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45 Cards in this Set
- Front
- Back
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Right Sided HF symptoms are seen where
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Peripherially
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What is Cardiac Output?
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The volume of blood the heart expels per minute
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Normal Cardiac Output rate?
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5-7 liters/minute
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What is Preload?
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Preload is the amount of blood sitting in the right ventricle before it is pumped out of the heart.
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What is Starling's Law?
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Starling's Law is the more preload the greater the cardiac output to a physiological point. After that physiological point the cardiac output decreases.
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What is afterload?
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Afterload is the resistance against the heart
Resistance is seen in the blood vessels |
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What is Ejection Fraction? What is the norm?
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Ejection Fraction is the fraction of the ventricles blood volume ejected with in each beat
NORM: 60 - 75% |
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CENTRAL VENOUS PRESSURE (CVP)
What does it measure? What is the normal value? What are the S/S of an abnormal reading? |
CVP measures preload and is used for the RIGHT side of the heart.
NORMAL VALUE: 2-8 mmHg BELOW 2: dehydration, blood loss ABOVE 8: Fluid Overload |
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PULMONARY ARTERY PRESSURE (PAP)
What does it measure? What is the normal value? What are the S/S of an abnormal value? |
PAP measures preload and is used for the LEFT side of the heart.
NORMAL VALUE: Systolic: 15-36 mmHg Diastolic: 5-15 mmHg DECREASED READING: dehydration, blood loss INCREASED READING: Fluid overload |
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PULMONARY CAPILLARY WEDGE PRESSURE (PCWP)
What does it measure? What is the normal value? What are the S/S of an abnormal value? |
PCWP measures preload and is most accurate for the LEFT side of the heart.
NORMAL VALUE: 4-12 mmHg DECREASED: dehydration, blood loss INCREASED:fluid overload |
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SYSTEMIC VASCULAR RESISTANCE (SVR)
What does it measure? What is the normal value? What are the S/S of an abnormal value? |
SVR measures afterload.
NORMAL VALUE: 900- 1400 DECREASED: vasodialated INCREASED:vasoconstricted |
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Valve disorders will present with what symptoms?
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Heart Failure
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STENOSIS
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Narrowing of the valve. Blood "backs up" into the chamber that it came from.
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REGURGITATION
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Valve leaflets dont fully close. Blood regurgitates back into the chamber that it came from.
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Mitral Valve Stenosis
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Blood backs up into the left atrium and lungs, pulmonary congestion occurs and the right ventricle eventually dialates and fails.
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Where is the murmur heard with Mitral Valve Stenosis?
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Mitral valve
5th ICS MCL |
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Mitral Valve Regurgitation
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Mitral valve does not close completely causing left atrial and ventricular dialation.
Rheumatic heart disease, infective endocarditis, papillary muscle rupture and congenital abnormalities are common causes. |
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Where is the murmur heard with Mitral Valve regurgitation
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Mitral valve
5th ICS MCL |
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Mitral Valve Prolapse
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Valvular leaflets enlarge and prolapse during systole.
Usually benign but can progress to mitral regurgitation. |
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S/S of Mitral Valve Prolapse
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May experience:
Syncope, Dizziness, and palpitations due to episodes of dysrhythmias. |
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Aortic Stenosis
Where is the murmur heard? |
Aortic valve
2nd R ICS SB |
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Aortic Regurgitation
Where is the murmur heard? |
Aortic valve
2nd R ICS SB |
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Symptoms of valvular disease
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Signs of Heart Failure, Angina, Palpitations, Syncope
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Prophylactic Treatment of Valvular Disease
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Antibiotics should be give prophylactically a week prior to any invasive procedure.
*non-functioning valves attract bacteria* |
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Nursing Care for Valve Disorders
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Low Sodium diet
Spaced Activities Prophylactic antibiotics Heart Failure teaching |
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Infective Endocarditis
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Microbial infection caused by bacteria, viruses, or fungi involving the endocardium or valves.
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Pts. with Infective Endocarditis are at R/F
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Clots
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Embolic symptoms of Infective Endocarditis
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RIGHT HEART EMBOLI:
Travel to lungs -> SOB, Dec. O2, Chest discomfort LEFT HEART EMBOLI: Travel systemically SPLEEN -> aching KIDNEY -> Hematuria, flank pain GI TRACT BRAIN EXTREMITIES |
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Infective Endocarditis appearance of emboli in the extremities
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Splinter hemorrhages
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Tx for Inf. Endocarditis
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Long term IV antibiotics (6wks+)
Rest balanced with activity Care for HF |
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Nursing Care for Inf. Endocarditis
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Assess for:
murmurs HF, S/S of embolization |
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Inf. Endocarditis teaching
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**Proper oral care
- soft toothbrush - brush twice daily - no flossing **Antibiotic ointment to all cuts **Prophylactic antibiotics required prior to every invasive procedure **Monitor temp for 6 wks |
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ACUTE PERICARDITIS
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Inflamation of the pericardium
Not always caused by an infection * Usually seen Post MI 1-12 wks (Dressler's Syndrome) |
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S/S OF ACUTE PERICARDITIS
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*Substernal pain that radiates to the left side of the neck
*Pain is grating *Aggrivated by breathing *Worse when supine |
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ABSOLUTE DIAGNOSIS FOR ACUTE PERICARDITIS
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Pericardial friction rub
*scratchy, staticy sound This is never normal |
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TREATMENT FOR ACUTE PERICARDITIS
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NSAIDS
*Pain should be relieved in 48-96 hours *NEVER ASPIRIN OR ANTICOAGULANTS *Antibiotics if it is bacterial pericarditis |
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NURSING CARE FOR PERICARDITIS
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Assess pain - MI or Pericarditis?
Auscultate for friction rub Position NSAIDS Assess for pulsus paradox & other S/S of cardiac tamponade |
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Extra complications of Pericarditis
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Pericardial Effusion & Cardiac tamponade
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S/S OF CARDIAC TAMPONADE
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BECKS TRIAD
1. Hypotension 2. JVD w/ clear lungs 3. Paradoxical Pulses |
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CARDIOMYOPATHY
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Enlarged heart
Chronic disease of cardiac muscle Cause unknown |
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Dialated Cardiomyopathy
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*Impaired pumping action of the heart
*Most cases *Causes include ETOH abuse and chemo Pts. look like HF pts |
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Hypertrophic Cardiomyopathy
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*Congenital
*Sudden death in young athletes |
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S/S of Cardiomyopathy
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DYSRYTHMIAS AND PALPITATIONS
S/S of HF |
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Cardiomyopathy treatment
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same as HF
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Cardiomyopathy teaching
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same as HF & report dizziness, syncope and palpitations.
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