Coronary artery bypass graft cabg percutaneous

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Coronary artery bypass graft (CABG)Percutaneous transluminal coronary angioplasty (PTCA)Stent placement•Myocardial infarction Etiology/pathophysiology• Occlusion of a major coronary artery or one of its branches with subsequent necrosis of myocardium ELEPHANT SITTING ON CHEST•Myocardial infarction • Most common causeatherosclerosis• Ability of the cardiac muscle to contract and pump blood is impaired•Myocardial infarction Clinical manifestations/assessment• Asymptomatic (silent MI)• Pain (not relieved by rest, position, or nitroglycerin)• Nausea• SOB; dizziness; weakness• Diaphoresis• Pallor—ashen color• Sense of impending doom•Myocardial infarction Medical management/nursing interventions• Oxygen• Fibrinolytic agents• Medications: vasopressors, analgesics, nitrates, beta-adrenergic blockers, calcium channel blockers, antidysrhythmics, diuretics, inotropic agents, diuretics, stool softeners•Myocardial infarction Surgical interventions• Percutaneous transluminal coronary angioplasty (PTCA)• Coronary artery bypass graft surgery• Heart failure Etiology/pathophysiology• Abnormal condition can result from structural changes in the heart & functional cardiacdisorders that impair the ability of the ventral to fill or eject blood.• Left ventricular failureMost common- primary reason is its inability to contract because direct damage to the muscular wall• causes of Left ventricular failure-MI affects the pumping ability of the left or right ventricle and frequently contributes to HF. acute HF may immediately follow an MI or developed sometime after the initial episode. -The pumping chamber enlarge & weaken & making the pumping ability of the ventral imposible to eject all the blood they receives.• Right ventricular failureUsually caused by left ventricular failure- edema in body, hands, feet•Heart failure Clinical manifestations/assessment
• Decreased cardiac outputFatigue ▪ Decreased GI motilityAngina ▪ Pale, cool skinAnxiety; restlessness ▪ Weight gainOliguria•Heart failure • Left ventricular failurePulmonary congestiono Dyspneao Paroxysmal nocturnal dyspneao Cough; frothy, blood-tinged sputumo Orthopneao Pulmonary crackleso Pleural effusion (x-ray)• Heart failure • Right ventricular failureDistended jugular veinsAnorexia, nausea, and abdominal distentionLiver enlargementAscitesEdema in feet, ankles, sacrum; may progress up the legs into thighs, external genitalia, and lower trunk•Heart failure Medical management/nursing interventions• Increase cardiac efficiencyDigitalisVasodilatorsACE inhibitors (decrease blood pressure)• Bedrest, HOB elevated• Oxygen• Treat edema and pulmonary congestion• Monitor fluid retention (weigh daily; strict I&O)•LEFT HEART FAILUREPulmonary edema Etiology/pathophysiology• Accumulation of fluid in lung tissues and alveoli• Complication of congestive heart failure (CHF)

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Term
Spring
Professor
D.Ugarriza
Tags
Nursing, right ventricle

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