Cardiovascular System Flashcards
Left side heart valves
- Bicuspid
2. Mitral
Right side heart valve
- Tricuspid
Location of the Pulmonic Valve
Between the right ventricle and pulmonary artery
Location of the Aortic valve
Between the left ventricle and aorta
Electrical conduction pathway
- SA Node (pacemaker)
- AV node
- Bundle of HIS
- R and L bundle branches
- Purkinje fibres
Troponin I - normal level
Less than .06 ng/mL
Troponin T - normal level
Less than 0.1 ng/mL
Function of myoglobin
Oxygen binding protein
Normal serum cholesterol level
Less than 200 mg/dL
Normal LDL level
Less than 130 mg/dL
Normal HDL level
30-70 mg/dL
ECG - small squares =
.04 seconds
ECG - large squares =
.20 seconds
PR interval =
.12-.20 seconds (3-5 small boxes)
QRS complex =
.04-.10 seconds (1.5-3 small boxes)
Holter monitoring
Monitors the heart, client wears while carrying out ADLs
Echocardiography
Looks at the structure of the heart using ultrasound.
Digital subtraction angiography
X-ray combined with fluoroscopy for visualization of the cardiovascular system. Contrast dye is used.
Transmyocardial revascularization
High powered laser cuts 20-24 channels in the left ventricle, blood enters through these channels providing the effected part of the heart with blood and oxygen.
Premature ventricular contracts
Early ventricular contractions resulting from increase irritability of the ventricles. Can be cause by hypokalemia.
Cardioversion
Synchronized shock to convert an unstable rhythm to a stable one. Synchronized with the R wave.
Defibrillation
Used to treat VT or VF
PTCA
Percutaneous transluminal coronary angioplasty - used to treat coronary artery disease.
Anterior wall or septal MI, what is obstructed?
The left anterior descending artery.
Posterior wall or lateral wall MI, what is obstructed?
The circumflex artery.
Inferior wall MI, what is obstructed?
The right coronary artery.
Cariogenic shock
Failure of the heart to pump adequately, thereby reducing cardiac output and compromising tissue perfusion. Results in up to 40% necrosis of the left ventricle.
Signs and symptoms of cardiogenic shock
- Hypotension <90mmHg systolic
- Urine output <30mL per hour
- Cold, clammy skin
- Decreased peripheral pulses
- Pulmonary congestion
- Tachypnea
- Disorientation, restlessness and confusion
Cardiac Tamponade
Accumulation of fluid in the pericardial cavity. Restricts ventricular filling resulting in reduced cardiac output. Treated with a pericardiocentesis.
Raynaud’s disease
Vasospasm of arterioles and arteries of the upper and lower extremities. Attacks are intermittent and occur with exposure to cold or stress.
Buerger’s disease
Occlusive disease of the median and small arteries and veins. Blood vessels become inflamed, swell and can become blocked with clots. Can lead to infection and gangrene.
Symptoms of cariogenic shock
- Decrease in BP
- Tachycardia
- CVP increases due to backup of fluid
- Dysrhythmias due to decreased oxygen levels.
Ventricular tachycardia (on the ECG)
No P waves present, wide QRS complex and a heart rate of 140-180 bpm.
Symptoms of AF
Low cardiac output due to a lack of atrial contraction. Symptoms include:
- Hypotension
- Fatigue
- Weakness & dizziness
How many joules are used when defibrillating a patient?
360 joules
During cardiac catheterization what diabetic medication is withheld?
Metformin.
Atrial Flutter - on an ECG
- No P waves
- regular R waves
- sawtooth F wave
PVC - Premature Ventricular contractions - on ECG
- Occur repetitively
2. QRS can be uni- or vari-focal
Ventricular Tachycardia - on ECG
- Wide QRS complex
- No P waves
- 120-150 BPM
Ventricular Fibrillation - on ECG
- Irregular rhythm
- No P Wave
- QRS Complex
1st Degree Heart Block - on ECG
- P & R waves regular
2. Long PR interval
Heart Block
Electrical conduction signal is slowed or disrupted as it moves through the heart.
1st degree - long PR interval
2nd degree - skipped beats
3rd degree - limits the ability to pump blood and can be fatal.
Symptoms of Arterial ulcer
- Pale deep base
- Cool skin
Caused by tissue ischemia due to inadequate blood supply.
Venous status ulcer - appearance and cause
Appears dark red, brown skin and localized edema. Caused by accumulation of waste products due to venous congestion.
Hyperkalemia - appearance on ECG
Tall T waves
Hypokalemia - appearance on ECG
Lowered ST segment
Management of DVT includes:
- Bed rest
- Limb elevation
- Warm moist heat compress
- Analgesia (tylenol)
Sclerotherapy
Injection of sclerosing agent into a varicose vein which damages the vessel causing thrombosis and closing the vessel.
Bundle branch block - on ECG
Widened QRS complex
Variant angina
Vasospasm which at the same time of day without exertion. Treated with calcium channel blockers.
Function of Calcium in heart contractility
Calcium enters the heart during depolarization, exits during depolarization. Low Calcium levels can lead to cardiac arrest.
Symptoms of Hypothermia
Low BP and Pulse
Symptoms of DVT
- Warm and red leg
- Low grade fever
- Tenderness
- Dilated veins
Management of Peripheral Arterial Disease
- Exercise
- Warmth (blanket)
- Pain relief
- Foot care
- Nutrition
Types of edema
1 + : mild pitting, slight indentation, no swelling
2+ : moderate pitting, indentation subsides rapidly
3+ : deep pitting, indentation remains a short time, leg swelling
4+ : very deep pitting, indentation remains long time, leg very swollen
How many joules are used initially for cardioversion?
50-100 joules
Pain assessment questions
- Location
- Intensity
- Duration
- Precipitating & alleviating factors
- Associated symptoms
Ventricular tachycardia treatment at bedside
Cough CPR
Polycythemia vera
Bone marrow condition causing excessive production of WBC, RBC and platelets. Risk of thrombosis.
Normal Cardiac Output
4-7 liters per minute.
