Letter to my Students

Dear Students,

After reading my letter, I hope that you as a class are excited to start your new endeavor and for the new knowledge and skills you will develop after this class.  I have created this blog as an assignment for my nursing informatics course required to complete my masters degree in Nursing Education.  It is through this class that I have been able to learn and complete many new assignments using tools that I never knew existed.  My instructor, D. T, assigned weekly technology based assignments to facilitate learning through tools we were not familiar with.

I have always tried to avoid new technology and usually stuck with things I was familiar with.  I was comfortably with Microsoft Word, Microsoft Excel, and Powerpoint.  And thats pretty much it.  I have completed many class presentations while using Powerpoint.  I have tried to use interesting slides making the material enjoyable to my students, but always felt that there was something missing.  The class was just not engaged in the material as they could be. UNTIL I TOOK THIS CLASS.  From here on out, I will use many different techniques learned in order to facilitate learning for my students.  I will incorporate technology based learning into my curriculums to make sure the students are responsible for their own learning.

We were required to learn and use JINGS, Glogster, Blogs, Vokis, Skype and much more.  After the class, I have found myself using these tools in my personal life as well.

I hope that as you complete this class you are just as excited as I am with all the information you will learn.


See you for class soon,
Stephanie

Atrial Fibrillation

WHAT IS ATRIAL FIBRILLATION (A-FIB)??

          *It is the most common type of arrhythmia.

          *This type of arrhythmia occurs if rapid disorganized electrical signals cause the hearts upper chambers (atrium) to fibrillate.

*Fibrillate means to contract very fast and irregularly. 

*During this type of heart rhythm, blood stays pooled in the atria and isn't completely pumped into the ventricles because the two chambers are not working together like they should. 

                                        Which patients are at Risk??

Patients who have high blood pressure, coronary artery disease, heart failure, rheumatic heart disease, mitral valve prolapse, pericarditis, congenital heart defects, or those with recent heart attacks.

Signs/Symptoms

Palpitations

Shortness of Breath

Weakness/Trouble Exercising

Chest Pain

Dizziness/Fainting

Fatigue

Confusion

Diagnosis

This can be diagnosed based on your medical and family history, physical exam, and through tests and procedures.  An electrocardiogram can be done to test for A-Fib because sometimes you don't have any signs or symptoms.  When diagnosed with A-Fib it is important to start seeing a cardiologist to receive care specialized in this area.

Treatment

*Blood thinning medications are prescribed to reduce the risk for a clot forming and preventing a stroke.

*Medication such as metoprolol, diltiazem, or digoxin are prescribed to control the rate at which your heart is beating.

*Cardioversion- this treatment is used to try and shock the patient out of the arrhythmia and back to their normal heart rhythm. 

THIS IS WHAT CARDIOVERSION LOOKS LIKE...CHECK IT OUT!!!!

Two Major Complications of A-Fib

Stroke-The blood is not being accurately pumped through the body it starts to pool in the atria.  That blood begins to clot because it is not moving.  Once the clots have formed, the heart may accidentally pump that clot throughout the body which could cause it to lodge in the brain, causing a stroke.

Heart Failure-This occurs because the body is not able to pump enough blood to meets the body's needs.  The ventricles are beating so fast they are not able to properly fill with enough blood to pump it to the lungs and body.

Myocardial Infarction

A myocardial Infarction or heart attack is when blood flow to your heart is blocked for a long enough time that part of your heart muscle is damaged or dies 

          Risk Factors for a heart attack

Age

Diabetes

Hypertension

High Cholesterol

Obesity

Stress

Lack of Physical Activity

Illegal Drug Use

                                 

        Causes of a heart attack

There are many different causes for a heart attack, so it is difficult to find the exact cause of each and every one.  Most heart attacks are caused by a block clot that blocks one of the coronary arteries, which provide blood and oxygen to the heart.

                              When do Heart attacks Occur?

Heart attacks can happen at any time but the most common times for a heart attack to occur are:

after a sudden increase in physical activity

after a sudden, severe emotional or physical stress

   Signs/Symptoms of Heart attack

Chest pain that sometimes radiates to the jaw or left arm

Lightheaded/dizziness

Shortness of breath

Anxiety

Nausea or vomiting

Sweating

Fainting

           Nursing Priorities for a heart attack

Obtain an EKG to check for changes

Place the patient on continuous telemetry monitoring to monitor for cardiac arrhythmias

Place an IV and obtain blood work such as a CBC, BMP, electrolytes, coagulation factors and a troponin

Administer aspirin for the anti platelet properties and administer morphine and nitroglycerin to reduce the pain

Place the patient on oxygen so the heart doesn't have to work as hard

If your patients EKG looks like this... they are having a heart attack

Treatment for a heart attack

If the patient is having a complete heart attack or STEMI they will go to the cardiac cauterization lab immediately to get the heart reperfused quickly

If the patient is having an incomplete heart attack or NSTEMI, the treatment is patient specific and would rely on the cardiologists.  Often times IV heparin will be administered to the patient for its anticoagulation properties 

Pericardial Tamponade

This week I want to talk about PERICARDIAL TAMPONADE. While this diagnosis is not very common, it is life threatening which needs an IMMEDIATE INTERVENTION. 

Pericardial Tamponade: When blood or fluid collects in the pericardium, which is the sac that surrounds the heart.  This fluid prevents the heart ventricles from expanding fully.  The excess pressure from the fluid prevents the heart from functioning normally.  As a result, the body does not get enough blood/oxygen. 

When to suspect Pericardial Tamponade in a Patient

                        Causes            

Stab Wound

Penetrating chest wounds such as a stab wound or gun shot wound

Heart attack (MI)

Heart Surgery

Pericarditis

Aortic Aneurysm 

EKG of a patient with a Cardiac Tamponade

                Signs/Symptoms

Tachycardia

Difficulty Breathing

Distended Neck Veins

Muffled Heart Sounds

Anxiety/Restlessness

Weak Peripheral Pulses

Chest Xray of a Cardiac Tamponade

Tests

Chest X-ray

Chest CT 

Echocardiogram

                                              Treatment

Pericardial Window

Pericardiocentesis

The fluid around your heart needs to be drained as quickly as possible.  

This is done by a:

pericardiocentesis- uses a needle to remove the fluid from the pericardial sac 

Pericardial Window- surgical procedure which produces a window to help drain the fluid

Fluids- given to help normalize the blood pressure and heart rate

Oxygen- given to reduce the oxygen demand of the heart

I am an Emergency Room nurse who loves the heart so I have decided to create a blog dedicated to both of these topics.  Hopefully this information will be helpful and educational to both current ED and future nurses.

Each week I will choose different cardiac diagnoses and provide you with:
1)background information
2)signs and symptoms
3)treatment

Hopefully this information will be presented in a fun, interactive, creative, and engaging manner.  Please feel free to share your thoughts and insights.  Ask as many questions as you wish, and I will answer them to the best of my ability.