NUR 118 - Lecture 9/10 - Cardiovascular

Question 1

Function of Autonomic Nervous System in cardiovascular function:​

Parasympathetic stimulation

Answer 1

General:
Cardiac Rate
Cardiac Muscle contractility
Vascular Tone (BP)

Sympathetic = Fast & Strong Contraction
Parasympathetic = Slow & No impact on contraction

Sympathetic:
- Norepinephrine & Epinephrine: help with constriction of blood vessels
- “Fight or flight”
- Concerned for beta receptors; for drug, atenolol = beta blocker

Parasympathetic:
- Regulates heart via vagus nerve = slows heart rate
- “Rest & Digest”

Question 2

Function of Autonomic Nervous System in cardiovascular function:​

Sympathetic Stimulation

Question 3

Cardiovascular Assessment: Inspection

Answer 3

• Signs of distress
• Skin & mucus membrane color
• General appearance
• Breathing effort
• Jugular neck vein distention (JVD)
  Position Semi Fowler’s
• Edema
• Clubbing of fingers
• Inspect precordium:
  >size, shape, symmetry
  > Apical Impulse/PMI
  > Pulsations, heaves, lifts

Question 4

Cardiovascular Assessment: Palpation

Answer 4

• Warm hands

Palpation Locations:
Aortic Area
Pulmonic Area
Erb’s Point
Tricuspid area
Mitral area

• Temperature and moisture
• Discomfort
• Pu;se: Rate, rhythm, quality
  >Rate: Tachycardia/bradychardia
  >Rhythm: Regular/Irregular
  >Quality: 0:absent, 1:thready, 2:weak, 3:strong, 4:bounding
• Edema: Pitting vs dependent

Question 5

Cardiovascular Assessment: Auscultation

*ADD MORE LATER IF NECESSARY

Answer 5

• Listen to apical
• Rate, rhythm
• Identify S1 & S2 ( First and second heart sounds)

S1 = Closure of atrioventricular valves: mitral & tricuspid
S2 = Closure of semilunar valves: aortic & pulmonary

APE TO MAN:
Mitral – between left atrium and left ventricle​
Tricuspid – between right atrium and right ventricle​
Aortic – between left ventricle and aorta​
Pulmonic – between right ventricle and pulmonary artery​
Erb’s Point​
Cardiac murmurs caused by aortic insufficiency and mitral stenosis can in particular be heard.​

Question 6

Laboratory studies r/t cardiovascular assessment

Answer 6

Cholesterol: Should be under 200 mg/dl
C-Reactive Protein (CRP): Believe to be value of predicting coronary events
Complete Blood Count (CBC): WBC for infection, hemoglobin for O2 carrying capacity
Electrolyte:

Question 7

Diagnostic tests r/t cardiovascular assessment

Answer 7

Electrocardiogram (EKG): Records the electrical impulses that stimulate heart to contract
>Evaluates arrhythmias, conduction defects, myocardial injury

Echocardiogram: Evaluates structure and function of the heart & how they move blood through the heart
> Detects: heart wall function, mainly left ventricle; disease of heart valves; determines cardiac output

Pulse Oximetry: Measure O2 Saturation

Question 8

Define Ischemia and Infarction

Answer 8

Ischemia - Lack of blood supply to an organ, or body part; ischemia is reversible

Infarction - Necrosis; not reversible

Question 9

APE TO MAN

Answer 9

Apical
Pulmonary
Erb’s Point
Tricuspid
Mitral

Question 10

Risk factors for Coronary Heart Disease

Answer 10

Non Modifiable risks:
Heredity
Age
Gender

Modifiable risks:
Hypertension
Type II Diabetes
Obesity
Elevated serum lipid levels
Smoking