HNN227 WEEK 3 ASSESSING AND MANAGING PATIENT FUNCTION AND RISK:
ISCHAEMIA
On completion of this week students should be able to:
Define the terms ischaemia and infarction
obstruction of the blood supply to an organ or region of tissue,
typically by a thrombus or embolus, causing local death of the
tissue.
Identify various body sites ischaemia may occur and possible
subsequent conditions
Brain-stroke, eye-vision deficit, carotic artery, heart-angina/cardiac
arrest, arrthymia, small/large intestine-bowel obstruction, kidney-
renal failure, limbs-peripheral artery-lost of limbs,
Describe the pathophysiological process of atherosclerosis
Thickening of artery cause by plaque and narrow the circulartion
State the common sites within the arterial system for atherosclerotic
plaque development
Above the Common carotid bifurcation, branches from the aorta,
innominate, and subclavian arteries, Lt coronary artery, rt coronary
artery, common iliac artery, superficial femoral artery, deep femoral
artery, anterior tibial artery, posterior tibial artery, peroneal artery
Describe the anatomy and physiology of the heart and blood vessels
Review anatomy & physiology book
Define what is meant by the term Acute Coronary syndrome
a range of conditions associated with sudden, reduced blood flow to
the heart
o Identify risk factors for ACS
Older age (older than 45 for men and older than 55 for
women)
High blood pressure
High blood cholesterol
Cigarette smoking
Lack of physical activity
Unhealthy diet
Obesity or overweight
Diabetes
Family history of chest pain, heart disease or stroke
For women, a history of high blood pressure, preeclampsia
or diabetes during pregnancy
o Identify diagnostic assessments (including possible differential
diagnostic outcomes)
, Electrocardiogram (ECG).
Blood tests. Certain enzymes may be detected in the blood if cell
death has resulted in damage to heart tissue. A positive TROPONIN
T result indicates a heart attack.
Coronary angiogram.
Echocardiogram.
Myocardial perfusion imaging (MPI).
Computerized tomography (CT) angiogram.
Stress test.
Identify goals of management for ACS
O2, blood flow, decrease o2 demand, decrease viscouscity of
blood
IV fluid
Sit up
Analgesic
Vital sign
Pre Op- angioplasthy
Report any pain / discomfort
Response honestly to pt concern
o Define and understand the term Peripheral Arterial Disease
(PAD)
a common circulatory problem in which narrowed arteries
reduce blood flow to your limbs.
o Identify commonly affected arteries
Femoral polethial, thigh, lower limb
o Identify risk factors and common symptoms of PAD (including
intermittent claudication)
Diminishes color, lost of leg, pain when walking,
o Identify diagnostic features for PAD
Walking program
o Identify potential patient problems related to PAD
Diet control- cholesterol control
Educ on feet care-nail, shoe fitting
o Outline nursing management required for patients with PAD
two major goals:
, 1. Manage symptoms, such as leg pain, so that you can resume
physical activities.
2. Stop the progression of atherosclerosis throughout your body
to reduce your risk of heart attack and stroke.
a) Medications
Cholesterol-lowering medications. You may take a cholesterol-
lowering drug called a statin to reduce your risk of heart attack and
stroke.
High blood pressure medications. If you also have high blood
pressure, your doctor may prescribe medications to lower it.
Medication to control blood sugar.
Medications to prevent blood clots. Because peripheral artery
disease is related to reduced blood flow to your limbs, it's important
to improve that flow.
Symptom-relief medications. The drug cilostazol (Pletal)
increases blood flow to the limbs both by keeping the blood thin and
by widening the blood vessels. It specifically helps treat symptoms
of claudication, such as leg pain, for people who have peripheral
artery disease. Common side effects of this medication include
headache and diarrhea.
b) Angioplasty and surgery
c) Supervised exercised to gain strength and pain free
Myocardial Infarction Nursing Interventions & Lecture
Nursing Interventions for Myocardial Infarction
Monitoring & Assessing Cardiovascular system:
o Obtain a 12-lead EKG, have continuous bedside cardiac monitoring
o Monitoring blood pressure and heart rate
Place on oxygen via nasal cannula per MD order 2-4 L
Working IV access (multiple…may start drips and administer other IV medications)
Monitor respiratory system: lung sounds “crackles”..represent heart failure
Strict bedrest (activity puts strain on heart)k
Collect cardiac enzymes as ordered by the physician
Administering medications per MD order:
ISCHAEMIA
On completion of this week students should be able to:
Define the terms ischaemia and infarction
obstruction of the blood supply to an organ or region of tissue,
typically by a thrombus or embolus, causing local death of the
tissue.
Identify various body sites ischaemia may occur and possible
subsequent conditions
Brain-stroke, eye-vision deficit, carotic artery, heart-angina/cardiac
arrest, arrthymia, small/large intestine-bowel obstruction, kidney-
renal failure, limbs-peripheral artery-lost of limbs,
Describe the pathophysiological process of atherosclerosis
Thickening of artery cause by plaque and narrow the circulartion
State the common sites within the arterial system for atherosclerotic
plaque development
Above the Common carotid bifurcation, branches from the aorta,
innominate, and subclavian arteries, Lt coronary artery, rt coronary
artery, common iliac artery, superficial femoral artery, deep femoral
artery, anterior tibial artery, posterior tibial artery, peroneal artery
Describe the anatomy and physiology of the heart and blood vessels
Review anatomy & physiology book
Define what is meant by the term Acute Coronary syndrome
a range of conditions associated with sudden, reduced blood flow to
the heart
o Identify risk factors for ACS
Older age (older than 45 for men and older than 55 for
women)
High blood pressure
High blood cholesterol
Cigarette smoking
Lack of physical activity
Unhealthy diet
Obesity or overweight
Diabetes
Family history of chest pain, heart disease or stroke
For women, a history of high blood pressure, preeclampsia
or diabetes during pregnancy
o Identify diagnostic assessments (including possible differential
diagnostic outcomes)
, Electrocardiogram (ECG).
Blood tests. Certain enzymes may be detected in the blood if cell
death has resulted in damage to heart tissue. A positive TROPONIN
T result indicates a heart attack.
Coronary angiogram.
Echocardiogram.
Myocardial perfusion imaging (MPI).
Computerized tomography (CT) angiogram.
Stress test.
Identify goals of management for ACS
O2, blood flow, decrease o2 demand, decrease viscouscity of
blood
IV fluid
Sit up
Analgesic
Vital sign
Pre Op- angioplasthy
Report any pain / discomfort
Response honestly to pt concern
o Define and understand the term Peripheral Arterial Disease
(PAD)
a common circulatory problem in which narrowed arteries
reduce blood flow to your limbs.
o Identify commonly affected arteries
Femoral polethial, thigh, lower limb
o Identify risk factors and common symptoms of PAD (including
intermittent claudication)
Diminishes color, lost of leg, pain when walking,
o Identify diagnostic features for PAD
Walking program
o Identify potential patient problems related to PAD
Diet control- cholesterol control
Educ on feet care-nail, shoe fitting
o Outline nursing management required for patients with PAD
two major goals:
, 1. Manage symptoms, such as leg pain, so that you can resume
physical activities.
2. Stop the progression of atherosclerosis throughout your body
to reduce your risk of heart attack and stroke.
a) Medications
Cholesterol-lowering medications. You may take a cholesterol-
lowering drug called a statin to reduce your risk of heart attack and
stroke.
High blood pressure medications. If you also have high blood
pressure, your doctor may prescribe medications to lower it.
Medication to control blood sugar.
Medications to prevent blood clots. Because peripheral artery
disease is related to reduced blood flow to your limbs, it's important
to improve that flow.
Symptom-relief medications. The drug cilostazol (Pletal)
increases blood flow to the limbs both by keeping the blood thin and
by widening the blood vessels. It specifically helps treat symptoms
of claudication, such as leg pain, for people who have peripheral
artery disease. Common side effects of this medication include
headache and diarrhea.
b) Angioplasty and surgery
c) Supervised exercised to gain strength and pain free
Myocardial Infarction Nursing Interventions & Lecture
Nursing Interventions for Myocardial Infarction
Monitoring & Assessing Cardiovascular system:
o Obtain a 12-lead EKG, have continuous bedside cardiac monitoring
o Monitoring blood pressure and heart rate
Place on oxygen via nasal cannula per MD order 2-4 L
Working IV access (multiple…may start drips and administer other IV medications)
Monitor respiratory system: lung sounds “crackles”..represent heart failure
Strict bedrest (activity puts strain on heart)k
Collect cardiac enzymes as ordered by the physician
Administering medications per MD order:
