Cardio/valves Flashcards
Final
What does the coronary system require?
Oxygenated blood
Left side of heart
- High pressure
- Oxygen rich blood pumped propelled through body
Right side of heart
- Low pressure
- Oxygen poor blood through pulmonary system
Cycle
One complete heart beat
Cardiac output
- amount of blood ejected in 1 minute
- HR X stroke volume
Stroke volume
- Amount of blood ejected with each contraction
- Effected by preload, after load, and contractility
Preload
-Degree of stretch before contraction
Afterload
-Amount of tension the ventricle must develop to open valves
Major determinant of afterload
Arterial B/P
Contractility
Intensity of cardiac muscle contraction
What is the #1 cause of death in the US?
Coronary Artery Disease (CAD)
Coronary Artery Disease (CAD) begins with…
atherosclerosis >Asymptomatic >stable angina >unstable angina >MI
Risk factors for CAD
- family and genetics
* If dad/brother had heart attack before 55, or mom/sister before 65.
CAD complications
- Angina
- MI
- HF
- Arrhythmias
How many valves does the heart have?
2 atrioventricular valves
2 semilunar valves
What are the atrioventricular valves?
Mitral (bicuspid)
Tricuspid
What are the semilunar valves?
Aortic
Pulmonic
What is stenosis?
Constriction/narrowing
What is regurgitation?
Backflow of blood due to incomplete closure of valves
What is contracture?
Stiffening
What is mitral valve stenosis?
decreased blood flow from left atrium to left ventricle
What does mitral valve stenosis increase?
Increases left atrial pressure and volume
Increases pressure in pulmonary vasculature
What does mitral valve stenosis cause?
Back pressure to lungs
S/S mitral valve stenosis
Exertional dyspnea Loud S1 Murmur Fatigue Palpitations Chest pain, seizures/stroke Coughing up blood
Acute mitral valve regurgitation-S/S
Pulmonary edema
- thready peripheral pulses
- cool, clammy extremities
Chronic mitral valve regurgitation
Left atrial enlargement
Ventricular hypertrophy
S/S of chronic mitral valve regurgitation
Asymptomatic for years until some degree of left ventricular failure
- weakness
- fatigue
- palpitations
- progressive dyspnea
- peripheral edeam
- S3
- murmur
What is mitral valve prolapse?
Mitral valve prolapse backs into left atrium during systole
S/S mitral valve prolapse
Most patients asymptomatic for life.
- murmur
- dysrhythmias-palpitations, light-headedness, dizziness
- infective endocarditis
- chest pain
Patient teaching for mitral valve prolapse
Antibiotic prophylaxis Take meds as prescribed Healthy diet Avoid caffeine Avoid OTC stimulants Exercise When to call Dr.
What is aortic valve stenosis?
Obstruction of flow from left ventricle to aorta
S/S aortic valve stenosis
Angina Syncope Exertional dyspnea Normal to soft S1 Diminished or absent S2 Systolic murmur Prominent S4
Aortic valve stenosis: is prognosis good or poor if patient is symptomatic and not corrected?
Poor
What is aortic valve regurgitation?
Backward blood flow from ascending aorta into left ventricle
Acute aortic valve regurgitation
Infective endocarditis
Trauma
Aortic dissection
*Life-threatening emergency
S/S of acute aortic valve regurgitation
- Severe dyspnea
- Chest pain
- Hypotension
- Cardiogenic shock
S/S of chronic aortic valve regurgitation
May be asymptomatic for years
- exertional dyspnea, orthopnea, paroxysmal dyspnea
- angina
- Water-hammer pulse is severe**
- Soft or absent S1
- S3 or S4
- Murmur
What happens with tricuspid valve stenosis?
Right atrial enlargement and increased systemic venous pressure
Who is at risk of getting tricuspid valve stenosis?
Patients with rheumatic fever and IV drug abuse
Clinical manifestations of tricuspid valve stenosis
- peripheral edema
- ascites
- hepatomegaly
- murmur
What does pulmonic valve stenosis cause?
Right ventricular hypertension and hypertrophy
Clinical manifestations of pulmonic valve stenosis
Fatigue
Loud murmur
Diagnostics of valvular heart disease
- history/exam
- CT
- Echo
- Chest x-ray
- EKG
- Cardiac cath
A 19 year old with rheumatic heart disease is admitted to the hospital with a recurrence of rheumatic fever. In planning care for the patient, which nursing diagnosis should the nurse include?
a. Ineffective coping related to refusal to carry out health promotion activities
b. Risk for infection related to recent exposure to group A B-hemolytic streprococci
c. Impaired adjustment related to unsuccessful lifestyle modifications, goal setting, and problem solving.
d. Ineffective self-health management related to lack of knowledge about long-term prophylactic antibiotic therapy
d. Ineffective self-health management related to lack of knowledge about long-term prophylactic antibiotic therapy
The nurse is caring for a patient with aortic stenosis. For what should the nurse assess the patient?
a. systolic murmur
b. pericardial friction rub
c. diminished or absent S4
d. low-pitched diastolic murmur
a. systolic murmur
