Overwhelmed By Cardiac...

carolinapooh, BSN, RN · Feb 13, 2008

Yep - go get your hands on a copy of the book "Cardiovascular Care Made Incredibly Visual". I used it during my preceptorship on a cardiac floor and ALL the RNs were impressed with it.

I couldn't have learned ECGs without it!

yoginurse2b · Feb 22, 2008

This is how I learn. I studied the patho really well for all the systems, especially cardiac. Once I know the patho, I will kind of have a clue of what are the S/S. With those S/S, it will lead me to nursing interventions and treatments, especially meds.

So if you master the patho well, and understand it (not just memorizing), you will eventually get it.

Hope that helps.

WDWpixieRN, RN · Feb 22, 2008

Hi all,
Well second round of cardiac just started.....9 hours of lecture with no powerpoints and crazy handouts, we are working on reading 12 leads, assessment which is ok, clinical significance of any abnormal cardio findings in a clinical situation: causes, medical interventions, diagnosis, and nsg interventions....plus meds the different classes etc...also clinical significance and nsg care for acute pulmonary edema, MI in depth, cardiomyopathy, tamponade, cardiogenic shock.......am overwhelmed.....exam in 2 weeks...

I am almost in exactly the same boat, same timeframe...we are 4th semester students and are just so brain-dead at this point!! I am working to learn as much as my peabrain will hold at this point and then PRAY!!

I do have to add that our instructor is pretty good; it's just an overwhelming amount of info!!

Best wishes!!

GretaRN · Feb 22, 2008

May I wish....I'm done in August!!! My brain is fried, exam next Thursday. Overwhelming is not the word!!!!! Good Luck to you!

Miami NightNurse · Feb 23, 2008

here is the mi part of handbook i wrote, maybe it can help you guys.

what is a heart attack (also called an acute myocardial infarction or mi)?

acute myocardial infarction (ami) is the rapid development of myocardial necrosis caused by part of the heart not getting enough oxygen.

this usually results from plaque rupture with thrombus(clot) formation in a coronary vessel, resulting in an acute reduction of blood supply to a portion of the myocardium. blood clots love to form on the rough surface that plaque(fat) causes.

signs & symptoms:

♥chest pain,most commonly on the left side ♥ nausea/vomiting

♥epigastric pain-mistaken for indigestion ♥ sob

♥jaw pain ♥ dizziness

♥radiating pain in shoulders,arms & neck ♥ very anxious

some people experience no symptoms, especially diabetics

[color=#990000]transmural infarct[color=#990000]-includes necrosis of all layers of the myocardium. pathological q waves are seen.

[color=#990000]subendocardial infarct or non q wave mi-involves the inner layers of the myocardium, has less effect on wall motion and cardiac output than a transmural mi

various types of rhythm or conduction abnormalities can occur during or following an acute mi. supraventricular tachyarrhythmias (most commonly, atrial fibrillation) generally occur with a rapid heart rate and may cause or exacerbate ischemia, provoke a serious sustained ventricular tachyarrhythmia, or induce or worsen heart failure(chf). because the mi causes death of the heart muscle, it becomes akinetic(motionless)

look for ekg changes....the three ekg changes are:

1. elevated st segments (myocardial injury )

2. inverted t waves( myocardial ischemia)

3. pathological q waves(myocardial infarction)

afib and a inferior wall mi with q waves in leads ii, iii,

avf, and elevated st segments

acute anterior wall mi, old inferior wall mi . sinus rythm, q wave in leads ii, iii, avf , old inferior wall infarction, q waves in precordial leads, vi- v6. transmural anterior infarction with markedly elevated st segments in precordial lead

posterior wall mi- look for tall r waves & st depression

-sorry rhythm strips wouldn't copy here-

♥ have patient describe his symptoms to you. if

patient has had a previous mi ask if symptoms are similar. make

sure you document patient’s symptoms later.

♥administer oxygen(remember ischemia is caused by

lack of oxygen)

♥get a stat ekg + obtain vital signs

♥ give the patient nitro sl(this is part oftelemetry

protocol. give 1 nitro every 5 mins x3 nitros). take vital signs after

each nitro, don’t give if sbp

relieve the pain & they have morphine ordered-give it

♥call the cardiologist, if no cardiologist then

call the primary md

if md orders a nitro drip. make sure he

understands that patient will have to be transferred to icu

or cvs. if cvs does not have a bed ,the md

must call intensivist to get a bed(md’s job not yours!!)

do not leave patient alone, get another nurse to stay with

them if you have to leave the room. remember they are

scared. leaving the patient alone will increase their anxiety

therefore increase the hearts oxygen demands. keep

patient calm!!! don’t let them exert any energy.

m-monitor

o- oxygen

n-nitrates

a-asprin

m-morphine

b-beta-blockers

a-ace inhibitors

t-thrombolytics

h-heparin

remember the mnemonic: mon am bath

GretaRN · Feb 23, 2008

alexis, you are the best!!!!! thank you so much for the info.....

wish us luck!:heartbeat:heartbeat:heartbeat:heartbeat:heartbeat:heartbeat:heartbeat

Miami NightNurse · Feb 23, 2008

You are welcome. If you want the rest of handbook send me a private message here on allnurses with your email address and I'll email it to you. It's to big to put here. But it's got stuff on rhythms, CHF vs. Pulm Edema, Cardiac caths, etc.

pooshx2 · Feb 24, 2008

I really enjoyed the easy reading of Cardiovascular Care made Easy and Hemodynamic Monitoring made easy series of books that are the visual books. It really did what I needed as a CV for dummies (ie me initially!). Good luck!

~Erica