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Nursing School > Cardiovascular > Flashcards

Cardiovascular Flashcards

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1
Q

Formula for cardiac output

A

stroke volume x heart rate

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2
Q

Systemic vascular resistance (SVR)

A

amount of force exerted on blood (pipeline)

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3
Q

Afterload

A

the pressure/force pushing blood out; squeeze

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4
Q

Preload

A

the volume of blood that fills ventricles, heart is relaxed; stretch

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5
Q

Pathway of blood through heart

A

(DEOXYGENATED) Body tissues - Superior and inferior vena cava - Right atrium - Tricuspid AV valve - Right ventricle - Pulmonary semilunar valve - Pulmonary arteries - Lungs - (OXYGENATED) - Pulmonary veins - Left atrium - Bicuspid/mitral valve - Left ventricle - Aortic semilunar valve - Aorta - Body tissues

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6
Q

Systole (S1, lub)

A

Ventricles contracting

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7
Q

Diastole (S2, dub)

A

Ventricles relaxed, filling with blood

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8
Q

What situations would cause preload to increase?

A

hypervolemia, regurgitation of cardiac valves, heart failure

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9
Q

What situations would cause afterload to increase?

A

hypertension, vasoconstriction (narrowed vessels)

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10
Q

An increase in afterload would cause…

A

increase in cardiac workload

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11
Q

What two factors affect cardiac output?

A

stroke volume and heart rate

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12
Q

What 3 factors affect stroke volume? (Stroke volume is the amount of blood pumped out of ventricle)

A

preload, afterload, contractility

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13
Q

What two factors affect preload?

A

end-systolic volume (fullness) and venous return (how much blood is coming back to body)

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14
Q

What two factors affect afterload?

A

aortic pressure (how wide is the aorta? any blockage?) and total peripheral resistance (vasoconstriction? clogged?)

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15
Q

What three factors affect contractility?

A

end-diastolic volume, sympathetic stimulation, and myocardial oxygen supply (needs oxygen)

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16
Q

What five factors affect heart rate?

A

central nervous system (pons, medulla), autonomic nervous system (increase in SNS, decrease in PNS), neural reflexes, atrial receptors, hormones (epinephrine - fight or flight)

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17
Q

Sustained elevation of arterial blood pressure

A

Hypertension
- primary risk factor for cardiovascular disease
- leading cause of morbidity/mortality

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18
Q

Normal blood pressure

A

systolic less than 120 and diastolic less than 80

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19
Q

What systolic and diastolic numbers represent elevated blood pressure

A

systolic 120-129 and diastolic less than 80

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20
Q

High blood pressure (hypertension stage 1)

A

systolic 130-139 OR diastolic 80-89

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21
Q

High blood pressure (hypertension stage 2)

A

systolic 140 or higher OR diastolic 90 or higher

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22
Q

Hypertensive crisis

A

systolic higher than 180 AND/OR diastolic higher than 120

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23
Q

Non-modifiable risk factors for hypertension

A

age, sex (estrogen protects heart), race (African Americans are at greater risk), family history/genetics

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24
Q

Modifiable risk factors for hypertension

A

diet (watch cholesterol levels), blood lipid levels, tobacco/alcohol consumption, activity/fitness level, weight, blood glucose control

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25
Q

What factors affect blood pressure?

A

blood volume, cardiac output (HRxSV), total peripheral resistance

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26
Q

What five organs of the body does high blood pressure target and damage?

A
  1. Brain (stroke, confusion, headache, convulsion)
  2. Retina of eye
  3. Heart (heart attack, heart failure)
  4. Blood (elevated sugar levels)
  5. Kidneys (chronic renal failure)
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27
Q

Plaque buildup in arterial walls

A

Atherosclerosis

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28
Q

Risk factors for atherosclerosis

A

Hypercholesterolemia, elevated LDL, age, family history, biological males, smoking, obesity, diabetes, hypertension

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29
Q

Effects of cigarette smoke on cardiovascular system

A
  1. increased sympathetic response (fight or flight, increase HR, increase systolic and diastolic)
  2. increase risk for thrombosis (clots); platelet aggregation, platelet adhesiveness, plasma fibrinogen, blood viscosity, decreased clotting time
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30
Q

Coronary artery disease (CAD)

A

fatty deposits that buildup in wall of arteries; most common heart disease

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31
Q

Peripheral artery disease (PAD)

A

narrowing of blood vessels caused by buildup of plaque reduce blood flow to limbs; circulatory problems

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32
Q

Risk factors for CAD and PAD

A

family history, age, smoking, high cholesterol, diabetes, obesity

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33
Q

What stage of progression of coronary artery disease would cause a person to have relief of chest pain after ceasing activity and resting?

A

stable angina

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34
Q

What stage of progression of coronary artery disease would cause a person to experience chest pain while sitting?

A

acute coronary syndrome, can be further split into unstable angina, NSTEMI, STEMI

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35
Q

Stable angina

A

angina pain develops when theres an increase in demand and the vessel is unable to dilate enough to allow adequate blood flow to meet demand
- ECG shows normal
- troponin levels may reveal heart damage

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36
Q

Unstable angina

A

plaque ruptures and thrombosis forms around ruptured plaque, causing partial occlusion of vessel, pain can occur at rest or progress over period of time
- ECG can show normal, inverted T waves, or ST depression
- normal troponin levels

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37
Q

NSTEMI

A

plaque ruptured and thrombus formation causes partial occlusion to vessel that results in injury and infarct
- ECG shows elevation
- related to ST elevation have myocardial infarction

38
Q

STEMI

A

complete occlusion of blood vessel lumen, results in injury and infarct to myocardium
- elevated ECG (elevated ST)
- tissue death, impaired activity

39
Q
  1. Pain that is sudden onset, crushing, substernal, tight, severe, may radiate to back, neck, jaw, shoulder, arm
  2. Dyspnea (difficult breathing)
  3. syncope (fainting)
  4. nausea/vomiting
  5. diaphoresis (excessive sweating)
  6. increase HR
A

Symptoms of myocardial infarction

40
Q

Diagnosing acute myocardial infarction

A

clinical representation, serial 12-lead ECG’s, lab findings (cardiac enzymes)

41
Q

Complications of myocardial infarction

A

impaired contractility (diminished heart pumping), tissue necrosis (lack of O2), electrical instability (arrhythmias), pericardial inflammation (pericarditis)

42
Q

Inflammation of the pericardium

A

Pericarditis

43
Q

Inflammation of the pericardium causes…

A

pain, exudate (buildup of serous fluid) can result in cardiac tamponade which is when exudate compresses the heart, fibrous friction rub

44
Q

Restriction due to pericarditis may result from

A

serous exudate filling the pericardial cavity, fibrous scar tissue making pericardium stick to heart

45
Q

Consequences of pericardial effusion (fluid in pericardial cavity)

A

restricts heart expansion (left ventricle cant accept enough blood), decreased cardiac output (right ventricle cant accept enough blood, decreased blood pressure and shock, increase in venous pressure, jugular distension)

46
Q

What are the two valve disorders?

A

stenosis and regurgitation

47
Q

What valves are open during systole?

A

semilunar valves, aortic and pulmonary

48
Q

What valves are open during diastole?

A

AV valves, mitral and tricuspid

49
Q

Which valve disorder causes the narrowing of valves, doesn’t open fully, not enough blood passes through

A

Stenosis

50
Q

Which valve disorder causes blood to leak backwards

A

regurgitation

51
Q

Where does blood back up into if someone has aortic or mitral stenosis? what would a pt present with?

A

into lungs; coughing, shortness of breath

52
Q

Mitral valve stenosis signs and symptoms

A

pulmonary congestion, orthopnea (breathlessness when lying, may ask for more pillows), nocturnal paroxysmal dyspnea (shortness of breath that wakes pt), palpitations, fatigue

53
Q

Aortic valve stenosis signs and symptoms

A

angina, syncope (fainting), easily tired, dyspnea, peripheral cyanosis (blue in color)

54
Q

Regurgitation can be caused by…

A

mitral valve prolapse (improper closure), damaged tissue cords, rheumatic fever, endocarditis, heart attack, abnormality of heart muscle, trauma, congenital heart disease

55
Q

Mitral valve regurgitation signs and symptoms

A

may not develop symptoms for years, pulmonary congestion, dyspnea on exertion (difficult breathing), orthopnea (breathlessness)

56
Q

Aortic valve regurgitation signs and symptoms

A

exertional dyspnea (running out of air, not being able to breath deep enough), drop in diastolic pressure, widening arterial pulse pressure

57
Q

When do systolic murmurs occur?

A

during ventricular squeeze
- aortic stenosis
- mitral regurgitation
- pulmonic stenosis
- tricuspid regurgitation

58
Q

When do diastolic murmurs occur?

A

during ventricular filling
- aortic regurgitation
- mitral stenosis
- pulmonic regurgitation
- tricuspid stenosis

59
Q

Progressive and often fatal mortality resulting from decreased cardiac output and tissue perfusion and increased fluid retention
- peripheral edema, shortness of breath, exercise intolerance

A

Heart failure

60
Q

How does the body compensate for heart failure, decrease in cardiac output?

A

cardiac remodeling (dilating ventricles and increasing wall thickness), increased fluid and Na+ retention (increasing BP), activating the SNS (force of heart beat and HR)

61
Q

What are two main consequences of compensation?

A

Dilation and Hypertrophy

62
Q

Dilation of heart

A

Enlarges chambers occurs when pressure in left ventricle is elevated, initially an adaptive mechanism, but eventually becomes inadequate and CO decreases

63
Q

Hypertrophy of heart (buildup of muscle wall)

A

increase in muscle mass and cardiac wall thickness in response to chronic dilation, which results in impaired filling, higher O2 needs, poor coronary artery circulation, risk for ventricular dysrhythmias

64
Q

Diastolic heart failure is an issue with?

A

filling

65
Q

Systolic heart failure is an issue with?

A

pumping

66
Q

Based off these characteristics would this pt have systolic or diastolic HF?
- normal ejection fraction
- concentric remodeling or hypertrophy
- elderly
- female
- S4 heard

A

Diastolic heart failure

67
Q

Based off these characteristics would this pt have systolic or diastolic HF?
- reduced ejection fraction
- chamber dilation and eccentric remodeling (big heart)
- all ages
- often male
- S3 heard

A

Systolic heart failure

68
Q

S3 heart sound
“Kentucky”

A

heard during early diastole, low pitched, suggests poor systolic function/volume overload, occurs when mitral valve opens and blood enters overfilled ventricle

69
Q

S4 heart sound
“Tennessee”

A

heard during late diastole, low pitched, suggests poor diastolic function, occurs from atrial kick squeezing blood into stiff ventricle

70
Q

Where do symptoms manifest for left-sided heart failure?

A

pulmonary congestion and pressure, failure leads to low organ perfusion and hypoxia since left side of heart supplies body organs

71
Q

Where do symptoms manifest for right-sided heart failure?

A

venous congestion of body organs, failure occurs bc of increase in pulmonary vascular pressure

72
Q

Clinical manifestations of acute decompensated heart failure

A

pulmonary edema (alveoli fill with fluid)
signs and symptoms:
- anxious
- pale
- clammy and cold skin
- severe dyspnea (difficult breathing)
- wheezing, coughing
- crackles, rhonchi (bubbling)
- rapid HR, BP variable

73
Q

What are natriuretic peptides?

A

natural substances released by the heart

74
Q

What are the two natriuretic peptides?

A

ANP (atrial natriuretic peptide) secreted from atria and BNP (B-natriuretic peptide) secreted from ventricles (gives good indication that heart is being stretched too much)

75
Q

What do higher levels of natriuretic peptides indicate?

A

heart is stretched too much and releasing high levels of ANP and BNP

76
Q

Which natriuretic peptide should you monitor to reveal cardiac health?

A

BNP levels

77
Q

Higher BNP indicates

A

poor cardiac health (low chance survival)

78
Q

Lower BNP indicates

A

better cardiac health (levels below 100 pg/mL = no heart failure)

79
Q

Natural pacemaker of heart

A

SA node

80
Q

Electrical system of the heart consists of

A

SA node, AV node, Bundle of His, Right and left bundle branches, Purkinje fibers

81
Q

Abnormal conduction and/or formation of cardiac impulses

A

Arrhythmias

82
Q

Common causes of arrhythmias

A

abnormal structures, inadequate O2, fluid/electrolyte/pH disturbance, injury, excessive demand

83
Q

What abnormal structures can change rhythm?

A

Hypertrophy and Dilation

84
Q

Common arrhythmias include

A

second-degree partial block, atrial fibrillation, ventricular tachycardia, ventricular fibrillation, third-degree block

85
Q

Which arrhythmia can cause blood clots and stroke?

A

atrial fibrillation

86
Q

Which arrhythmia can cause cardiac arrest, muscle quivering, straight line (asystole)

A

Ventricular fibrillation

87
Q

Sudden cardiac death usually result from

A

ventricular dysrhythmias: ventricular tachycardia and ventricular fibrillation, asystole

88
Q

Which term is used to describe the amount of stretch on the myocardium at the end of diastole?

A

preload

89
Q

The pt reports shortness of breath, tachycardia, productive cough, and orthopnea (breathlessness in resting position). These symptoms are consistent with…

A

left ventricular failure

90
Q

The pt arrives in the ED with a diagnosis of right-sided heart failure. What clinical manifestations should the nurse expect?

A

Distended neck veins, pitting edema in the feet and ankles, abdominal ascites (fluid collects in spaces of abdomen)

91
Q

What three conditions would likely lead to diastolic heart failure?

A

cardiac hypertrophy from long-standing hypertension, cardiac tamponade (space around heart fills with blood or other fluid putting pressure on heart), restrictive cardiomyopathy

Nursing School (9 decks)

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