Medical Therapeutic - CardioVascular Assessment         CONGESTIVE HEART FAILURE LEFT Congestion in lungs - RIGHT Low systemic circulation Blood can't get into lungs Large veins distended LEFT Fatigue;Dyspnea Orthopnea - anxiety apprehension Confusion restlessness - Cough blood tinged Frothy sputum - wheezing stertorus breathing Rates (moist) - Diaphoresis profuse Cold and clammy - RBP + Pulse changes RIGHT Peripheral edema - feet,legs,sacrum,back buttocks - Ascites N / V, anorexia, - hepatomegaly oliguria, Day - polyuria Night CVP - jugular vein - distension Tx Rx - S/A    MI Restrict fluid; oxygen 6 L /minute Restrict, I and 0 (intake and output) Fowler's Position (semi or high) Rotating tourniquets DRY Take BP find mean - Using tourniquets towel under them Must have weak arterial pulse - check for arterial hypotension Rotate 15" - Remove at 15 " intervals WET Phlebotomy 250 - 500cc Legs may dangle - low venous return - PaceMakers Demand set only signals on need - Asynchronous Fixed fires constantly - Variable rate can be varied DIURETICS Hydrodiuril,Esidix (Thiazides) / K potassium - Aldactcone Dyrenium K sparing Lasix.Edecrin (Potent or loop) K - K (potassium supplement) Apricots (raw) orange - banana (highest) fruit baked potato (highest) vegetable - avocado white cook beans MANIFESTATONS HYPOKALEMTA Fatigue Anorexia,N/V Muscle weakness (cramping leg /arms) Low bowel sound Low motility Paresthesias Dysrhythmias irregular pulse Severe: cardiac & respiratory arrest Renal damage = Plyuria,nocturia,polidipsia HYPERKALEMIA low muscle tone (peripheral weakness) quadriplegia resp.down - cardiac down... death of ventricles no effect on CNS - nausea GI colic - diarrhea DIGITALIS   Cardiotonic -   Cardiac Stimulant  (slows and strengthens heart muscle) Diqoxin (Lanoxin) - Take apical/radial pulse X 1 minute Patienys with hypokalemia can develop digitalis toxicity. Dig Toxicitv (overdose) -  Arrhythmia  (bradycardia,tachycardia) 2.Anorexia (G.I N / V - Diarrhea and/or constipation -  abdominal pain 3.CNS effects Fatigue,depression,H/A,confusion,agitation 4.Disturbed color perception,halos arround dark objects 5.pruritus,urticaria CALCIUM BLOCKERS  stop spasm (angina) inhibits influx of calcium accross cell membranes low heart rate by slowing SA and AV conduction (coronary vasodilatation (periphera) < low BP CARDIZEM S/E nausea,edema,arrythmia.H/A Procardia  S/E  S/A plus flushing Vepramil Hydrochloride (CALAN) E/E low BP vertigo