Applied Cardiovascular System Flashcards

1
Q

What is pulse?

A

The rhythmic expansion of an artery, which corresponds to each contraction of the heart

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2
Q

What is heart rate?

A

The speed of the hearts contractions (bpm)

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3
Q

What is stroke volume?

A

The volume of blood pumped out of the ventricles with each heart beat (approx 70ml)

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4
Q

What is total peripheral resistance?

A

The force exerted on circulating blood by the vascular urge of the body

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5
Q

What are the 3 factors affecting total peripheral resistance (TPR)?

A

(1) autonomic activity - sympathetic system&raquo_space;>vasoconstriction
(2) blood viscosity - increased thickness of blood leads to an increased TPR
(3) medications - vasoconstrictor and vasodilator drugs

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6
Q

What is cardiac output?

A

The volume of blood your heart pumps each minute&raquo_space;> CO = SV x HR

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7
Q

Understanding cardiac output

A

Remember the heart is a pump
- it pumps blood around the body and the blood delivers oxygen and removes carbon dioxide

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8
Q

If the body has a need for more oxygen what will happen to cardiac output?

A
  • cardiac output will increase so more oxygen is available throughout the body - it does this by increasing heart rate and TPR - through vasoconstriction
  • this increases blood pressure
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9
Q

The cardiac cycle

A

The heart goes through a rhythmic cycle of contraction and relaxation
- ventricular contraction = systole
- ventricular relaxation = diastole
- systole refers to ventricular systole
- atrial systole is not included as a part of systole as it occurs when the ventricles are relaxed

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10
Q

What is an ECG?

A
  • the heart has its own electrical conduction system
  • an ECG records the electrical signals in your heart
  • it looks at HR, rhythm and electrical activity&raquo_space;> it can also indicate enlargement of the heart (cardiomyopathy) and evidence of a previous heart attack
  • sensors are attached to the skin and detect electrical activity
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11
Q

What can an ECG tell us?

A
  • you can see the HR and rhythm
  • you can check for abnormalities such as lack of P wave or arrhythmias
  • you can see if there is any evidence of damage
  • raised, depressed, flipped or even flat ST waves can show evidence of ischaemic heart damage
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12
Q

What is blood pressure?

A
  • blood pressure is a measure of the force that moves blood around your body&raquo_space;> generated by the heartbeat
  • the force of your blood punching against the walls of your arteries is what is measured as blood pressure
  • arterial blood pressure
  • BP = CO x TPR
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13
Q

How do we control blood pressure?

A

Short term&raquo_space;> via baroreflex receptors found in the carotid sinus’ and the aorta - these detect changes in blood pressure and vasoconstrictor or dilate vessels as required - innervation the parasympathetic (vasodilation and slow HR) to decrease BP or the sympathetic system (vasoconstriction and fast HR) to increase BP
Long term&raquo_space;> via renin-angiotensin- aldosterone system (RAAS) - a hormonal system that controls BP

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14
Q

The renin-angiotensin-aldosterone system (RAAS)

A

(1) renin is released from the kidneys into the blood
(2) it converts angiotensen, which released from the liver, into angiotensin (AT1)
(3) AT1 is converted into AT2 via angiotensin converting enzymes (ACE) in the lungs and kidneys
(4) it binds to AT2 receptors on tissues to elicit a response
(5) AT2 stimulates the release of ADH and aldosterone

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15
Q

How does hypertension affect the heart?

A
  • the constant increased pressure against the walls of the heart can cause them to stretch and either become stiff or baggy
  • this then leads to the heart pumping led efficiency and in severe cases can cause heart failure
  • this is where the heart is unable to meet the needs of the body for an increase in cardiac output and causes significant symptoms
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16
Q

Acute coronary syndrome (ACS)

A
  • reduced blood flow the heart
  • could be caused by the blockage or a spasm of the vessels
    This can cause pain such as:
    »> chest pain (angina) worsened by extension
    »> nausea
    »> sweating/shivering (cold/grey/clammy)
    »> referred pin such as jaw or left sided chest pain
    »> severe indigestion
    »>shortness of breath
17
Q

Coronary heart disease (CHD)

A

The hearts blood supply is blocked or interrupted by a build up of fatty substances in coronary arteries. This could be a fatty plaque blockage or a blood clot.
- can lead to myocardial infarction
- can be avoided with a balanced diet, reduced smoking and alcohol consumption
Symptoms
»> angina - th hearts way of saying its not getting enough O2
»> unstable angina - occurs and not related to CHD but may be due to ACS

18
Q

Arrhythmia

A

Can occur naturally but irregular heart rates can often be a sign or symptom of underlying illness or disease

19
Q

Atrial fibrillation (AF)

A

Where damage to the atria or disease has caused the atrium to beat irregularly and inhibit filling and emptying and increasing is of development of thrombosis

20
Q

SupraVentricular tachycardia (SVT)

A
  • can be life threatening where the ventricles are stimulated to beat faster than normal (120-220bpm). This can be caused by anxiety or stress or even coffee but if it doesn’t resolve quickly then it can be life threatening.
  • SVT occurs due to damage or irritation of the SA node and causes abnormal stimulation of the cardiac muscle resulting in a significantly fast arrhythmia
21
Q

Ventricular tachycardia/ventricular fibrillation (VT/VF)

A
  • both are life threatening arrhythmias
  • VT causes ventricles to beat fast (+160bpm) causing insufficient time for cardiac filling therefore less O2 is pumped to the brain
  • VF is where ventricles are unable to beat correctly leading to insufficient filling and emptying. The ventricles fibrillate (wobble) unable to pump and therefore the heart and body is starved of O2. This a cardiac arrest.
22
Q

Risk factors for heart conditions

A

1) obesity
2) high cholesterol
3) high blood pressure
4) inactivity
5) smoking
6) diabetes
7) family history
8) sex
9) age
10) sleep apnoea
11) stress
12) diet

23
Q

Nurses roe for patients with heart conditions

A

General nurse role
»> lifestyle advice/risk factor modification
»> medication advice
»> reassurance
»> rehabilitation
Specialist nurses role
»> managing case load of patients with cardiac conditions
»> booking and interpreting scans and diagnostic tests
»> supporting patients in living with new diagnosis or ongoing illness
»> health promotion

24
Q

Renin-angiotensin-aldosterone system (RAAS)

A

1) renin is released from the kidneys into the blood
2) it converts angiotensen which is released from the liver into the angiotensin (AT1)
3) AT1 is converted into AT2 via angiotensin converting enzymes (ACE) in the lungs and kidneys
4) it binds to AT2 receptors on tissues to elicit a response
5) AT2 stimulates the release of ADH and aldosterone

25
Q

How does hypertension effect the heart?

A
  • the constant increased pressure against the walls of the heart can cause them to stretch and either become stif or baggy
  • this then leads to the heart pumping led efficiently and in severe cases can cause heart failure
  • this is where the heart is unable to meet the needs of the body for an increase in cardiac output and causes significant symptoms
26
Q

Acute coronary syndrome (ACS)

A
  • reduced blood flow to the heart
  • could be caused by the blockage or a spasm of the vessels
    This can cause pain such as:
    »> chest pain (angina) worsened on extension
    »> nausea
    »> sweating/shivering
    »> referred pain such as jaw or left side chest pain
    »> women often report indigestion
    »> shortness of breath
27
Q

Coronary heart disease (CHD)

A

Hearts blood supply is blocked or interrupted by a build up of fatty substances in coronary arteries. This could be a fatty plaque blockage or blood clot.
- this can lead to myocardial infarction
- can be avoided with a balanced diet, reduced smoking and alcohol consumption
Symptoms:
»> angina - the hearts way of saying its not getting enough O2
»> unstable angina - occurs and not related to CHD but maybe die to ACS

28
Q

Arrhythmia

A

Can occur naturally but irregular heart rates can often be a sign of or symptom of underlying illness or disease

29
Q

Atrial fibrillation (AF)

A

Where damage to the atria or disease has caused the atrium to beat irregularly and inhibit filling and emptying and increasing risk of development of thrombosis

30
Q

SupraVentricular tachycardia (SVT)

A
  • can be life threatening where the ventricles are stimulated to beat faster than normal (120-220bpm). This can be caused by anxiety or stress or even coffee but if it doesn’t resolve quickly then it can be life threatening.
  • SVT occur due to damage or irritation of the SA node and causes abnormal stimulation of the cardiac muscle resulting in a significantly fast arrhythmia.
31
Q

Ventricular tachycardia/ventricular fibrillation (VT/VF)

A
  • both life threatening arrhythmias
  • VT causes ventricles to beat fast (+160bpm) causing insufficient time for cardiac filling therefore less O2 is pumped to the brain
  • VF is where ventricles are unable to beat correctly leading to insufficient filling and emptying. The ventricles fibrillate (wobble) unable to pump and therefore the heart and body is starved of O2. This is a cardiac arrest.
32
Q

Risk factors for heart conditions

A

1) obesity
2) high cholesterol
3) high blood pressure
4) inactivity
5) smoking
6) diabetes
7) family history
8) sex
9) age
10) sleep apnoea
11) stress
12) diet

33
Q

Nurses role for patients with heart conditions

A

General nurse role
»> lifestyle advice/risk factor modification
»> medication advice
»> reassurance
»> rehabilitation
Specialist nurses role
»> managing case load of patients with cardiac conditions
»> booing and interpreting scans and diagnostic tests
»> supporting patients in living with new diagnosis or ongoing illness
»> health promotion