CARDIAC Flashcards
1
Q
Define BP
A
The force produced by the volume of blood in artieral walls
2
Q
What is systolic pressure?
A
Top #
Working phase of the heart.
3
Q
What is diastolic pressure?
A
Bottom #
Resting phase of the heart.
4
Q
Define hypertension
A
Sustained elivations in systolic/diastolic BP that exceed Prehypertension Levels.
5
Q
Pre hypertension #
A
120-139 ; systolic
80-89 ; diastolic
6
Q
Hypertension stage 1
A
140-159/90-99
7
Q
Hypertension stage 2
A
160+/100+
8
Q
What are the 2 types of hypertension?
A
Essential hypertension
Secondary Hypertension
9
Q
Define Essential hypertension
A
Sustained elivated BP that has no known cause
10
Q
Define secondary hypertension
A
elvated BP that results from/ or is secondary to aome other diease
- kidney failure
- diabetiese
11
Q
Pathophysiology of Essential hypotension
A
- increase w/age
- Runs in family
- African american are higher at risk
- Obesity, inactivity, smoking, excessive alcohol intake, inafective stress managment
12
Q
Pathophysiology of Secondary hypertension
A
- diabetes
- kidney failure
- cocain/ cardiac stimulants
- oral contraceptives
- atheroscloresis
- hyperaldosteronism
- artireral vasconstriction
- phenochromocytoma- tumor adrenal mudulla
13
Q
What are s/s of hypertension?
A
- Asymptomatic
- The silent killer
- throbbing/ pounding headache dizziness
- dizziness
- fatigue
- insominia
- nervousness
- nosebleeds
- blurred vission
- angina
- sustained elvated BP
- Dspnea
- bounding pulse
- over wt.
- flushed face
- periphal edema
- papilledema- edema of optic nerve
14
Q
Dignostic Test for hypertension
A
- EKG
- Echo
- Chest X-Ray
- Blood Test; Elevated BUN, serum creatine= impaired renal function
- MUGA scan; detects how well/ inefficent the heart pumps
15
Q
Medical Management for hypertension?
A
- Low BP; Priorty with HTN pt.
-Prevent Complications
-Mild Elivations;
weight loss
lower sodium intake
moderate exersise
low fat diet
DASH Diet
-Pharmalogic Interventions;
dosage increased in icreaments
adding 2nd, 3rd, or 4th antihypertensive agents
secomdary hypertension may resolve by treating its cause
16
Q
When taking HTN meds
A
- DO NOT stop taking suddenly
- Take med @ same time everyday
- diuretic HTN meds are not to be given @ night
17
Q
What is accelerated hypertension
A
elavated BP with hemorrages & exudates in the eye
leaking of cellular protein
18
Q
What is malignant hypertension
A
Dangerously high BP with papilledema ( welling behind the eye)
19
Q
What is medical managment for malignant hypertension?
A
Lower BP w/in 1-2 hours. -Hyperstat; IV -Nitropress -Nitroglceryin -normodyne - Oxygen other drugs for less critical (Procardia, Isoptin, Capoten, Minipress)
20
Q
DASH diet
Diet Approaches Stop Hypertension
A
Rich in fruits, Veggies, and low fat diary products, w/ reduced contents of fat, red meat, sweets, and sugar containg beverages.
21
Q
DASH diet includes
A
6-8 serving grain 4-5 serving veggie 4-5 serving fruit 2-3 low fat/non diary products 6oz or less of meat,poultry,fish 2-3 servings of added fats per day 5 or less servings of sweet/sugar per week
22
Q
What is heart failure?
A
Failure of the heart to perform this main function adequtely.
23
Q
What is Acute heart failure
A
- Sudden change in hearts ability to contract
- Can develop pulmonary edema
24
Q
What is Chronic heart failure
A
-Occurs when some other chronic disorder compromises the heart ablity to pump
-Examples;
High BP
Coranary artery diease
Valvular heart diease
Abnormal heart rythms
Overactive thyroid
cardio myopaty
anemia
25
What 2 mechanisms cause heart failure?
1. Inability of the heart to contract due to damage to the heart muscle wall (MI)
2. When the pumping chambers enlarge and weaken due to cardiopathy/hypertension.
26
What happens in Left Sided Heart Failure?
- When left vent. cant pump enough blood, it gets backed up in lungs. Which causes? (pulmonary edema)
- SOB
- Left side fails , leads to right side failure
- Left is lung= respitory probs
27
What happens in Right Sided Heart Failure?
- The right ventricule cannot pump out enough bld, causing fluid to back up in the veins & then in capilaries of the body. (behind the right ventrical)
- Right is the Body/sytemic
28
What Compensatory Mechanisms does the body have when it comes to heart failure?
- The body compensates overtime for changes in the heart function.
- When further compromised the heart will eventually fail.
- Myocardial oxygen demand increase
- Renin- angrotension-aldosterone mechanism
- B-type natiuretic peptide
29
Left side heart failure symptoms?
LEFT IS RESPIRATORY
- Fatigue w/activity
- Exertional dyspnea
- Orthopnea; diff. breathing laying down
- proxysmal nocturnal dyspnea
- rapid/ irreg pulse
- high BP
- Deminished urine output
- Severe; hypoxic, restless, confused
30
Right sided heart failure symptoms?
RIGHT IS BODY/SYSTEMIC
- Gradual unexpected wt. gain
- Pitting EDema
- Enlarged Liver
- Jugular vein Distension
- Dyspnea
- Anorexia
- Nausea
- Flantulence
31
DIagnostic findings for LEFT heart failure
- Heart enlargment seen in chest x-ray
- fluid accumalition in lungs on x-ray
- Increased size of left ventricule and ineffective pumping of the heart seen on ECHO
- Resp. Alkolosis- ABGs
- Metabolic acidosis
- Elevated serum sodium levels
- Elevated BUN
- hemodynamic monitoring changes
- Decrease in ejection function- MUGA
32
MUGA is?
Multiple gated acquistion Scan
| - a gated blood pool scan measures a decrease ejection fraction.
33
Diagnostic findings for RIGHT sided heart failure?
- Chest x-ray
- ECG
- Echocardiogram
- Lung scan
- pulmanary Arteriography
- Liver Enzymes
34
What is BNP?
BETA-TYPE NATRIURETIC PEPTIDE
| Lowers BP by increasing excertion of sodim and water and promoting arterial dialation.
35
What is the Medical Managment for someone with heart failure?
-Reduce the heart workload
-Improve cardiac output
Dietary managment
drug therapy
life style changes
36
Assessment for pulmonary Edema
```
Sudden dyspnea
Wheezing
orthopnea
restlessness
cough
cyanosis
tachycardia
severe apperhension
```
37
What is Pulmonary Edema?
Fluid accumilation in the lungs. Which leads to acute resp. distress.
38
What is The Medical treatment for pulmonary edema?
```
Relieve lung congestion
meds
O2
Drug therapy
Oxygenation
Invasive Measures
```
39
What is the Nursing managment for Pulmonary Edema?
- Close observation
- IV
- Mecanical ventilation
- Diretics & inotropic agents
- ECG monitoring
- Pulse Ox
- BP & Pulse Every 15 mins
- Internal monitoring
40
What is the major purpose of the heart?
Supply body cells and tissue w/ oxygen-rich blood & eliminate carbondioxide and cellular waste
41
The right and left ATRIA are the?
Reciving Chambers of the heart
42
The right and left VENTRICLES are the?
Pumping Chambers of the heart
43
List the 3 layers of the heart
Epicardium
Myocardium
Endocardium
44
Epicardium
Fibrous tissue and loose connective tissue
45
Myocardium
muscle tissue
46
Endocardium
Thin smooth bayer of endothelial cells
47
What is the sac surrounding the heart called?
Pericardium
48
What are the layers of the pericardium
Partial pericardium
| Visceral pericardium
49
What are the 4 chambers the heart is dived into?
Left Ventricle
Right Ventricle
Left Atria
Right Atria
50
Describe the structure of heart valve
AV valves- are leaflike
| Tricuspid valves- have 3 cups
51
What seperates atria from ventricles?
Two atrioventricular valves
52
What valve is between th RA and the RV?
Tricupsid Valve
53
What is the Valve between the LA and the LV?
Bicupsid valve
54
What valve is between the RV and pulmonary artery
Pulmonic valve
55
What valve is between the LV and the aorta?
Aortic Valve
56
What are chordae tendineae?
Cordlike structures
57
What is the function of the right side of the heart?
Receives oxygen-poor blood from your veins and pumps it to your lungs, where it picks up oxygen and gets rid of carbon dioxide.
58
What s the function of the left side of the heart?
Recieves oxygen-rich blood from your lungs and pumps it through your arteries to the rest of your body.
59
Arteries?
Carrie oxygenated blood from the heart.
60
Veins?
Return deoxygenated blood to the heart
61
Arterioles?
Smallest arteries
62
Venules
Smallest veins
63
Capillaries
Microscopic vessels that form a connecting network between arteroles and venules
64
Where does the heart muscle get its blood supply?
The left and right coronary arteries supply oxygnated blood to the heart
65
What is afterload?
The force that the ventricle must empty its diostolic volume
66
What is preload?
When the ventrcles feel with blood
67
What is cardiac output?
Amount of blood pumped out of the left ventricle each min
68
What is cardiac output?
Amount of blood pumped out of the left ventricle each min.
69
Angina
When someone w/ blocked arteries exerts themselves they can experiance angina which is chest pain
70
MONA
Morphine
Oxygen
Nitroglycerin
Asprin
71
What makes heart sound?
- 1st Sound LUB; acceleration and decleration of blood and vibration of the heart at the time of the closure of tricupisd and mitral valves
- 2nd Sound DUB; Same accerlation and deceleration of blood and vibrations at the time of closure of pulmonic and aortic valves
72
What is the natural pacemaker of the heart?
Sinoatrial Node (SA Node)
73
P wave represents?
Spread of electrical activity over the ATRIA and the begining of its contraction
74
QRS wave represents?
Spread of electrical activity over the VENTRICLES and the begining of its contraction
75
T-Wave Represents?
The recovery phase of the ventricles
76
What is Chemoreceptor?
Sense the chemical changes in the blood and adjust to the HR accordingly
77
Healthy cardiac output is ?
4-8 mL/min the average being 5mL/min
78
What is stroke volume?
Amount of blood pumped per contractionof the heart.
79
What is a Chemoreceptor?
Sense the chemical changes in the blood and adjusts the heart rate accordingly.
80
What is healthy cardiac output?
4-8 mL/min with the average being 5mL/min
81
What is stroke average volume?
65-70mL
82
Cardiac Output =
HR x Stroke Volume
83
What is included in a Cardiac Assessment?
-History
-Physical Examination;
Genral Apperance
pain
Vital Signs
Cardiac Rhythm
Heart Sounds
Perphial Pulses
Skin
Perphial Edema
Weight
Jugular Veins
Lung Sounds
Sputum
Cough
Mental Status
84
What are some Cardiac Dignosis Test used for Cardiac Dieases
- Blood Chemistry
- Serum Enzymes and isoenzymes
- EBCT
- ECG
- Phonocardigraphy
- Radiograaphy and radio
85
Care for patients during/ following a cardiac catheterization?
- Short Stay
- NPO
- ALlergies
- IV (hydration)
- Monitor HR
