Heart) Monitoring
Overview Cardiac monitoring Assess signs and symptoms Monitoring devices Nursing Points General Why monitor heart? Abnormal heart rhythm/rate Current or history Chest pain Syncope Electrolyte imbalance Alcohol withdrawal Assessment How to monitor Nursing judgement Pulse oximetry Listen to heart Palpate pulses Doctor orders Electrocardiogram (EKG) Single measurement Telemetry Short term, while in hospital Holter monitors […]
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Overview Pathophysiology: Coronary arteries are responsible for delivering oxygen to the heart. CAD occurs when plaque forms in the arteries. This plaque narrows the arterial space or the lumen. This narrowing causes blood flow to be impaired. When the blood flow is impaired oxygen delivery is inadequate. Oxygen can not supply the heart adequately. When […]
Pacemakers
Overview Pacemakers On or implanted in chest Correct electrical issues in heart Nursing Points General Need for pacemaker Sick sinus syndrome–>SA node damaged–>alternating slow and fast heart rates Poor electrical signals in heart Irregular rhythm Slow rate Electrical signals Make heart beat–>normal 60-100 beats/minute Control rate and rhythm Ensure contraction of ventricles–>pump blood through vessels […]
Nutrition (Diet) in Disease
Overview Understand how disease can affect nutrition in the human body Nursing Points General Diseases that have a very significant impact on nutrition Cardiac Disorders Diabetes Mellitus Gastrointestinal Disorders Renal Disorders Assessment Cardiac Disorders Nutrition-Disease Relationship Heart is a pump Vessels deliver blood to the body Diet can affect the elasticity of the blood vessels, […]
Dysrhythmias Labs
Overview Dysrhythmias Labs to consider for disease process Lab purposes Special Considerations Nursing Points General Dysrhythmias Labs to consider 12 lead EKG Not necessarily a lab, but a diagnostic tool Indicates particular dysrhythmia Comprehensive/Basic metabolic panel Electrolytes Complete Blood Count Cardiac Markers BNP D-Dimer Thyroid Studies Digoxin level Toxicology screen Lab purposes Comprehensive/Basic metabolic panel […]
Sepsis Labs
Overview Sepsis Labs to consider for disease process Lab purposes Special Considerations Nursing Points General Sepsis Labs to consider for disease process Comprehensive/Basic Metabolic Panel plus electrolytes Complete Blood Count Type and screen ABG Coagulation Studies Lactate Cardiac markers Cultures Lab purposes Comprehensive/Basic Metabolic Panel plus electrolytes Organ function Electrolyte imbalances Monitoring Anion Gap Complete […]
The 5-Minute Assessment (Physical assessment)
Overview Completing a shift assessment in 5-minutes is all about multi-tasking Below you will find the action steps to take. In italics below that, you will find the OTHER information you can/will be gathering simultaneously Words in BOLD are statements you should make Underlined words are equipment you will need Nursing Points General Remember to […]
Heart (Cardiac) and Great Vessels Assessment
Overview Major heart assessments: Sounds Murmurs Apical pulse The great vessels to be assessed are: Carotid arteries Jugular veins Aorta Nursing Points General Supplies needed Pen light Stethoscope Assessment Inspect Anterior chest for visible apical pulse 5th ICS, Left MCL Abdomen for pulsation May indicate an abdominal aortic aneurysm Jugular venous pulse Lay patient at […]
Troponin I (cTNL) Lab Values
Overview Troponin I Normal value range Pathophysiology Special considerations Elevations in lab values Nursing Points General Normal value range Typically, less than 0.035 ng/mL or less Can vary among institutions Has to be greater than the 99th percentile Pathophysiology Troponin is released during myocardial cell damage Decreased perfusion causes myocardial cell damage Causes of myocardial […]
Brain Natriuretic Peptide (BNP) Lab Values
Overview BNP Normal Value Range Pathophysiology Special considerations Lab value elevations Nursing Points General Normal value range 100 pg/mL Pathophysiology Increased pressure overload due to increased SVR or volume Ventricular stretching causes release of BNP into bloodstream BNP released to aid in stress due to overload by: Increases excretion of sodium in urine = natriuresis […]