medical-surgical management for rhd

7/29/2019 Medical-Surgical Management for RHD

1/4

Medical-Surgical Management

Ideal Actual

DIAGNOSTICS/ LABORATORY PROCEDURES

Complete Blood Count (CBC)-This can detect

Leukocytosis(WBC Count of 10, 000 to 20, 000)

which usually appears, on the second day

after Acute MI due to inflammatory process

Chemistry-the basic metabolic panel (BMP) is

a group of tests that measures different

chemicals in the blood. These tests usually are

done on the fluid (plasma) part of blood. The

tests can give doctors information about yourmuscles (including the heart), bones, and

organs, such as the kidneys and liver

Troponin I- is a muscle protein that helps your

muscles contract. When muscle or heart cells

are injured, troponin leaks out, and its levels in

your blood rise. Troponin are measured to

differentiate between Unstable Angina

Pectoris and Myocardial Infarction in patients

with chest pain

Electrocardiogram (ECG)-records the electrical

activity of the heart. The heart produces tiny

electrical impulses which spread through the

heart muscle to make the heart contract. These

can be used to detect various kinds of heart

disorders

Chest X-Ray-evaluates the organs and

structure with the chest. May be used to

detect enlarged cardiac shadow, suggestiveheart failure, or show ventricular aneurysm,

affecting ventricular wall motion

DIAGNOSTICS/ LABORATORY PROCEDURES

- DONE()

- DONE()

- DONE()

- DONE()

- DONE()


2/4

Echocardiogram-A non-invasive test to

evaluate the structure and motion of

heart function, heart valves, and blood

flow through the heart.

Echocardiogram uses ultrasound (high-

frequency sound waves) to create an

image of your heart on a television

screen (monitor). This test identifies

whether an area of your heart has

been damaged by a heart attack.

Cardiac Catheterization & Coronary

Angiogram- Cardiac catheterization is

an invasive, non-surgical procedure. A

coronary angiogram is a specialized x-ray procedure that is done as part of a

cardiac catheterization. A cardiac

catheterization and a coronary

angiogram are done to study the

structure of the arteries that bring

blood to the heart muscle and to

evaluate the function of the main

pumping chamber of the heart. During

a cardiac catheterization, the

cardiologist inserts a small hollow tube

(catheter) into an artery or vein and

then advances it into the heart. The

cardiologist injects contrast (x-ray dye)

through the catheter to outline the

arteries to show any blockages or

narrowings that may exist within them.

Myocardial Perfusion Imaging (MPI)

StressTesting (Persantine Thallium)-

These tests help identify blood flow

problems to your heart. Small amounts

of a radioactive material are injected

into your bloodstream through your IV.

Special cameras can detect the

radioactive material as it flows through

your heart.

- NOT DONE

- NOT DONE

- NOT DONE


3/4

MEDICATION

BETA-Adrenergic Blocking Agent-to slow the

heart rate and to reduce the chance of

abnormal heart rhythms developing

Anticoagulant-helps prevent the formation of

blood clots.

Angiotensin Converting Enzyme Inhibitor- is

also used to treat a disorder of the ventricles

(the lower chambers of the heart that allow

blood to flow out of the heart)

Corticosteroid-

decreasing inflammation andreducing the activity of the immune system

Platelet Aggregation Inhibitors-to reduce the

stickiness of platelets in the blood, which

helps to prevent blood clots forming

Statins-used along with diet, exercise, and

weight loss to reduce the risk of heart attack

and stroke and to decrease the chance that

heart surgery will be needed in people who

have heart disease or who are at risk ofdeveloping heart disease. Atorvastatin is also

used to decrease the amount of cholesterol (a

fat-like substance) and other fatty substances

in the blood

Hyperosmotic agent-Produces increased

osmotic pressure within colon and acidifies its

contents, resulting in increased stool water

content and stool softening. Causes migration

of ammonia from blood into colon, where it isconverted to ammonium ion and expelled

through laxative action.

MEDICATION

Carvedilol 125 mg 1 tab BID(GIVEN)

Enoxparin 0.6cc sq q 12H(GIVEN)

Enapril 10mg 1tab OD(GIVEN)

Hydrocortisone 200mg IVTT(GIVEN)

Aspirin 80mg 1 tab PO(GIVEN)

Clopidogrel 75mg 1tab PO(GIVEN)

Atrovastatin 80mg 1tab q HS(GIVEN)

Lactulose 30cc q HS PO(GIVEN)


4/4

DIET

Low Salt Diet-People with heart failure canimprove their symptoms by reducing the

amount of salt (sodium) in their diet. Sodium

is a mineral found in many foods. Eating too

much salt causes the body to keep or retaintoo much water, worsening the fluid build-up

associated with heart failure

Low Fat Diet-Limiting how much saturatedand trans fats you eat is an important step to

reduce your blood cholesterol and lower your

risk of coronary artery disease. A high blood

cholesterol level can lead to a buildup of

plaques in your arteries, called

atherosclerosis, which can increase your riskof heart attack and stroke

DIET

Low Salt Diet includes bread, cereals, pasta

rice potatoes, dried peas and beans, meats

and protein, fruits and vegetables

Low Fat Diet includes whole wheat pasta, egg

whites, tuna, crab, shrimp, fruits and

vegetables

medical-surgical management for rhd

Documents