Cardiomyopathies (Dilated, Hypertrophic, Restrictive) for Progressive Care Certified Nurse (PCCN)
Included In This Lesson
Outline
Cardiomyopathies (Dilated, Hypertrophic, Restrictive)
Definition/Etiology:
- Definition
- Diseases that affected the Myocardium (middle layer/pumping muscle)
- Types & Etiology/Cause
- Dilated
- Most Common/90% Cases
- Idiopathic
- Myocarditis
- Pregnancy
- Drug/ETOH abuse
- Chagas Disease = Travel to Africa
- Hypertrophy
- Inherited (60-70%)
- Hypertension
- Common in Athletes (SCD)
- Dilated
Pathophysiology:
- Gas Station Analogy = PUMP FAILURE
- Dilated Cardiomyopathy
- Ventricular walls thin
- Ventricles Dilated/Weak
- Muscle construction weak
- Cannot squeeze = Systolic Dysfunction
- Hypertrophic Cardiomyopathy
- Ventricular Walls VERY thick
- Ventricles Rigid/Stiff
- Muscle cannot Relax
- Cannot FIll = Diastolic Dysfunction
Noticing: Assessment & Recognizing Cues:
- Subjective
- Chest Pain
- Tired/Fatigues
- SOB/Dyspnea
- Swelling of feet
- Objective
- Heart Sounds
- Dilated = S3 “Sloshing-In”
- Hypertrophic = S4 “A-Stiff-Wall”
- Murmurs – Mitral/Aortic
- Lung Sounds
- Lungs = WET
- Heart Sounds
Interpreting: Analyzing & Planning:
- Labs
- ABGs – Hypoxemia
- Electrolytes – Decreased KCL/MAG
- Troponin – Infarcts
- BUN/Creatinine – Rebel Function
- Diagnostics
- ECG
- Arrhythmias
- Atrial, Ventricular or AV Blocks (Lesson included)
- Echocardiogram
- Wall Thickness
- Ventricle dimensions
- Ejection Fraction
- CXR
- Cardiomegaly
- Pulm Congestion
- ECG
Responding: Patient Interventions & Taking Action:
- Pharmacological Interventions
- 02 Support
- Beta-Blockers – increase Cardiac Output
- Ace-Inhibitors – Decrease Afterload
- Diuretics – Get Fluid OUT
- Digoxin – Better Contraction
- Non-Pharmacological Interventions
- Ambulate AS TOLERATED
- Sodium Restriction
- Implanted Placemakers/DEFIB
- Valve Replacement
- Transplant
- Adjunct Medical Therapy
- Cardiology – Plumbing
- Electrophysiologist_Electricity
Reflecting: Evaluating Patient Outcomes:
- DR – Identify underlying cause (Treat/remove)
- Nothing we do will help if not identified!
- HF Symptoms Relieved
- Prevent MIs & Sudden Cardiac Death
- Pain Management
Linchpins (Key Points):
- Notice
- Objective/Subjective Cues HF
- Interpret
- ECHOCARDIOGRAM
- Walls, Ventricles, Valves & Output
- ECHOCARDIOGRAM
- Respond
- Treating underlying cause
- Pharm, Non-Pharm
- Cardiology & Electrophysiologist
- Reflect
- Symptomatic? Reduce MIs/SCD
Transcript
References
- AACN, and Tonja Hartjes. AACN Core Curriculum for Progressive and Critical Care Nursing. Available from: Pageburstls, (8th Edition). Elsevier Health Sciences (US), [Insert Year of Publication].
NCLEX
Concepts Covered:
- Circulatory System
- Emergency Care of the Cardiac Patient
- Cardiac Disorders
- Cardiovascular
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- Shock
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- Basics of NCLEX
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- Newborn Care
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