chapter 17 Flashcards
Assessment of cardiovascular
Inspection.
palpation.
percussion.
auscultation.
Inpection
inspect for bulges and masses, symmetry
Palpation
should not feel any pulsations, heave, or vibratory sensation against palm.
Percussion
resonance all over lung tissue. dullness over heart.
auscultation
listen for S1 and S2. possible S3 and S4 or bruits (tympanic) or murmurs.
Apical pulse.
felt at the apex of the heart
Cardiac cycle
the events of one complete heartbeat-that is, the contraction and relaxation of the atria and ventricles.
Calculating stroke volume
stroke volume= cardiac output/ heart rate for 1 minute.
cardiac output
the amount of blood ejected from the left ventricle over 1 minute. normal in adult 4 to 8 liters/ minute
Cardiac output =stroke volume/heart rate for 1 minute
Carotid Artery assessment
assess presence, strength and equality. palpate each carotid pulse separately. Normal findings bilaterally should demonstrate equality in intensity and regular patterns. the pulses should be strong not bounding.
Heart sounds and Murmurs
S1 lub AV valves close
S2 dub aortic and pulmonic valve close
S3 ventricular gallop. when AV valve open and blood flow into the ventricles and cause vibrations
S4 atrial gallop
MURMURS harsh blowing sounds caused by disruption of blood flow into the heart in between the chambers of the heart or from the heart into the pulmonary or aortic systems
atherosclerosis
renal arteries
carotid bruit
a loud blowing sound, is an abnormal finding. it is most often associated with a narrowing or stricture of the carotid artery usually associated with atherosclerotic plaque
marfans syndrome
degenerative of the connective tissue, which over time may cause the ascending aorta to either dilate or dissect leading to abrupt death.
Preload,
the amount of blood and stretching of the ventricular myocardial fibers.
Afterload
the pressure that the ventricles must overcome in order to open the aortic and pulmonic valvular cusps.
Electrocardiogram wave
Electrical representations of the cardiac cycle are documented by deflections on recording paper
cardio output
The amount of blood ejected from the left ventricle over 1 minute
JVD (jugular and neck vein distention),
indicates elevation of the central venous pressure commonly seen with congestive heart failure, fluid overload, or pressure on the superior vena cava
MI (myocardial Infract)
During infarction there is complete disruption of oxygen and nutrient flow to the myocardial tissue in the area below a total occlusion. Infarction leads to the death of the myocardial tissue unless floe of blood is reestablished.
Valve disease
Disease of the valves denotes either narrowing of the valves leaflets or incompetence of the same leaflets. may be caused by rheumatic fever, congenital defects, MI, and normal aging.
VSD (ventricular septal defect),
Regurgitation occurs through the defect, resulting in a holosystolic murmur. the murmur is loud, coarse, high-pitched, and heard at the LSB, third to fifth ICS.
Heart Failure (left and right sided),
inability of the heart to produce a sufficient pumping effort. Most commonly, both right-sided and left-sided heart failure are present. left-sided heart failure causes blood to back up into the pulmonary system and results in pulmonary edema. right-sided heart failure causes backup of the blood into the systemic circulation and leads to distended neck veins, liver congestion, and peripheral edema.
tetralogy of fallot,
this condition involves four cardiac defects: dextroposition of the aorta, pulmonary stenosis, right ventricular hypertrophy, and ventricular septal defect.
Coarctation of aorta,
the aorta is severely narrowed in the region inferior to the left subclavian artery. the narrowing restricts blood flow from the left ventricles into the aorta and out into the systemic circulation, thus contributing to the development of congestive heart failure in the newborn.
Heart block
slow heart rate can be as low as 20 to 40 beats/min. conduction between the atria and ventricles is disrupted.
pleural effusion,
excess fluid that accumulates between the two pleural layers, the fluid-filled space that surrounds the lungs. Excessive amounts of such fluid can impair breathing by limiting the expansion of the lungs during ventilation.
aortic aneurysms
enlargement (dilation) of the aorta to greater than 1.5 times normal size. the cause of an aneurysm may be multifactorial, the end result is an underlying weakness in the wall of the aorta at that location.
Older client, diet and healthy cardiac function
- hypertension
- vessels become more rigid
- the aorta may dilate and lengthen.
- might have s4 sound
- systolic murmurs become more common as people age, specially because of aortic stenosis
- diet and exercise decreases heart rate, maximum oxygen consumption and an increase in stroke volume during exercise.
Infants and children, cardiac function
the heart beat in a new borne initially may be as high as 175 to 180 beats/min
Behaviors and detrimental effects on developing fetus
in a fetus the blood passes through the placenta to the right side of the heart. the majority of the blood passes through the foramen ovale to the left side of the heart, then into the aorta to enter the systemic circulation. the foramen ovale is a passageway for blood between the right and left atria. the rest of the blood passes through the pulmonary artery ans ductus arteriosus is an opening between the pulmonary artery and the descending aorta.
Health Promotion 2020 behaviors
- Reduce CHD
- increase awareness on the early signs and symptoms of a heart attack
- reduce the proportion of adults that are obese
