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126 Cards in this Set
- Front
- Back
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muscle encapsulated by protective covering called pericardium
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the heart
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in flammation of the heart is called
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pericarditis
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what is a chamber of the heart that seperates the haert into halves, right and left
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septum (muscle wall)
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recieves deoxygenated blood via the SUPERIOR AND INFERIOR VENA CAVAE through the tricuspisd valve
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Atrium
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venous return propelled by right atrium via the pulmonic valve to pulmonic artery (where blood becomes oxygenated)
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right ventricle
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what side of the heart recieves reoxygenated blood from lungs
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left atrium
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what side passes through the mitral valve to aortiv valve to the aorta to the systemic arterial circulation
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left ventricle
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what open and close passively in response to pressure and volume changes within cardiac chambers
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cardiac valves (4 of them)
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what valves seprate atrium from ventricles
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atrioventricular valves
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atrioventricular valve from right atrium to right ventricle
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tricuspid
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atrioventricular vlve from left atrium to left ventricle is called
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mitral valve
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pulmonic and aortic valves are called
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semilunar valave
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semilunar valve from right ventricle to pulmonary artery
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pulmonic
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semilunar valve from left ventricle to aorta
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aortic
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what provide blood to heart muscle
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coronary arteries
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where do coronary arteries originate from
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aorta (beyond aortic valve)
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what coronary artery delievers blood to left ventricle
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left anterior descending branch
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blood to the left atrium goes through what coronary artery
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left circumflex
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what coronary arteries supply both right atrium and right ventricle and part of left ventricle
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right coronary arterys
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number of times ventricles contract per minute is the
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heart rate
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adult normal resting herat rate is
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60-80
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what is the heart rate controlled by
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autonomic nervous system
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amount of blood ejected by the left ventricle during systole, influenced by the heart rate
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stroke volume
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A DECREASE IN STROKE VOLUME =
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AN INCREASE IN HEART RATE
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amount of pressure generated by the left ventricle to distribute blood to aorta is called
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systoluic bp
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amount of pressure sustained by the arteries during relaxation phase of heart
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diastolic bp (diastolic =rest)
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normal systolic range
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90-135
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normal diastolic range
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60-85
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volueme of blood in liters ejected by the heart each minute (4-7L/MIN)
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Cardiac output
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cardiac disease increases with
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age, gender , ethnicity and HEREDITY
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What is the major risk for cardiac problems
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positive family history
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NUMBER ONE RISK FACTOR OF CARDIAC DISEASE
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DIABETES MELLITUS and then renal disease
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Evidence shows that patients whose diet is high in what have a decrease risk of cardiac disease
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fruits and vegs
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LDL= bad, transfat- level =
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60-180
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HDL = GOOD, oils, level =
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55-60
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3 modifiable risk factors
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excercises, stop smoking, diet
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major risk factor for cardiac disease is
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smoking
pack years = number iof packs per day x years smoked |
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high risk in women for cardiac disease , waist greater then hips =
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abdominal obesity
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CARDINAL SYMOTOM OF HEART DISEASE IS
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CHEST PAIN
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chest pain in women is found
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in back, indigestion
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what is an early sign of heart failure
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dyspnea on exertion
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occurs lying flat, need several pillows
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orthopnea
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after lyring for a few hours, suddenly awake to suffocation caused by FLUID IN HEART AFTER LYING DOWN
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paroxysmal nocturnal dyspnea
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2.2 pounds of wieght gain due to cardiac disease is most likely
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EXCESS FLUID
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transient loss of consciousness due to decreased perfusion to brain is
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syncope
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dizziness with inability to remain upright is
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Near Syncope
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arteries blocked, cant pump blood to extremys due to ARTERIOSCLEROSIS (Stiffened arteries)
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ischemia
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due to prolonged standing/ sitting, cautercation
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venous insufficiency
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what pain goes away with rest?
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ischemic
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what pain goes away with excercise
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venous inssuffiency
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heart and circulation trouble, can be found by looking at your patient and seeing
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engorged neck veins
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fluid in abdomen is called
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ascites
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first you must INSPECT, look for
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color of skin, clubbing, edema
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what is an importeant test (CK ISOENZYMES) For the mycoacardial heart
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CK-MB
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the best way to see artery blockage by inserting catheter into right or left side of heart through femoral or brachial arteries, many complications
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cardiac catherization
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what shows how blood flows through veins
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angiography
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who has a decreased contractibility of heart, decreased hr, thick valves, urmors, blood vessel thickening
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elderly
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with which of the following patients is the nurse alrter for the possibility of HTN and CAD
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45 YEAR OLD AFRICAN AMERICAN MAN WITH DIABETES
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a patient in theER has chest pain with possible MI, which lab toest would be performed to determine this diagnosis
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CK-MB
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one of the most modifiable risk factors for Cardiovascular disease is
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obesity
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angina, MI and coronary artery bypass surgery are 3 kinds of
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CORONARY ARTERY DISEASE
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leading cause of death in the US
decreased blood flow through coronary arteries (ischemia) |
Coronary Artery Disease! CAD
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MAJOR CAUSE OF CAD
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atherosclerosis
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insufficent oxygen supplied to myocardium/heart is called
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ischemia
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overgrowth of smooth muscle cells with acumulation of macrophages, t cells...formation of a connective tissue in vessels...accumulation of lipds , cholesterol in tissue
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CAD
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imbalance bc O2 supply and demand causing chest pain, strangling and a manifestation of REVERSIBLE ischemia.
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angina pectoris
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lack of O2 supplied to heart causing chest discomfort with EXERTION...intermittent.
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STABLE ANGINA
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no chest pain, absence of symptoms is
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silent ischemia
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at night only but not always in supine position
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noctural angina
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pain with running or excricse relieved by REST or nitroglycerin medication is
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stable angina
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pain at rest from a spasm, rare
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prinzmetals angina
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chest pain occurs at REST , increase in intensity and pain poorly relieved with nitroglycerin
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UNSTABLE ANGINA
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what percentage of unstable angina progress to MI
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10-30 percent
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deterioration of stable atherosclerotic plaque, plaque ruptures causing partial or total occlusion of coronary artery
ex) HEART ATTACK MI |
acute coronary syndrome
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occurs when tissue is abruptly and severly deprived of oxygen...blood flow reduced by 80-90 percent ischemia
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myocardial infarction/ HA
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M I is most offen due to what
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atherosclerosis of a coronary artery
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Most defective layer of heart muscle, thrombus forms 80-90 percent
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LEFT ventricle
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L Anterior Descending =
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ANTERIOR
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suppression of normal conduction and contractile function due to necrosis causes a
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heart attack /mI
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L CIRCUMFLEX =
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LATERAL
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R CORONARY ARTERY =
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INFERIOR
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LEFT CIRCUMFLEX =
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POSTERIOR
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Modifiable MI risk factors are
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INCREASED SERUM CHOLESTEROL VALUES
Smoking HTN physical inactivity stress |
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30 Percent mortality rate comes from
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CAD
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Targeted cholesterol value should be less than
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260
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LDL should be
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decreased
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HDL should be
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increased
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NUMBER ONE SIGN OF MI - FOR MEN ON LEFT SIDE OF CHEST, DOWN LEFT ARM =
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CHEST PAIN
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Pale, cool, clammy nausea vomiting, impending doom, and ___________________are symtpoms of MI
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INCREASED TEMPERATURE FOR FIRST 24 HOURS
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WHAT IS YOUR EARLY MARKER FOR M.I.
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MYOGLOBIN
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Number one nursing diagnosis deals with
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PAIN
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How much oxygen do you give for internventions for cardiac disease
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2-3L
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What dilates arteries, given IV
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nitroglycerin
spray=quickest |
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if pain is unrelieved by nitroglycerin, you may give
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Morphin IV to reduce pain and improve coronary blood flow
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what dilates arteries gives better blood flow and prevents future clotting , restores perfusion to injured area
(RETAVASE, STREPTOKINASE) |
aspirin or thrombolytic therapy
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nitroglycerin is containdicated by what medication
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viagra
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REMOVE NITROGLYCERIN PATCH AT BEDTIME TO PROVIDE 8 HOUR NITRATE FREE
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COMMON SIDE EFFECT OF NITROGLYCERIN IS HEADACHE AND ORTHISTATIC HYPOTENSION
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what med helps to increase the pumping action of the heart
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dijoxin
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causes vasodilation, enhances myocardial perfusion, cuses orthostatic hypotension
ex) procardia, verapamil, cardizem, norvask |
calcium channel blockers
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who has dijoxin toxicity with calcium blockers causing nasuea and vomitting
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elderly
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calcium channel blockers can increase what levels first weeks of use...pulse less than 40 DO NOT GIVE CALCIUM CHANNEL BLOCKER
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Dijoxin levels
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what fix arteries for MI patient, invasive, baloon inflated in vessel wall to compress plaque cuasing dialtion of vessel, NOT FOR MAIN ARTERY
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PTCA/STENTING
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STENTING/PTCA is great to use for evolving MI when
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within 70 minutes of chest pain
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used to maintain patent lumen , expandable meshline structure designed to maintain vessel patency by compressing arterial wall and resisting vasoconstriction
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stenting
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patients who do not respond to med management of desisease progression, left main artery or THREE VESSEL DISEASE, must have
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heart bypass, coronary artery bypass graft surgery CABG
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occluded artery is bypassed with patients owen venous vessel- complication major is a clot after bypass, stroke
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cabg bypass
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heart not paralyzed for this single vessel disease surgery, benefit is less risk for emboli
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off-bypass surgery
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post op care for bypass is
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assess f/e imbalance, vitals, CHEST TUBE, VENTILATOR 6-12 hours, assess for hypotension, hypothermia
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high energy laser to create chanels between ventricle and circulation, performed during cardiac catheterization, takes 3-6 months for esults, large complications like bleeding
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laser revasculation
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elderly post op concertnns are
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more neuro deficits, increased side effects, dysrthymias, dijoxin toxicity
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what clinical manifesation i na client taking beta blockers should you explore as a complciation of drug therapy
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WHEEZING
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BETA BLOCKERS - DO NOT GIVE IF
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ASTHMA OR COPD
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patient cardiac catherization revealse a 95 percent blockage of LAD- Left anterior descending artery....the patient is at greatest risk for an infaction of the
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ANTERIOR WALL
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what can u do to prvent tolerance to affects of transdermal nitrates?
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remove patch at night
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signs and symptoms of adult that would allert possibility of MI
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dyspnea and weakness
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when teaching sexual activity following MI...discuss when
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teaching about physical activies
sex : no food or alcohol prior, foreplay desirable, relaxed, prophlactic use of nitrates to decrease angina, avoid anal. |
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when myocardial ischemia is TEMPORARY AND REVERSIBLE - the condition is called
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STABLE ANGINA
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angle of nail bed greater than 160 degrees is called
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CLUBBING
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Major post op complication of cardiac cath is
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bleeding hematoma at insertion site
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nurse suspects stable angina rather than MI pain because stable angina is relieved by
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nitroglycerin
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common side effect of NTG is
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headache
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an IV analgesic used to releive chest pain associated with MI is
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morphine sulfate
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MOST COMMON SITE OF MI is
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LEFT VENTRICLE
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a healthy serum cholesterol value is
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160-200
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the pain of angina pectoris is produced primarily by
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myocardial ischemia
oxygen cannot get to heart |
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women symptoms of MI are
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dysphagia (difficulty swallowing) and fatigue
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