Cardiology Flashcards
Chambers
Vessels
Depolarization
Heart is contracting
Repolarization
Heart is relaxing
Refractory Periods
Cardiac Cycle
Pathway of Deoxygenated Blood
The Only Artery That Carries Deoxygenated Blood
Pulmonary artery
The Only Vein That Carries Oxygenated Blood
Pulmonary vein
Ejection Fraction
Test for Ejection Fraction
Ranges of Ejection Fraction
Cardiac Output
Stroke volume x heart rate
Stroke Volume
Preload
Amount of stretch during diastole
A lot of preload = heart is working hard
Afterload
Pressure that needs to be overcome to pump
Contractility
Ability of heart muscle to shorten in response to electrical impulse
High contractility = lower HR
Influencing Factors
HR: Autonomic nervous system, baroreceptors
?Stroke volume:
Primary Pacemaker
SA node
Bradycardia occurs if not working
Secondary Pacemaker
Assessment of CV System
Health history
Common sx: chest pain (women may have pain in the jaw instead, elderly may not have chest pain due to diminished baroreceptors), SOB, peripheral edema,
Physical Assessment of CV System
Pallor (pale)
Peripheral cyanosis
Central cyanosis
Increased skin turgor
Zensomethingsomething???
Scars (past surgeries)
Ecchymosis (bruises could indicate blood outside the vessels)
Skin + extremities
Pulse pressure/blood pressure? (difference between systolic and diastolic)
Baseline vitals
Mean Arterial Pressure (MAP)
True MAP
Can only be acquired with an invasive procedure
Murmurs
Scale of I to VI
Grade I = barely audible
Grade II = audible but quiet and soft
Grade III = moderately loud
Grade IV = loud with a thrill
Grade V = very loud with palpable thrill
Grade VI =
Edema
Scale of 0 to 4
0 = None
+1 = Minimal (less than 2 mm)
+2 = Depression 2 to 4 mm
+3 = Depression 5 to 8 mm
+4 = Depression greater than 8 mm
You could also weigh your patient to measure edema but you must be consistent (same instrument, time, clothes, factors)
Heart Sound Sites
APTM
Aortic -> pulmonary -> tricuspid -> mitral
EKG
Diagnostic tool
EKG can be normal during heart attack
Cardiac Stress Testing
Can be physical or pharmacological
Electro-physiologic Testing (EPS)
Invasive
Used to diagnose and manage serious dysrhythmias
Used for: syncope, palpitations,
Cardiac Catheterization
Invasive
Determine how much plaque
Diagnose structural and fnctional dx of heart and great vessels
Right Heart Cath
Obtains pulmonary artery pressure and oxygen saturation
Obtains biopsy of myocardial tissue
Left Heart Cath
Involves use of contrast agent
Get dye out of system as fast as possible to avoid kidney failure (pt needs fluids ahead of operation, contrast always needs to be removed quickly)
Nursing Interventions - Cardiac Cath
Observe cath site for bleeding, hematoma
Assess peripheral arteries (looking for perfusion/blood flow)
Evaluate temp, color, and cap refill of affected extremity
Screen for dysrhythmias
Bed rest for 2 to 6 hours (rolling and bed pan will be used)
Instruct pt that chest pain, bleeding, or neuropathy must be reported
Ensure pt safety
May need a stent
Hemodynamic Monitoring
Invasive (minimally)
Central venous pressure (CVP) = 0 to 8 mm
Pulmonary artery pressure (PAP) = 25/9 mm or mean pressure of 15 mm?
Intra-arterial B/P monitoring
Minimally invasive cardiac output monitoring devices
Typically used in ICU
Know normal values, complications, how its done, interventions, how to read/monitor values
Central Venous Pressure (CVP)
Indirect measure of preload
Increase in CVP caused by hypervolemia (administer diuretics)
Increase in CVP caused by hypovolemia (give fluids)
Pulmonary Artery Pressure (PAP)
Evaluate pt reaction to medication
Intra-arterial B/P Monitoring
Used to monitor
Genetic & Cardiovascular Disorders
Assess all pts with cardiovascular sxs for CAD
Assess for family hx of Sudden Cardiac Death
Ask about family history of biochemical or neuromuscular conditions
Assess whether
Aging & The Cardiac System
Atrium in elderly is increased in size, irregular rhythm,
Female Heart
Smaller, weighs less, smaller coronary arteries
More easily occluded by arthrosclerosis
Procedures like cardiac cath and angiograms are more difficult leading to more complications
Resting rate, stroke volume, and ejection fraction are higher than a man’s
Conduction of electrical impulses from the AV node to Purkinji fibers are briefer
Coronary Atherosclerosis
Risk Factors for Coronary Artery Disease (CAD)
