Chapter 20 - Cardiac Emergencies Flashcards
What does the cardiovascular system consist of
- Heart (Pump)
- Blood (Fluid)
- Circulatory system (pipes)
4 Chambers of the Heart
- Right Atrium
- Left Atrium
- Right Ventricle
- Left Ventricle
Right Atrium
Receives blood from veins; pumps to right ventricle
Left Atrium
Receives blood from lungs; pumps to left ventricle
Right Ventricle
Pumps blood to the lungs
Left Ventricle
Pumps blood through the aorta to the body
The circulation of blood in the heart
- Vena cava
- right atrium
- right ventricle
- pulmonary arteries
- lungs
- pulmonary veins
-left atrium - left ventricle
L
Left ventricle is larger than the right
body likes a certain rate, pH, temp which helps prevent blood clots
semilunar
one way, dont like returning back into the body
deoxygenated blood is carried by the pulmonary artery, only one that carries deoxygenated blood
Pulmonary vein brings oxygenated blood from the lungs (only time it is flipped)
Cardiac Conduction System
- system of specialized muscle tissue that conducts electrical impulses that stimulate the heart to beat
- automatic, involuntary process
- regulated by cardiac control centers in the brain
Cardiac Cycle
- Pulse and blood pressure
pulse
the outward expression of the heart beating
blood pressure
- heart at work = systole = systolic pressure
- heart at rest = diastole = diastolic pressure
Pulmonary
- CHF
- CUPD
- athsma
- allergic reaction
- PE
-pneumathora
-pheneumia
A
Aphib, on blood thinners so it doesnt clot.. people who have aphib uncontrolled? they cant fill up quick
dephib… shockable rhythms, ventricles truly out of control, nonsustainable rhythm, like something was vibrating out of focus… train wreck
coronary arteries
heart attack
clot in the vascular that prevents the heart from doing its job
left atrial empidenge, more likely to clot as you get older….
Composition of blood
white blood cells
mma fighter
Keep it simple. different types of shock
- pump
- pipes
- stuff in the pipes
ACS - Acute Coronary Syndrome
heart isnt getting enough oxygen
Heart Attack symptoms
- crushing, dull, heavy, squeezing
- sometimes describes as pressure of discomfort
- radiates to arms, upper abdomen, jaw
- shortness of breath
Associated signs and symptoms
- anxiety, feeling of impending doom
- nausea and pain or discomfort in upper abdomen
- sweating
- abnormal pulse (tachycardia/bradycardia)
- abnormal blood pressure
important to look at med history and her blood pressure is fine but shes not
Three patient populations have atypical presentation in ACS
women
diabetics
elderly
Assessment
- perform primary assessment
- use OPQRST-ASPN to get history of present illness
- obtain SAMPLE history
- take baseline vital signs
- Associated symptoms and pertinent negatives
- perfusion… if concerned check signs of perfusion in ALL extremeties
- lung sounds (good ventilatory status)
- inspection of the chest
- palpation of the chest… rule out pleuritic chest pain
- JVD
12 Lead EKG
- If trained, equipped, and authorized to do , obtain a 12 Lead EKG
- an EKG is a paper print that reflects the electrical conductivity activity of the heart
- 12 lead tells us about STEMI (ST segment elevation Myocardial Infarction)
(must be placed correctly)
RA.LA.RL.LL
V1.V2.V3.V4.V5.V6
(not directly above bone, must be in the space between leaves. V6 supposed to be midaxillary)
pulmonary vein
Pulmonary veins are the veins that transfer oxygenated blood form the lungs to the heart
Largest pulmonary veins are the 4 pulmonary veins, two from each lung that drain into the left atrium of the heart. The pulmonary veins are part of the pulmonary circulation
Treatment of ACS
- position of comfort
- oxygen
-aspirin… CHEW, cant give water - nitroglycerin
- transport to a cardiac center
Treatment - aspirin
Indications:
- chest pain (cardiac in nature)
-ability to safely swallow
Contraindications:
-inability to swallow
-allergy to aspirin
-history of asthma (relative)
–active bleeding
Treatment rules for aspirin
- do not need to consult med command
- four 81 mg baby aspirin
- make sure they chew the medication
- check the patients mouth to ensure the medication is gone
Nitroglycerin
Indications:
- chest pain
- history of cardiac problems
- need to ask if they have taken it before
- prescribe nitroglycerin
agina
agina, women, elderly, diabetics
Treatment medication - Nitroglycerin
Coronary Artery disease
- plaque build up
- build up or restricts blood flow
CAD
(three, parts)
-
Aneurysm
- weakened sections of blood vessels begin to dilate (balloon)
- bursting (rupture)
- brain bleeds, not giving enough oxygen… high blood pressure for a long time and they get weak till they eventually blow
marphanes more likely to have weakened blood vessels
really tall, long fingers, thin
electrical malfunctions of the heart
a.
b. slow
c.
pace makers
send electrical impulse … stimulate the atrea or ventriclricals or both…
pacemaker defribillator - shockable rhytm rechognizes it when it goes to shock and sends a shock to it.
angina pectoris
chest pain in heart muscle
acute myo
tissue death within heart because of lack of oxygen
widow makers
people drop dead, 40s
80s are more likely to survive a blockage of bloodflow because their bodies make more pathways
congestive heart failuure
heart dies if untreated… DO NOT LIE THEM FLAT
