Chronic Cardiovascular Disorders General Overview Hypertension Disorders of aorta and branches Arterial thrombosis & embolism Peripheral arterial disease (PAD) Aortic aneurysms Thromboangiitis obliterans Raynaud’s disease/phenomenon Venous disorders Venous thrombosis: Superficial & Deep Chronic venous insufficiency Lymphedema General Overview Gender, Cultural, & Ethnic Differences Use of the Genogram Medication Reconciliation Risk factors Diagnostic Tests Collaborative Care Nursing Interventions Prioritization Cardiac Markers Creatine Kinase (CK) Measures an enzyme that is released when there is muscle damage or breakdown Does not tell specific muscle CK-MM (skeletal); CK-BB (brain); CK-MB (cardiac) Report Rise, Peak and Fall levels Troponin Elevated levels mean Myocardial Damage Elevates earlier than CK-MB Reaches peak @ 24 hours and may not fall for 7-10 days Good indicator for patient who presents non-classic MI symptoms Cardiac Markers BLOOD STUDY RANGE RISE, PEAK, FALL Creatine Kinase (CK) 36-160 Units/L (F) 50–204 units/L (M) CK-MB < 4-6% of total CK Rise 4-6 hrs Peak 18-24 hrs Return to baseline 24-36 hrs Troponin < 0.35 ng/ml (I) < 0.2 mcg/L (T) Rise 2 – 6 hrs Peak 15-24 hrs Return to baseline 7-10 days
Lipid Panel (Cholesterol Test) Blood study Range Total Cholesterol < 200 mg/dL Low-density lipoprotein (LDL) or “bad” cholesterol Without CAD <130mg/dL With CAD ≤100mg/dL(< 70) High-density lipoprotein (HDL) or “good” cholesterol > 40 mg/dL (men) > 60 mg/dl (women) Triglycerides < 150 L Brain (or B-type) Natriuretic Peptide (BNP) Test Hormone secreted by the left ventricular when the left ventricular is overstretched from excess volume BNP level Condition < 100 Normal heart function 100-199 Mild heart failure 200-400 Moderate heart failure >400 Moderate to severe heart failure Diagnostic Studies Homocysteine Level Homocysteine is an amino acid your body uses to make protein and to build and maintain tissue. Normal: 4.6-11.2 mcg/L Damage inside lining of artery Encourage clot formation Stroke Heart disease Chest X-ray A chest x-ray is typically the first imaging test used to help evaluate symptoms such as: Shortness of breath Persistent cough Chest pain Takes 15 minutes Painless procedure PA & Lateral views Portable – AP view Always check if there is a chance pt is pregnant Echocardiogram (echo) Non-invasive ultrasound procedure that utilizes ultrasound to image the heart, muscle, chamber sizes, valves, ejection fraction, and blood flow Hypokineases less movement of muscle A-kineases non movement (MI) Ejection Fraction tells how well heart is pumping
Transthoracic Echocardiography (TTE) No special preparation Transducer is applied to chest wall to evaluate: Size and shape Valves Abnormal structures Blood clots or tumors Walls of heart Pumping ability Ejection Fraction (EF) Transesophageal Echocardiogram (TEE) Prep NPO for 6 hours prior to test Consent IV access Remove dentures During the procedure Sedation (Versed) Oxygen
You've reached the end of your free preview.
Want to read all 21 pages?
- Spring '13
- Nursing, varicose veins, chronic venous insufficiency