Cardiovascular Nursing Care Flashcards
This is the muscle length prior to contractility. It is dependent of ventricular filling for end diastolic volume and this value is related to R atrial pressure. The most important determining factor is venous return.
Preload
What is afterload?
It is the tension or the arterial pressure against which the ventricle must contract. If atrial pressure increases, this also increases.
This is the intrinsic ability of cardiac muscle to develop force for a given muscle length. It is also known as inotropism.
Contractility
CO = SV x HR
Cardiac output = stroke volume x heart rate
Each heartbeat is the result of an electrical stimulus. The impulse which originates in the SA nose in the R atrium is conducted through a network of fibers w/in the heart and finally stimulates the myocardium to contract
Conduction
This causes a discharge of electrical forces from within the membrane
Depolarization
After contraction, the muscle cells recover and restore electrical charges within
Repolarization
What is the cardiac cycle?
Combined periods of polarization and repolarization
What are age related differences?
Decreased elasticity, thickening and rigidity of valves. Increased connectivity tissue in the SA and AV nodes and bundle branches
What are gender related differences?
Women - arteries and heart are smaller, HR, SV and ejection fraction higher in women. Hormone protection pre menopause + clotting
What are racial/ethnic differences?
Essential HTN incidence, DM, access to health care and treatments, mortality and morbidity
What are some pathogenic risk factors?
Hyperlipidemia + hypolipoproteinemia, HTN, glucose intolerance, hypercoagulation states
Gender, age, family hx of CAD and ethnicity are what kind of risk factors?
Non modifiable
What are some assessment techniques you would use for a pt with CVD?
Hx, demographic data, family hx and genetic risk, personal hx, diet hx and socioeconomic status
Chest pain can also result from noncardiac problems. Name four
Pleurisy, pulmonary embolus, hiatal hernia and anxiety
Women often do not experience pain in the chest and instead feel either or both of these
Discomfort or indigestion
Difficult or labored breathing experienced as uncomfortable breathing or SOB
Dyspnea
What is orthopnea?
Dyspnea when lying flat
When does paroxysmal nocturnal dyspnea occur?
After lying down for several hours
This enzyme is specific to cells of the brain, myocardium and skeletal muscle. The appearance of this enzyme in the blood indicates tissue necrosis or injury
Creatinine kinase
Elevations indicate possible brain myocardial and skeletal muscle necrosis or injury
Creatinine kinase
What does CK-MM measure? (100% of total CK)
Elevations that occur with muscle injury
This measures elevations that occur with myocardial injury or after percutaneous transluminal angioplasty and intracoronary streptokinase infusion
CK-MB (CK2) (0% of total CK)
What does CK-BB (CK1) measure?
Elevations that occur with brain tissue injury
What does C reactive protein measure? (<1.0 mg/dl)
Elevations may indicate tissue infarction or damage
Client preparation for cardiac catheterization includes?
Assessment of the patient’s physical and psychosocial readiness and knowledge level, purpose, length, who will be present during the procedure and appearance of the cath lab.
These complications may occur during catheterization.
MI, stroke, thromboembolism, arterial bleeding, lethal dysrhythmias and death
Follow up care of a cardiac catheterization includes
restricted bedrest, insertion site extremity is kept straight, monitor V.S and assess for complications
What is hemodynamic monitoring?
It is an invasive system used in critical care areas to provide quantitative information about vascular capacity, blood volume, pump effectiveness, and tissue perfusion