Cardiac Surgery1 - Cardiac Surgery Open heart surgery use of cardiopulmonary bypass machine(pumps oxygenates cools suctions filters blood Closed heart

Cardiac Surgery1 - Cardiac Surgery Open heart surgery use...

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Cardiac Surgery Open heart surgery: use of cardiopulmonary bypass machine (pumps, oxygenates, cools, suctions & filters blood) Closed heart surgery: without use of the machine CABG: coronary artery bypass graft Valve stenosis: valve does not open completely so blood does not flow freely through it Valve insufficiency/regurgitation: valve does not close well and there is backflow (mitral and aortic valves) CABG Over 450,000 performed each year though use of nonsurgical methods for treating CAD may be impacted this (angioplasty, thrombolytic tx) Men more than women Women have increase after menopause Treatment for coronary artery disease (CAD) with 70% or occlusion of vessel; 50% if L main CA Seen in older adults CAD Risk factors Same as for ASHD, CAD and MI: HTN Diabetes Smoking Obesity Lack of exercise (sedentary) High fat, high cholesterol diet Type A personality (stress) Genetic hyperlipidemia High triglicerides, high LDL, low HDL, High CRP (C-reactive protein) shows inflammation Nursing Process: Assessment: Clinical Manifestations CAD Clinical Manifestations would be the same as for Acute MI but milder and transient Angina pectoris which may be relieved by rest (stable angina) if angina at rest (unstable angina) Shortness of breath on exertion, fatigue Jaw, back or arm pain, especially on left side, either during exertion or at rest Palpitations, dysrhythmias Dizziness, light-headedness, or fainting Weakness on exertion or at rest Irregular heartbeat
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Nursing Process: Assessment: Testing CAD Hgb & Hct (12-16; 36-50) Cardiac enzymes BNP (above 300 CHF/heart damage) CXR Cholesterol (<200); HDL (30-70) Triglycerides (<160) LDL (65-180) CRP (greater than 3 high risk) Electrolytes ( K+, Ca+, Na+) EKG and stress test Echocardiogram Thallium scan CT scan looking for calcium plaques Cardiac catherization with angiography BUN & Creatinine (7-20; 0.5-1.4)
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