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Content Review

- Cardiovascular
Know about chest pain. Quality, type, location etc. Is it cardiac, GI, Pulmonary etc.
How do you recognize fluid overload? What assessment techniques do you use? What interventions

- Dysrhythmias:
Know risks, pathophysiology, and complications; Be able to recognize simple rhythms- NSR, Tachy, brady, PVC’s V-Fib; Would you know the rhythms from description?
What treatments for lethal dysrhythmias?

- Hyperlipidmia: What is it? What is the role in CAD? What are the different labs? Abnormals? What about diet? Treatment for hyperlipidemia. Drugs, lifestyle changes/management.
Priority setting? Which patients come first

- Hypertension:
Risks, treatment, symptoms, complications, end target organs
Know your anti-hypertensives: Categories, side effects, etc.
Coronary Artery Disease, Risks, Complications

- Heart failure:
Risks, pathophysiology, Signs symptoms- know the difference between right and left heart failure, Treatments- pharmacology, Lab
Atrial Fibrillation in heart failure- complications, prevention
CAD- Acute myocardial infarction- Core measures, Acute MI- risks, signs, symptoms, treatment, EKG findings
Coronary Angiography- Percutaneous Coronary Intervention
Nursing care post PCI
Complication

- Know lab values:
Lipids- cholesterol, triglycerides,
Digoxin toxicity- risks, symptoms,
Post op care of the pacemaker insertion

- Peripheral vascular disease:
Know the patho, signs, symptoms, treatment, nursing care
Buerger’s Disease

- Contents
Arterial insufficiency versus peripheral venous disease
Thrombophlebitis
Anemia- know types of anemia, the lab of HGB and HCT, symptoms, risks,
Know polycythemia
What are iron preparations, dietary sources
Blood transfusions- know process, risks, reactions,
What is the risk with phosphodiesterase inhibitors in coronary artery disease.

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Know about chest pain. Quality, type, location etc. Is it cardiac, GI, Pulmonary etc.
Chest pain may be a symptom of a number of serious disorders and is, in general, considered a medical emergency. Even though it may be determined that the pain is noncardiac in origin (does not come from a heart problem), this is often a diagnosis of exclusion made after ruling out more serious causes of the pain. Cardiac (heart-related) chest pain is called angina pectoris.
Knowing a patient's risk factors can be extremely useful in ruling in or ruling out serious causes of chest pain. For example, heart attack and thoracic aortic dissection are very rare in healthy individuals under 30 years of age, but significantly more common in individuals with significant risk factors, such as older age, smoking, hypertension, diabetes, history of coronary artery disease or stroke, positive family history (premature atherosclerosis, cholesterol disorders, heart attack at early age), and other risk factors. Chest pain that radiates to one or both shoulders or arms, chest pain that occurs with physical activity, chest pain associated with nausea or vomiting, chest pain accompanied by diaphoresis or sweating, or chest pain described as "pressure," has a higher likelihood of being related to acute coronary syndrome, or inadequate supply of blood to the heart muscle, but even without these symptoms chest pain may be a sign of acute coronary syndrome.
In the emergency department the typical approach to chest pain involves ruling out the most dangerous causes: heart attack, pulmonary embolism, thoracic aortic dissection, esophageal rupture, tension pneumothorax, and cardiac tamponade. By elimination or confirmation of the most serious causes, a diagnosis of the origin of the pain may be made. Often, no definite cause will be found and reassurance is then provided.
If acute coronary syndrome ("heart attack") is suspected, many people are admitted briefly for observation, sequential ECGs, and measurement of cardiac enzymes in the blood over time. On occasion, further tests on follow up may determine the cause.
Careful medical history and physical examination is essential in separating dangerous from trivial causes of disease, and the management of chest pain may be done on specialized units (termed medical assessment units) to concentrate the investigations. Occasionally, invisible medical signs will direct the diagnosis towards particular causes, such as Levine's sign in cardiac ischemia. A rapid diagnosis can be life-saving and often has to be made without the help of medical tests. However, in general, additional tests are required to establish the diagnosis.
How do you recognize fluid overload? What assessment techniques do you use? What interventions
Hypervolemia, or fluid overload, is the medical condition where there is too much fluid in the blood. The opposite condition is hypovolemia, which is too little fluid volume in the blood. Fluid volume excess in the intravascular compartment occurs due to an increase in total body sodium content and a consequent increase in extracellular body water. The mechanism usually stems from compromised regulatory mechanisms for sodium handling as seen in congestive heart failure (CHF), kidney failure, and liver failure. It may also be caused by excessive intake of sodium from foods, intravenous (IV) solutions and blood transfusions, medications, or diagnostic contrast dyes. Treatment typically includes administration of diuretics and restriction of the intake of water, fluids, sodium, and salt.
The excess fluid, primarily salt and water, builds up in various locations in the body and leads to an increase in weight, swelling in the legs and arms (peripheral edema), and/or fluid in the abdomen (ascites). Eventually, the fluid enters the air spaces in the lungs (pulmonary edema) reduces the amount of oxygen that can enter the blood, and causes shortness of breath (dyspnea) or enters pleural space by transudation (pleural effusion which also causes dyspnea), which is the best indicator of estimating central venous pressure is increased. It can also cause swelling of the face. Fluid can also collect in the lungs when lying down at night, possibly making nighttime breathing and sleeping difficult (paroxysmal nocturnal dyspnea).
The cornerstone of therapy is the use of diuretics that will deplete the body from excess fluid.
Dysrhythmias:
Know risks, pathophysiology, and complications; Be able to recognize simple rhythms- NSR, Tachy, brady, PVC’s V-Fib; Would you know the rhythms from description?
Cardiac arrhythmia, also known as cardiac dysrhythmia or irregular heartbeat, is a group of conditions in which the heartbeat is irregular, too fast, or too slow. A heart rate that is too fast – above 100 beats per minute in adults – is called tachycardia and a heart rate that is too slow – below 60 beats per minute – is called bradycardia. Many types of arrhythmia have no symptoms. When symptoms are present these may include palpitations or feeling a pause between heartbeats. More seriously there may be lightheadedness, passing out, shortness of breath, or chest pain. While most types of arrhythmia are not serious, some predispose a person to complications such as stroke or heart failure. Others may result in cardiac arrest.
There are four main types of arrhythmia: extra beats, supraventricular tachycardias, ventricular arrhythmias, and bradyarrhythmias. Extra beats include premature atrial contractions, premature ventricular contractions, and premature junctional contractions. Supraventricular tachycardias include atrial fibrillation, atrial flutter, and paroxysmal supraventricular tachycardia. Ventricular arrhythmias include ventricular fibrillation and ventricular tachycardia. Arrhythmias are due to problems with the electrical conduction system...

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