Cardiovascular (EXAM2) Flashcards
1
Q
Blood is oxygenated through ___, ___, and ___ of respiratory gases
A
Ventilation
Perfusion
Transport
2
Q
__ and ___ regulators control rate and depth fo respiration in response to changing tissue oxygen demands
A
Neural and chemical regulators
3
Q
Pumps blood through the pulmonary system to oxygenate the blood
A
R Ventricle
4
Q
Pumps oxygenated blood through the systemic circulation
A
L ventricle
5
Q
Brings blood back to heart from the bottom part of the body to the heart
A
Inferior vena cava
6
Q
4 chambers, 2 atria, 2 ventricles are called the:
A
Myocardial pump
7
Q
Diseases that decreased ejection fraction (% squeeze the heart can pump).
A
- Coronary artery disease (CAD)
- Cardiomyopathy
- Cardiomegaly (enlarged heart)
8
Q
Heart’s ability to stretch for filling of the heart (more chambers fill, the stronger the chambers will push blood out)
A
Starling’s Law
9
Q
S1
A
Mitral and tricuspid valve closing
10
Q
S2
A
Pulmonary and aortic valves closing
11
Q
Heart muscles is called ___
A
Myocardium
12
Q
Coronary artery circulation supply blood to:
A
Myocardium of heart. Provide nutrients and remove waste
13
Q
Systemic circulation supplies blood to:
A
Arteries and veins
To body
14
Q
Coronary arteries (3)
A
- Right coronary artery
- Left Coronary artery (most abundant blood supply)
- Circumflex artery
15
Q
Coronary artery circulation
-general-
A
-branch off of aorta
(LCA)- brings flow to myocardium of ventricles of heart.
16
Q
The coronary arteries wrap around the ___ of the heart
A
Outside
17
Q
Left Main Coronary Artery (LMCA)
A
Supplies blood to left side of the heart muscle
Divides into 2 different arteries: left anterior descending artery , circumflex artery
18
Q
Left anterior descending artery
A
Branches off of the left coronary artery and supplies blood to the front of the left side of the heart
19
Q
Circumflex artery
A
Branches off the left coronary artery and encircles the heart muscle. Supplies blood to the outer side and back of the heart.
20
Q
Right Coronary Artery
A
Supplies blood to the right ventricle, the right atrium, and the SA and AV nodes.
21
Q
The right coronary artery divides into smaller branches: (2)
A
- Right posterior descending artery
2. Acute marginal artery (R atrium and R ventricle and bottom portion of both ventricles)
22
Q
The Main portion of the right coronary artery provides blood to the __ ____ of the heart, which pumps blood to the ___
A
Right side
Lungs
23
Q
Left Loves the Heart
A
Supplies the main blood supply for the heart.
24
Q
The amount of blood ejected from the left ventricle each minute
A
Cardiac output
25
Normal amt for cardiac output
4-6L/min
26
Amount of blood pumped from the LV with each contraction
Stroke Volume
27
Body needs to change circulation based on your metabolic demand. Ex of metabolic demand:
-exercise
-pregnancy
-fever
^ CO and O2 demand
28
The blood that is in left ventricle at the end of diastole
Preload
29
The more the ___ on the ventricular muscle the greater the ____
Stretch
| Contraction *** Starling’s law**
30
The resistance to the left ventricular ejection
Afterload
31
In ___ the afterload increases which makes cardiac workload increase
HTN
32
Preload, or degree of stretch, of cardiac muscle cells before they contract is the critical factor controlling stroke volume
Frank-Sterling Law of the Heart
33
___ Preload lead to ___ EDV leads to ___ stretch of myocardium : ______
^, ^, ^ : ^ stroke volume
34
Influences their ate of impulse generation and speed of conduction pathways
Autonomic NS
35
Originates with the SA nod or pacemaker, transmitted to the AV node, bundle of HIS and Purkinje fibers
Conduction system
36
Increases the rate of impulse generation and impulse transmission and innervates all parts of atria and ventricle
Sympathetic NS (SOS)
37
Decreases the rate and innvervates atria, ventricles, sinoatrial and atria-ventricular nodes
Parasympathetic NS
38
“Pacemaker of the heart”
SA node
| 60-100 beats per minute (BPM)
39
SA Node rate of impulses:
AV Node rate of impulses:
Bundle of His and Purkinje Fiber impulse rate:
60-100 bpm
40-60 bpm
20-40 bpm
40
If the heart rate is at 43 BPM, what can you infer from this?
That the SA node is not firing and the AV node is doing all the work. AV node rate for bpm (40-60bpm)
41
Contraction of the atria (EKG) wave
P wave
42
The electrical signal passes through the bundle of his to the R and L bundle branches in the septum (EKG) wave:
Q wave
43
(EKG) The contraction of the Left Ventricle. Which wave?
R wave
| Electrical signals passes across the ventricles through the Purkinje fibers making the ventral contract
44
(EKG) the contraction of the Right ventricle
S wave
Electrical signals forces the ventricles to push blood through the pulmonary valve and aortic valve, into the lungs and into the systemic circulation
45
(EKG) the relaxation of the ventricles
T wave
46
No flow of current. Cardiac cells are resting
Polarization
| Diastole
47
The flow of electrical current (or electrical connection/action potential) which results in a contraction of tissue
Depolarization
| Systole
48
The process of returning to a state of polarization
Repolarization
49
Cardiac monitoring purpose:
- identify the patient’s baseline
- recognize significant changes
- recognize lethal dysrhythmias that require immediate intervention
50
Tachycardia
> 100
51
Bradycardia
Less than 60
52
Ectopic
Extra beats in rhythm
53
Supraventricular
Above the ventricles
54
Juncitonal
Within the AV node
55
Ventricular
In the ventricles
56
Irregular and often rapid heart rate that can increase your risk of stroke, HF, and other heart-related complications
Atrial fibrillation
57
Atrial Fibrillation symptoms:
- heart palpitations
- shortness of breath
- weakness
58
Abnormal ventricle contractions in a very rapid and UNCOORDINATED manner
Ventricular fibrillation
59
Symptoms of ventricular fib
- dizziness
- lightheadedness
- Palpitations
- Loss of consciousness
60
May be brief, lasting for only a few seconds, or last long. Can cause your heart to stop (sudden cardiac arrest)
Ventricular tachycardia
61
Ventricular tachycardia symptoms
-dizziness, lightheadedness, palpitations, or even loss of consciousness
62
Characteristic rhythm of the healthy human heart. Present in adults if hr is between 60-100 bpm
Normal sinus rhythm (NSR)
63
When the hr is >100
Sinus tachycardia
64
Sinus tachycardia symptoms:
```
SOB
Lightheadedness
Rapid pulse rate
Heart palpitations
Chest pain
Syncope
(Heart is beating too fast so heart cant fill completely to perfuse blood)
```
65
Normal physiological response to exercise and conditions in which catecholamine release is physiologically enhanced or less commonly, when PNS system is withdrawn.
- also caused by other bad things
Sinus tachycardia
66
Underlying causes of Sinus Tachycardia
Fever
Infection
Neuro injury
67
Lifestyle modifications to tx sinus tachycardia
DASH DIET
| Exercise
68
Medications for Tachycardia
Beta blockers
Ca++ blockers
Na++ sodium blockers- slows rate of repolarization of heart
K+ blockers- delay replorization in SA & AV node
Fluids
- pacemaker
69
A slow, regular, HR resulting from a low rate of pacing by SA node. (Regular rhythm) slow pace.
Sinus bradycardia
70
What type of pt’s is sinus bradycardia normal for?
- high physical fitness
| - hypothyroidism (metabolic rate reduced)
71
Medications that create Sinus Bradycardia:
- acetylcholine, acetylcholinesterase inhibitors
- sympatholytic drugs (beta blockers, methyldopa, clonidine)
- opioids and sedative
- digitalis
- Ca++ blockers (diltiazem, verapamil)
- Amiodarone (antiarrhythmic drugs)
- hepatitis C: sofosbuvir, daclatasvir
72
Etiology of sinus bradycardia:
1. ) acute myocardial infarction
2. ) sleep apnea
3. ) exaggerated vagal activity
4. ) ^ IC pressure
5. ) infectious causes- typhoid, dengue, viral fevers, sepsis**
6. ) other- hypothyroidism, hypothermia, anorexia, prolonged hypoxia
73
S/S of sinus bradycardia
- chest pain
- fatigue
- SOB
- weakness
- dizziness
- syncope
- confusion/memory issues
- diaphoresis
- tiring during physical activity
74
TX of sinus bradycardia
- atropine, Epi, NE, Dopamine
- saline bolus
- treat underlying cause
- pacemaker
- Na
- O2
- monitor vitals, K+, ABGs, Na, Ca++
75
Nursing care for bradycardia
- know baseline vitals
- monitor for hypotension, syncope, diaphoresis, dyspnea, altered mental state
- monitor vitals, pulse ox, telemetry
- PT in TRENDELENBURG (head facing down to ground)
- or lay down flat
76
Atrial Firbrillation
- no discernible p-waves
- multiple foci rapidly discharging
- no organized electrical activity in atria
- rhythm is irregular
A Fib CONTROLLED= rate < 100 bpm
A Fib UNCONTROLLED= rate >100 bpm
77
If its V-Fib you .....
De Fib!
| * clear*
78
Elective procedure where client is awake but sedated. Synchronized with QRS and is 50-200 Joules
Cardioversion
79
Caused by electrical impulses that didn’t originate from the SA node (disrhythmias)
Disturbance in conduction
80
Insufficient volume is ejected into the systemic and pulmonary circulation
Altered cardiac output
81
Acquired or congenital disorder of a cardiac valve by stenosis or regurgitation
Impaired valvular function
82
Coronary artery flow to the myocardium insufficient to meet myocardial oxygen demands
Myocardial ischemia
83
Release of catecholamines from sympathetic nervous system: ^ HR, contractility, vasoconstriction, and ^ tendency of blood to clot
- suppress immune and inflammatory system
- release cortisol from adrenal cortex
Stress
84
R sided heart failure -
- Impaired functioning of the right ventricle
- Elevated PVR (pulmonary vascular resistance)
- Blood begins to “back up”
85
S/S of right sided heart failure
weight gain,
distended neck veins, hepatomegaly,
splenomegaly,
dependent peripheral edema
86
Left sided heart failure
- Decreased functioning of the left ventricle
| - Decreased cardiac output
87
S/S left sided heart failure
-fatigue,
-shortness of breath,
-dizziness and confusion from tissue hypoxia
-crackles in lungs
- dyspnea on exertion (DEO)
- paroxysmal nocturnal dyspnea
*** pulmonary congestion
Monitor lung sounds closely
88
Transient imbalance between myocardial oxygen and demand
Angina
| -relieve with rest/coronary vasodilators
89
MI
- Pain occurs at rest or exertion
- CELLULAR DEATH occurs after 20 minutes.
- Rest, position change and nitroglycerin do not relieve pain
- Men and women may have different symptoms
* men- crushing, squeezing, elephant sitting on my chest
* women- short of breath, fatigue, indigestion, mid back hurts, jaw pain.
90
Heart enlargement
Cardiomyopathy
91
Plaque build up inside coronary arteries
Coronary artery disease
92
Mitral valve, aortic valve abnormalities
Heart valve abnormalities
| - lots of regurg
93
Peripheral Vascular disease
Functional PVDs don’t involve defects in blood vessels’ structure. (The blood vessels aren’t physically damaged.) These diseases often have symptoms related to “spasm” that may come and go.
• Organic PVDs are caused by structural changes in the blood vessels. Examples could include inflammation and tissue damage.
Peripheral artery disease (PAD) is a type of organic PVD. It’s caused by fatty buildups (atherosclerosis) in the inner walls of arteries. These deposits block the normal blood flow.
94
Oxygen transport abnormalities (2)
- anemia
| - carbon monoxide
95
Carbon monoxide poisoning ( cardiovascular abnormalities)
** cherry red appearance**
CO binds to cardiac myoglobin with an even greater affinity than to hemoglobin; the resulting myocardial depression and hypotension exacerbates the tissue hypoxia.
Carbon monoxide binding with hemoglobin results in carboxyhemaglobin. This has a cherry red color visually. This is why the hypoxic patient doesn’t appear blue or ashen. Their skin is pink.
