Cardiac Patho Flashcards
What is systole?
Systole is the period in which the ventricles contract.
What is diastole?
Diastole is the period in which the ventricles relax and fill with blood.
What is preload?
Preload is the volume of blood in the ventricle at the end of diastole.
What is afterload?
Afterload is the resistance the left ventricle must overcome to circulate blood.
How does blood flow through the heart?
Blood flows through the heart in the following pathway:
• Superior/ inferior vena cava
• right atrium
• Tricuspid valve
• right ventricle
• pulmonary semilunar valve
• pulmonary artery
• lungs for oxygenation
• pulmonary vein
• left atrium
• mitral valve (aka bicuspid valve)
• left ventricle
• aortic valve
• aorta
• systemic circulation
What are arteries?
High pressure system with thick vessel walls that carries oxygen rich blood to the body tissues.
What are veins?
Veins are a low pressure system with thin, collapsible, distensible vessel walls that contain valves to prevent backflow of blood.
What are capillaries?
Capillaries are thin microscopic vessels which contain capillary pores and are the site of nutrient, fluid, waste, and gas exchange for the body.
Describe the purpose of collateral circulation.
Collateral circulation is essentially bypass vessels that will restore circulation to tissues that have a severe reduction in blood supply.
What are baroreceptors responsible for?
These are receptors that are sensitive to changes in pressure and therefore function to maintain systemic blood pressure at a relatively constant level.
Describe hyperlipidemia.
Hyperlipidemia is an abnormally high concentration of fats or lipids in the blood.
What are the complications or risks associated with a patient having high cholesterol?
High cholesterol increases the risk for MI (heart attack), CVA (stroke), CAD (coronary artery disease), and peripheral artery disease.
What is the normal heart rate?
Normal HR is 60 - 100 beats a minute.
What is Raynaud’s Disease?
Raynaud’s disease is a functional disorder caused by vasospasm of arteries and arterioles in the fingers and/or toes.
What symptoms would you anticipate a client with Raynaud’s disease would complain of?
Client would describe coldness, numbness, and pain in the fingers and toes triggered by exposure to cold, stress, or smoking.
What should the nurse teach a client with Raynaud’s disease?
The nurse should teach the client to keep the body warm, wear gloves, smoking cessation, and take medications as prescribed.
What is peripheral artery disease?
PAD is a circulatory condition in which narrowed blood vessels decrease blood flow.
What symptoms would you as the nurse anticipate in peripheral arterial disease?
The patient will complain of intermittent claudication and have symptoms in the affected extremities of pale bluish discoloration of the skin.
What should the nurse teach a client about peripheral arterial disease?
The nurse should teach the client to reduce modifiable risk factors.
What is atherosclerosis?
Atherosclerosis is the hardening of the arteries with fatty lesions present (plaque).
What symptoms would you anticipate in a patient with atherosclerosis?
A patient with atherosclerosis is typically asymptomatic until an occlusion or thrombosis occurs.
What should the nurse anticipate teaching a client diagnosed with atherosclerosis?
Reduce modifiable risk factors.
What is the formula for cardiac output?
CO = SV (Stroke volume) x HR (Heart rate)
What is an acute arterial occlusion?
An acute arterial occlusion is a sudden event that causes obstruction of blood flow to the affected tissue or organ.
What symptoms would the nurse anticipate in a client with an acute arterial occlusion?
The nurse should anticipate that the client will complain of a sudden onset of extreme pain and paresthesia.
Is an acute arterial occlusion a medical emergency?
Yes! An acute arterial occlusion is an occlusion of a artery which is a major vessel supplying oxygen rich blood to the body tissues.
What is an aneurysm?
An aneurysm is an abnormal localized dilation of a blood vessel.
What is a berry aneurysm and where would this aneurysm type be located?
A berry aneurysm is small circular dilations of the vessel at a bifurcation.
What symptom could the nurse assess for to identify an abdominal aortic aneurysm in some patients?
A pulsating abdominal mass may be seen in certain patients.
What symptoms should the nurse anticipate in a dissecting abdominal aortic aneurysm?
• Sudden onset of pain described as a tearing or ripping sensation in abdomen
• decreasing blood pressure
• decreasing level of consciousness
The most severe complication of an untreated ruptured aneurysm is
Death
What are some risk factors for aneurysms?
• smoking
• HTN
• Advanced age
• trauma
• atherosclerosis
• certain congenital defects
What is hypertension?
Hypertension is a sustained elevation in blood pressure that will result in end organ damage and vessel changes.
What are the risk factors associated with untreated hypertension?
• RF (Renal failure)
• CAD (Coronary artery disease)
• CVA (Stroke)
• Vision loss
• HF (Heart failure)
What are some modifiable risk factors for hypertension?
• Diet (change to a low cholesterol, low sodium heart healthy diet)
• Smoking (advise on smoking cessation)
• Alcohol (advise on ETOH cessation)
• Obesity (advise on daily exercise)
What is preeclampsia?
Preeclampsia is a blood pressure that is elevated above 140/90 in pregnancy.
What assessment findings would you anticipate in a patient who has been diagnosed with preeclampsia?
• Reports of vision changes
• Headache
• Nausea / vomiting
• Decreased urine output
• Bilateral lower extremity edema
• Protein in the urine
• Low platelet count
• High creatinine level
• High liver function tests
What is the serious complication that can occur in preeclampsia-eclampsia?
HELLP syndrome
What is the treatment of preeclampsia?
• Delivery of the child.
• Magnesium can be given to prevent seizures.
What drug class of medication would you expect a client diagnosed with hypercholesterolemia to be given?
Statins
What is a DVT (deep vein thrombosis)?
A DVT is the presence of a clot (thrombus) in a vein.
What assessment findings would the nurse anticipate in a client diagnosis with a DVT?
The nurse would expect the client to complain of pain at the site of the DVT.
What is the most severe life-threatening complication of a DVT?
PE (Pulmonary embolism) which is a clot in the patient’s lungs.
What are the risk factors for development of a DVT?
• Sedentary lifestyle
• Prolonged rest
• Surgery
• Pregnancy
• Smoking
• Estrogen containing birth control pills
What medication treatment would the nurse anticipate for a client diagnosed with a DVT?
Anticoagulants
What are some non-pharmacologic methods the nurse can teach the client who is hospitalized to prevent a DVT?
Promotion of early ambulation (walking) and usage of SCD’s.
What is a cardiac tamponade?
A rapid filling of the pericardial sac which compresses the heart.
What symptoms would the nurse anticipate in a client with a suspected cardiac tamponade?
Anxiety, chest pain, difficulty breathing, increased heart rate, JVD, low SBP, and muffled heart sounds.
What treatment is performed for a cardiac tamponade?
Pericardiocentesis is performed for treatment.
What is a pericardial effusion?
A pericardial effusion is an accumulation of fluid in the pericardial cavity from inflammation or infection.
What is the most serious complication of a pericardial effusion?
Cardiac Tamponade from the increased pressure the fluid accumulating in the pericardial sac is placing on the heart.
What symptoms would the nurse anticipate in a patient diagnosed with a pericardial effusion?
• Chest pain
• Feeling faint
• Chest fullness
• Shortness of breath
• Difficulty breathing when lying flat
What symptoms would the nurse anticipate in a client diagnosed with right sided heart failure?
• Fatigue
• Pitting edema in lower extremities
• JVD
• Anorexia
• GI complaints
• Weight gain
• Ascites
• Enlarged liver and spleen
What symptoms would the nurse anticipate in a client diagnosed with left-sided heart failure?
• Fatigue
• Confusion
• Restlessness
• Cyanosis
• Orthopnea
• Exertional shortness of breath
• Tachycardia
• Chronic cough
• Wheezes, crackles, blood tinged sputum
What is a normal EF and what is considered abnormal?
EF is an ejection fraction which is determined by how much blood in the ventricle is pumped out with each beat.
• Normal is 50% to 75%
What are common symptoms of heart failure?
Restlessness, cyanosis, orthopnea, exertional shortness of breath, tachycardia, chronic cough, wheezes, crackles, and blood-tinged sputum.
What is a normal EF and what is considered abnormal?
EF is an ejection fraction which is determined by how much blood in the ventricle is pumped out with each beat. Normal is 50% to 75%. 41% to 49% is borderline and symptoms of HF may occur with activity. Heart failure symptoms will be present at rest and activity with an EF of 40% or less.
What does digoxin do to improve symptoms in heart failure patients?
This medication will increase the force and contraction of the ventricles.
What would the nurse anticipate for a patient with end-stage heart failure?
A heart transplant.
What medication class can be given in a heart failure patient to reduce excessive fluid volume?
Diuretics.
What symptoms would the nurse anticipate in a client with stable angina?
Chest pain occurring at a predictable pattern that is relieved with rest and/or nitroglycerin.
What would alert the nurse that a client may be experiencing a STEMI?
ST elevation on EKG, elevated cardiac enzymes, abrupt onset of symptoms, severe chest pain, pain radiating to the left jaw or neck, GI symptoms, fatigue, tachycardia, anxiety, restlessness, and pale, cool, moist skin.
What happens in the heart during atrial fibrillation (a-fib)?
A-fib results in the atrium quivering rather than contracting appropriately, causing stagnant blood flow and producing clots.
What two drug classes are prescribed for a-fib treatment?
Beta-blockers (for rate control) and anticoagulants (reduce clotting risk).
What occurs in the heart during ventricular fibrillation?
The rhythm originates in the ventricles rather than the SA node, resulting in ineffective blood flow and potential death if not corrected.
What immediate treatment is required for ventricular fibrillation?
Immediate defibrillation.
Where does the electrical impulse for a normal sinus rhythm originate?
The electrical impulse originates in the SA node, producing a heart rate of 60 to 100 beats a minute.
What symptoms would the nurse anticipate in a client diagnosed with shock?
Altered level of consciousness, pale or bluish skin, cool and moist skin, restlessness, increased thirst, rapid weak pulse, rapid breathing, and nausea or vomiting.
What treatment should be administered for anaphylactic shock?
Epi administered as quickly as possible, and call 911 if not in the hospital.
What acute event can result in cardiogenic shock?
Myocardial infarction (MI), cardiac contusion, or sudden change from sinus rhythm to an arrhythmia.
What are the symptoms of Kawasaki disease?
Acute onset of fever, measles-like rash, enlarged lymph nodes, redness of the sclera, and skin peeling on hands and feet after fever resolves.
