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NUR 324: Medsurg > Cardiac Part 1 > Flashcards

Cardiac Part 1 Flashcards

1
Q

Pericardium

A

The outermost layer of the heart wall and includes the visceral and parietal layers of the pericardium - lubricates the area between the sac and the heart

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2
Q

Myocardium

A

The muscular middle layer of the heart wall that contains the cardiac muscle tissue - makes up the majority of the thickness and mass of the heart wall and is the part of the heart responsible for pumping blood

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3
Q

Endocardium

A

The simple squamous endothelium layer that lines the inside of the heart - very smooth and is responsible for keeping blood from sticking to the inside of the heart

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4
Q

4 valves of the heart

A
  • Tricuspid valve
  • Mitral valve
  • Pulmonic valve
  • Aortic valve
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5
Q

AV valves

A
  • Tricuspid valve
  • Mitral valve
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6
Q

SL valves

A
  • Pulmonic valve
  • Aortic valve
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7
Q

S1 sound indicates

A

AV valves closing

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8
Q

S2 sound indicates

A

SL valves closing

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9
Q

Pathway of blood through the heart

A
  1. Right atrium from the inferior (lower body) and superior (upper body) vena cava
  2. Through the tricuspid valve
  3. Right ventricle
  4. Through pulmonic valve
  5. Right pulmonary artery (to right lung) and left pulmonary artery (to left lung)
  6. Right pulmonary veins (from right lung) and left pulmonary veins (from left lung)
  7. Left atrium
  8. Through mitral valve
  9. Left ventricle
  10. Through aortic valve
  11. Aorta (to body)
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10
Q

Preload

A

Blood volume, blood available for pumping

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11
Q

Afterload

A

Resistance (pressure) against which the heart pumps

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12
Q

Contractility

A

Performance of the heart muscle
- CO = SR x HR

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13
Q

SA node

A

The heart’s primary pacemaker
- Rate: 60-100

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14
Q

AV node

A

Slows down impulses before they reach the ventricles so the atria contract before the ventricles are stimulated
- Atrial output or “kick” contributes 25% of cardiac output
- Rate: 40-60

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15
Q

Purkinje fibers

A

Responsible for conduction of impulses throughout the ventricles, resulting in ventricular contraction
- Rate: 20-40

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16
Q

Troponin I

A

Lab value involved in heart contractions and gets released when the heart is stressed
- Normal range in blood: 0.000-0.040 (basically 0 because troponin should stay in the blood)

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17
Q

Creatinine kinase (CK)

A

Increased amounts are released into the blood when there’s muscle damage which may indicate a myocardial infarction
- Normal range in blood: 22-198

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18
Q

Normal levels of BNP

A
  • 0-74 years: 125 pg/mL
  • 75-99 years: 450 pg/mL
  • > 300 may indicate heart failure
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19
Q

Normal level of total cholesterol

A

200 mg/dL

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20
Q

Normal level of LDL (bad)

A
  • < 160 mg/dL
  • < 100 mg/dL is idea
  • < 70 mg/dL for patients with coronary heart disease
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21
Q

Normal level of HDL (good)

A
  • Men: 35-70 mg/dL
  • Women: 35-85
  • > 40 mg/dL for patients with coronary heart disease
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22
Q

Normal triglyceride level

A

< 150 mg/dL

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23
Q

Normal HDL/LDL level

A

1:3
- Determined by dividing the HDL cholesterol by the LDL cholesterol

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24
Q

Brain natriuretic peptide (BNP)

A

Secreted from the ventricles - neurohormone that responds to volume overload in the heart
- Elevation in BNP means worsening of heart failure

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25
Q

CRP-C Reactive protein

A

Produced by the liver in response to systemic inflammation
- Inflammation is thought to play a role in atherosclerosis

26
Q

Homocysteine

A

An amino acid that can damage the endothelial lining of the blood vessels and promote thrombus formation

27
Q

Resting electrocardiography

A

6 second period of time on what’s happening to the heart
- 11 lead

28
Q

Continuous electrocardiography

A

Continuous monitoring of the heart
- 3-5 lead monitor

29
Q

Atherosclerosis

A

The process of building up fatty deposits that harden with age in the inside lining of the arteries

30
Q

Coronary artery disease (CAD)

A

When the arteries that supply blood, oxygen, and nutrients to the myocardium are partially or completely blocked
- This causes ischemia or infarction

31
Q

Myocardial infarction (MI)

A

When there’s heart muscle death (necrosis) as a result of the myocardium being deprived of oxygen for at least 6 hours

32
Q

Angina pectoris

A
  • “Strangling of the chest”
  • Harder for blood to get through the artery
33
Q

Stable or exertional angina

A
  • Symptoms are absent at rest and during ordinary activity
  • Symptoms may appear during physical or emotional exertion, usually in a predictable pattern
  • Usually caused by atherosclerotic plaques
34
Q

Unstable or crescendo angina

A
  • “Pre infarction” angina
  • Symptoms occur at rest or with minimal exertion and may be unpredictable
  • Over time, frequency intensity, and duration of attacks increases
  • Requires immediate treatment
35
Q

Variant or prinzmetal’s angina

A
  • Pain caused by coronary artery spasm and associated with a high risk of infarction
  • Can occur in otherwise young, healthy people
36
Q

Treatment of angina: nitrates

A

Increase oxygenated blood supply to the myocardium by dilating arteries and increasing blood flow

37
Q

Treatment of angina: beta blockers

A

Aim at decreasing myocardial oxygen demand by decreasing heart rate and decreasing contractility

38
Q

Treatment of angina: calcium channel blockers

A

Vasodilate to increase the oxygen supply to the coronary arteries and help prevent vasospasm - decreases myocardial contractility, decreasing oxygen demand of muscle

39
Q

Treatment of angina: anti platelet

A

Used to prevent clots/decrease the risk of clot formation
- Aspirin

40
Q

Zone of necrosis in MI

A

The most injured part where the death of tissue occurs

41
Q

Zone of injury in MI

A

Where the tissue is damaged but not dead - middle area

42
Q

Zone of ischemia

A

Tissue that is oxygen deprived, but deprivation may only be a transient problem

43
Q

Non ST elevation MI (NSTEMI)

A

Refers to an MI without the ECG change of ST segment elevation - partial thickness MI

44
Q

ST elevation MI (STEMI)

A

In the ECG the ST segment is elevated - indicates full thickness damage of heart muscle

45
Q

MI diagnostic testing: thallium scan

A

Identifies areas of necrosis - visible 6 hours after onset of pain

46
Q

MI diagnostic testing: echocardiogram

A

Will evaluate left ventricular function

47
Q

MI diagnostic testing: cardiac catheterization

A

Will definitively identify the extent and location of the artery obstructions

48
Q

MI treatment: PTCA

A
  • A balloon tipped catheter is guided by fluoroscopy to the coronary artery
  • Balloon is inflated at 4-14 atmospheres of pressure, compressing the plaque against the vessel wall
49
Q

MI treatment: coronary artery bypass grating (CABG)

A

Superir long term form of revascularization in some selected groups of patients with two-vessel diseases and most groups of patients with three vessels CAD

50
Q

Cardiac rehab: phase 1

A
  • As soon as acute episode occurs
  • Mobilize when safe to do so in the hospital within first 24 hours
51
Q

Cardiac rehab: phase 2

A
  • Remainder of hospitalization
  • Realization of goal of independence
  • Short/long term goals established
  • Explanations about disease and lifestyle changes (chair sitting, walking, some stair climbing)
52
Q

Cardiac rehab: phase 3

A
  • Begins at discharge and goes through convalescence
  • Incremental increase in activities, exercise in supervised setting
53
Q

Cardiac rehab: phase 4

A

Long term conditioning and maintenance of cardiovascular stability (walking, possibly jogging)

54
Q

Heart failure

A

The inability of the heart to pump sufficient blood to meet the demands of the body
- Most commonly the problem is due to impaired pumping ability of the heart

55
Q

Compensatory mechanism: arterial peripheral vasoconstriction

A

Blood is shunted to major organs and away from the periphery

56
Q

Compensatory mechanism: retention of sodium and water

A

ACtivation of the RAAS mechanism

57
Q

Compensatory mechanism: myocardial hypertrophy

A

Thickening of the walls, more muscle and mass causing increased force of contraction and increased CO

58
Q

4 main categories of heart failure

A
  • Chronic vs acute
  • Left vs right sided
  • Systolic vs diastolic
  • High output vs low output
59
Q

Blood pressure regulation: beta I receptors

A

Increase cardiac output

60
Q

Blood pressure regulation: alpha I receptors

A

Causes vasoconstriction

NUR 324: Medsurg (3 decks)

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