Cardiac/Circulatory Assessment Flashcards
Apex of Heart
“Point of maximal impulse”
-pulsation caused by contraction can be felt
Where is the apex of the heart located?
Midclavicular line of chest wall at 5th intercostal space
What is the primary pacemaker of the heart?
Sinoatrial node
Depolarization
“Atrial Kick”
Contraction of the stimulated myocardium
Diastole
the period in which the atria and ventricles are in a relaxed state; allowing ventricles to fill w/ blood
Systole
period of myocardial contraction
Is pressure in the ventricles increased or decreased during Diastole?
Decreased
Decreased pressure in the ventricles during Diastole causes what?
the AV Valves (tricuspid in right/mitral in left) to open and let blood flow into ventricles
Is pressure increased or decreased during Ventricular Systole?
Increased
Increased pressure in the ventricles during Ventricular Systole causes what?
Closes AV valves and forces pulmonic valve on right and aortic valve on left to open
What is Cardiac Output?
refers to the amount of blood pumped by each ventricle in liters per minute
What is the average Cardiac Output for an adult?
4-6 L/min
What is the stroke volume?
amount of blood ejected w/ each heartbeat
What is the average stroke volume?
70 mL
What may cause a decrease in stroke volume?
- dehydration
- diuretics
- nitrates
How would you increase a patients stroke volume?
Giving fluids-Normal Saline
If the patients heart rate is decreased what does that mean for the cardiac output?
It is decreased
What is the preload?
- Amount of volume coming to the heart
- pressure generated in the ventricles at the end of diastole
If the preload increases what happens to the stroke volume?
Increases
How do you want to treat preload in a patient w/ HF?
Decrease w/ fluid restriction, diuretics, nitrates
How to tell if a patient has a Pericardial Friction Rub
- ask them to hold their breath and if the noise is still heard it is positive
- count the rate; should be 70 or more/min
Pericardial Friction Rub
Fluid in the pericardial space
How to tell if patient has a Pleural Friction Rub
- should not be able to hear noise when they hold their breath
- rate 14-18 per/min
Common CVD S/S
- chest pain/discomfort
- dizziness/syncope/change in LOC
- palpations/tachycardia
- peripheral edema
- SOB/dyspnea
- fatigue
Where is the Aortic Area/Valve found?
second intercostal space to the right of the sternum
Where is the Pulmonic Area/Valve found?
second intercostal space left sternal border
Where is the Tricuspid Area/Valve found?
fourth ad fifth intercostal space LSB
Where is the Mitral Area/Valve Found?
Left fifth intercostal space at midclavicular line
The first heart sound is created from what?
The closing of the Tricuspid and mitral valve
When is the second heart sound created?
Closing of the pulmonic and aortic valves
What types of drugs are used to treat CVD?
- positive inotrope
- negative inotrope
- positive chronotrope
- negative chronotrope
Positive Inotrope
increases myocardial contractility
Negative Inotrope
decreases myocardial contractility
Positive Chronotrope
increases heart rate
Negative Chronotrope
decreases heart rate
How does the blood flow during Diastole?
Flows from left & right atrium to ventricle through mitral and tricuspid valve
-SA node stimulates atrium; causes P wave
What happens during P Wave?
atrium is depolarized and contracts forcing rest of blood into ventricles
When does diastole end?
all the blood is in the ventricles and pressure increases in ventricles causing Mitral and Tricuspid Valve to close
-systole begins
How does Systole and blood flow work?
“QRS” wave
- aortic and pulmonic valves open; blood flows out and pressure in ventricles decrease
- valves close and diastole begins again
How can preload be increased?
controlling the loss of blood or body fluids and replacing fluids
