ch 21 Flashcards
Pressures in all of the chambers are the lowest during
diastole, which facilitates ventricular filling
parasympathetic leads to vagus nerve, which
slows down heart
sympathetic speeds up heart via
beta 1 receptors in SA node
HR also influenced by baroreceptors - high bp
detect change in BP. if hypertension, they increase impulses to cerebral medulla which activates the parasympathetic system, slows down the heart.
baroreceptors - low bp
use vasoconstriction and increased HR
Stroke volume is primarily determined by three factors: (stroke before, after, and contract)
preload, afterload, and contractility.
Preload refers to the degree
of stretch of the ventricular cardiac muscle fibers at the end of diastole. last second of diastole when vetricles are totally full, before contraction. this is frank starling.
Afterload
resistance to ejection of blood from the ventricle
relationship between afterload and stroke volume (after is over)
inverse
symptoms of aging heart in older adults - (for peet’s sake, I have symptoms)
fatigue, shortness of breath, or palpitations and present with new physical examination findings
benefits of estrogen (ester is good for cholesterol)
(1) an increase in high-density lipoprotein (HDL) that transports cholesterol out of arteries; (2) a reduction in low-density lipoprotein (LDL) that deposits cholesterol in the artery; and (3) dilation of the blood vessels
common symptoms of CVD - don’t forget weight
chest pain, SOB or dypnea, peripheral edema or weight gain, palpitations, fatigue, dizzy, sycope, LOC
chest pain - not what it seems
The location of chest symptoms is not well correlated with the cause of the pain
severity of chest pain..
does not predict the seriousness of its cause.
Because many cardiac medications can cause gastrointestinal side effects or bleeding, the nurse asks about (anything to do with gastro)
bloating, diarrhea, constipation, stomach upset, heartburn, loss of appetite, nausea, and vomiting
Patients with worsening HF often experience (you’ve got it)
orthopnea, a term used to indicate the need to sit upright or stand to avoid feeling short of breath. use extra pillows.
pulse contour - the contour is either stiff or insufficient
aortic valve stenosis = weak pulse
aortic insufficiency = valve doesn’t close and backflow, excess blood so pulse is strong
right side heart function can be assessed by (pass the jug on the right hand side)
jugular, which is central venous pressure.
Obvious distention of the veins with the patient’s head elevated 45 to 90 degrees
indicates an abnormal increase in CVP (central venous pressure)
gallop (slow and low gallop)
diastole, very low-frequency sounds S3 or S4
S3 - normal up to what ages? and when is it heard?
early diastole. normal up to 35 - 40 years old. in older adult indicates HF
S4 (4 is always resistant)
late diastole, caused by ventricle resistance.