Cardiovascular Assessment Flashcards
What happens to the left ventricle with aging?
— increases size
— becomes stiff
— less diste si le
— decreases speed of diastolic filling by 50%
— decrease in stroke volume, ejection fraction, and cardiac output
— less able to meet oxygen demands
*LV pumps against greater resistance
LV hypertrophy
What happens with the aorta with aging?
— thick, stiff, and less diste si le
— systolic BP increases
— systemic vascular resistance increases
— MONITOR FOR HTN
Current health concerns/symptoms to assess:
— chest pain
— dyspnea
— fatigue
— palpitations
— edema
— syncope
— extremity pain
Which laboratory assessment evaluates myocardial muscle protein when there is injury to myocardial muscle?
Troponin
What is creatinine kinase?
Enzyme specific to cells of the brain, myocardium, and skeletal muscle
CK indicates tissue necrosis or injury
Range: 30-170
What is the protein found in cardiac and skeletal muscle?
Myoglobin
<90
What is the normal range for total cholesterol?
<200
What is the normal range for triglycerides?
Below 150
What are normal ranges for HDL + LDL?
HDL= >45
LDL= <130
BNP (B-type natriuretic peptide)
Dx of HF
>100
BNP is produced and released by ventricles when they are stretched and fluid overload
What is homocysteine?
Amino acid produced when proteins break down
Elevated levels indicates increase risk for cardiac disease
<14
What is C-reactive protein?
Any inflammatory process can produce CRP in blood
<1.0
>3 indicates increase risk for heart disease
Elevations seen with HTN, infection, and smoking
What is microalbuminuria?
Small amounts of protein in urine
Incidentes endothelial dysfunction
What are CM of hypokalemia and hyperkalemia in heart failure patients?
What is normal range for potassium?
Hypokalemia:
— increased electrical instability
— ventricular dysrhythmias
— digitalis toxicity
Hyperkalemia:
— slowed ventricular conduction
— peaked T waved on ECG
— contraction followed by ASYSTOLE
3.5-5.0
What are CM with hypocalcemia + hypercalcemia? What is normal range of calcium?
Hypocalcemia:
— ventricular dysrhythmias
— prolonged QT interval
— CARDIAC ARREST
Hypercalcemia:
— short QT interval caused AV block
— digitalis hypersentitivity
— CARDIAC ARREST
8.4-10.5
What happens with hypomagnesemia?
Prolongs QT interval causing Vtach
1.5-2.5
What diagnostic testing examines size, silhouette, and position of the heart?
CXR
Which diagnostic testing uses contrast dye to examine arterial vessels?
Angiography/arteriography
— sedation required
— NPO status
— screen for allergies
What is an echocardiography?
Ultrasound to assess cardiac structures and mobility
Specifically looks at valves
No prep required
Which diagnostic testing examines cardiac structure and function using ultrasound that is placed behind the heart in the esophagus or stomach?
Transesophageal echocardiography
— sedation required
What do you need to screen for before an MRI?
Metallic objects
How do you prep your patient for a cardiac catheterization?
— fluids may be given 12-24 hr before procedure for renal protection
— CXR, CBC, coagulation screen, ECG done
— NPO after MN or liquid breakfast
— assess for contrast dye allergy
— sedative
— hold diuretics prior to procedure
What is post procedure care for cardiac cath?
— bed rest and keep insertion site extremity straight
— VS
— assess insertion site for drainage or hematoma
— assess peripheral pulses, temp, and color of skin
— monitor I&O / maintain hydration
— observe for complications
