SAS 9

Cardiomyopathy- Heart muscle disease associated with cardiac dysfunction/

enlargement of heart muscle

Dilated- Most common / Associated w/ childbirth D

Restrictive / Constrictive- Rock/tumitigas/ does not affect cardiac output R.
Hypertrophic- rare autosomal / septal involvement occurs H
Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) A

Left ventricle= Lungs

Right ventricle= may water

Ischemic cardiomyopathy- is a term frequently used to describe an enlarged heart

caused by coronary artery disease (CAD).

Most commonly occurs in client w/ cardiomyopathy= Heart Failure

Fourth Heart sound (S4) indicates failure of the ventricle to eject all the blood
during systole

Etiology:
Cardiomyopathies can have various causes, including genetic mutations,
infections, autoimmune diseases, toxins, and certain medications.

Clinical Presentation:
Symptoms may include fatigue, shortness of breath, chest pain, palpitations,
and edema.

Diagnosis:
-Electrocardiogram (ECG) and echocardiography are commonly used for initial
assessment.
-Angiography=dye iodine=seafood
-Troponin I(Blood test)- Most indicative of cardiac damage
Treatment:
-Treatment varies depending on the type and severity of cardiomyopathy.
-Medications like beta-blockers, ACE inhibitors, and diuretics may be
prescribed. (most widely used is beta-adrenergic blockers)
-Implantable devices, such as pacemakers or defibrillators, may be needed.
-In severe cases, heart transplantation may be necessary.
-Low sodium diet
-Left ventricular assist device

A-ACE inhibitor “pi”

B- Beta blockers “olol”
C- Calcium Chanel Blockers (Verapamil, Amlodipine, Nicardipine, Diltiazem,
Felodipine)
D- Diuretics (Furosemide)
D-Digoxin = ↑ cardiac contractility = strong muscle >60 = HOLD

Collaborative Problems/Potential Complications

-Heart Failure
-Ventricular and atrial dysrhythmias
-Cardiac conduction defects
-Pulmonary / cerebral embolism
-Valvular Dysfunction (Tricuspid / Bicuspid)

Major goals for pts:

-Maintenance of cardiac output
-Increase activity intolerance
-Dietary changes, exercise restrictions
-Alcohol cessation, may be advised.

PROMOTE LOW SODIUM AND ADEQUATE FLUID INTAKE

Potassium
In
Sodium
Out

SAS 10

Dysrhythmias
- are disorders of the formation or conduction of the electrical impulse w/in the heart.

ECG
-Electrical impulse that travels through the heart can be viewed by means of
electrocardiography

Ary = heart beat is too fast/slow

Dys = heart is irregular

-SA Node (sinoatrial node): this node is located in the upper part of the right atrium
and is known as the pacemaker of the heart, causing the heart to beat at 60-100
bpm.

-a node (atrioventricular node): this node is found in the lower part of the right atrium
just above the tricuspid valve and is known as the “gatekeeper”.

-The AV node is known for causing a delay in electrical signaling

Bundle of His > bundle branches (right and left) > Purkinje fibers

Sinus Tachycardia- Heart rate greater than 100 bpm (Pantay pantay yung R)

Sinus Bradycardia- heart rate less than 60 bpm = atropine sulfate = vagal
stimulation
Atrial Flutter- Abnormal atrial rate: 250 - 400 bpm (Saw-tooth P-wave)

Atrial Fibrillation- Atrial rate: 350-600 bpm

Heart Blocks
First Degree AV Block: -Caused by wall MI or ischemia, hypokal, hyperkal,
digoxin toxicity
Second Degree AV Block Mobitz 1 (Wenckebach)

Second Degree Type II Mobitz II

Third Degree AV Block (Complete Heart Block)

Ventricular Tachycardia
Torsade de pointes = magnesium deficiency

Carotid massage = vagus nerve to slow the heart rate

SAS 11

Gastrointestinal (GI) bleeding is a symptom of a disorder in your digestive tract.

The blood often appears in stool or vomit but isn't always visible, though it may
cause the stool to look black or tarry. The level of bleeding can range from mild to
severe and can be life-threatening.

Signs and symptoms of GI bleeding can be either obvious (overt) or hidden

(occult).
Overt bleeding might show up as:
•Vomiting blood, which might be red or might be dark brown and resemble coffee
grounds in texture
•Black, tarry stool
•Rectal bleeding, usually in or with stool

With occult bleeding, you might have:

•Lightheadedness
•Difficulty breathing
•Fainting
•Chest pain
•Abdominal pain
Upper GI bleeding
Causes can include:
•Peptic ulcer. This is the most common cause of upper GI bleeding. Peptic ulcers
are sores that develop on the lining of the stomach and upper portion of the small
intestine.

•Tears in the lining of the tube that connects your throat to your stomach
(esophagus). Known as Mallory-Weiss tears, they can cause a lot of bleeding.
These are most common in people who drink alcohol to excess.

•Abnormal, enlarged veins in the esophagus (esophageal varices). This

condition occurs most often in people with serious liver disease.

•Esophagitis. This inflammation of the esophagus is most commonly caused by

gastroesophageal reflux disease (GERD)

COMPLICATIONS
A gastrointestinal bleed can cause:
•Shock
•Anemia
•Death
PREVENTION
To help prevent a GI bleed:
•Limit your use of nonsteroidal anti-inflammatory drugs.
•Limit your use of alcohol.
•If you smoke, quit.
•If you have GERD, follow your doctor's instructions for treating it

Abdominal compartment syndrome

-is a medical emergency that can occur in critically ill people, such as those in the
intensive care unit. Bleeding or swelling in your belly (abdomen) causes
dangerous pressure, which leads to organ malfunction. Abdominal compartment
syndrome is life-threatening.

-The most effective abdominal compartment syndrome treatment is surgical

decompression of your abdomen. Your surgeon will perform a procedure called
decompressive laparotomy.

SAS 12

Your liver performs many important functions, including

-Making blood proteins that aid in clotting, transporting oxygen and supporting your
immune system.

-Manufacturing bile, a substance needed to help digest food.

-Helping your body store sugar (glucose) in the form of glycogen.

-Ridding your body of harmful substances in the bloodstream, including drugs and
alcohol.

-Breaking down saturated fat and producing cholesterol.

Liver failure occurs when your liver isn’t working well enough to perform its
functions (for example, manufacturing bile and ridding your body of harmful
substances).

-Symptoms include nausea, loss of appetite, and blood in the stool.

-Treatments include avoiding alcohol and avoiding certain foods.

Causes

-Viral infections, such as Hepatitis B.

-The overuse of certain drugs or toxins, like acetaminophen (Tylenol®), and the
use of other medications (including certain antibiotics, antidepressants, anti-seizure
medications, man-made hormones and antifungal drugs) and herbs (green tea
extract and kava).

-Metabolic (biologic) or vascular (vessels that carry fluids, such as arteries)

disorders, such as Wilson disease and autoimmune hepatitis.
Management

-Liver transplant

-Not adding salt to food

-AVOID Alcohol

Pancreatitis

Endocrine Function

The endocrine cells called Islet of Langerhans cells

produce insulin, glucagon, somatostatin

Exocrine Function:

Another type of cells are called Acinar cells which

secrete digestive enzymes into the pancreatic ducts

The enzymes secreted by the Acinar cells include:

amylase: breaks down carbs to glucose

protease: breaks down proteins to amino acids

lipase: breaks down fats

Cullen’s and Grey-Turner’s Sign (seen with SEVERE cases of acute

pancreatitis)

Cullen’s Sign: bluish coloration around the belly button.

Remember the “C” in the word Cullen for the word Circle. Your belly button forms a
circle.

Grey-Turner’s Sign: bluish discoloration on the flanks

Acute pancreatitis: Main causes gallstones and high alcohol consumption

Gallstones are hardened deposits of undissolved cholesterol, salts, or bilirubin that

can block the bile duct which will cause pancreatic juices to build up in the pancreas