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Adult Health II > The Heart > Flashcards

The Heart Flashcards

1
Q

Preload

A

The amount of ventricular stretch at the end of diastole. (The heart loading up for the next big squeeze of the ventricles)

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2
Q

Afterload

A

The amount of resistance the heart must overcome to open the aortic valve and push the blood volume out into the systemic circulation

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3
Q

Central Venous Pressure

A

The blood pressure in the venae cavae

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4
Q

How is Preload affected?

A

-Structure of the myocardium
-Thickened myocardium = Dec. stretch

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5
Q

How is Afterload affected?

A

-Blood pressure
-Blood vessel flexibility (arteriosclerosis)
- Valve abnormalities

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6
Q

Cardiac output

A

-The amount of blood the heart pumps through the circulatory system in a minute

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7
Q

Stoke Volume

A

The volume of blood pumped out of the left ventricle of the heart during each systolic cardiac contraction

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8
Q

Ejection Fraction

A

The percentage of blood that leaves your left ventricle when your heart contracts. (Normal = 55%-75%)

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9
Q

Acute Coronary Syndrome: What is it?

A

Any condition brought on by a sudden reduction or blockage of blood flow to the heart.

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10
Q

Acute Coronary Syndrome: Does it have any symptoms?

A
  • Chest pain/tightness
  • SOB
  • Diaphoresis (sweating)
  • Dizziness
  • Radiation of pain
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11
Q

Acute Coronary Syndrome: Causes?

A
  • Male >45 & postmenopausal Women
  • Ethic Background
  • Sedentary lifesyle
  • Hypertension
  • Tobacco Use
  • Hyperlipidemia
  • Obesity
  • Diabetes
  • Family Hx
  • Stress
  • Male pattern baldness
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12
Q

Coronary Artery Disease: Two Types

A

Ischemia: (reduced blood flow)
- Anina (stable/unstable)
- Can lead to MI
Myocardial infarction (MI): (Blocked blood flow)
- Tissue death

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13
Q

Stable Angina

A

Exertional Angina is caused by exertion and is relieved by rest or nitroglycerin

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14
Q

Unstable Angina

A

Preinfarction Angina is caused by

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15
Q

Variant Angina

A

Prinzmetal’s Angina

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16
Q

Myocardial Infarction (MI): NSTEMI

A

Non Q-wave MI - Only Endocardium affected

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17
Q

Myocardial Infarction (MI): STEMI

A

Necrosis-Entire Myocardium affected

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18
Q

Cardiac Lab Tests

A

Cardiac enzymes
- Creatine kinase
- Myoglobin
- Troponin I (first to become elevated after an MI)
- Troponin T (remains elevated longer than Trop I) (long-term indicator)

Lipid profile
- Cholesterol (total: max = 200)
- LDL (max = 100) (clogs the pipes)
- Triglycerides
- HDL (cleans out the clogged pipes)

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19
Q

Diagnostic Procedures

A
  • Electrocardiogram (ECG)
  • Echocardiogram
  • Stress testing
  • Thallium Scan - nuclear scan
  • Cardiac catheterization (angiography)
  • Coronary artery bypass graft (CABAGE)
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20
Q

What does an EKG Wave form look like?

A

Draw it out
-P
-QRS
-T
-PR
-QT
-ST

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21
Q

Heart Sounds: S1 & S2

A

You can hear the valves closing
- Systole (S1): “Lub” Caused by the closing of the mitral & tricuspid valves closing during ventricular contraction.
- Diastole (S2): “Dub” Caused by the aortic and pulmonic valves closing during ventricular relaxation.

22
Q

Heart sounds: Murmurs

A

Caused by turbulence through a valve (a whooshing sound)
- “lub”-“whoosh”-“dub” = systolic murmur
- “lub”-“dub”-“whoosh” = diastolic murmur

23
Q

Heart sounds: Systolic murmur

A

Two types:
- ejection murmurs (because of blood flow through a narrowed vessel or
irregular valve)
- regurgitant murmurs (backward blood flow into one of the chambers of
the heart

24
Q

Heart sounds: Systolic murmur - Causes?

A
  • Mitral Regurgitation
  • Physiologic murnurs
  • Arterial (valve) Stenosis
  • Mitral Valve prolapse

Mnemonic:
“Mr. Peyton Manning as MVP”

25
Q

Heart sounds: Diastolic murmur

A
  • narrowing (stenosis) of the mitral or tricuspid valves
  • regurgitation of the aortic or pulmonary valves.
  • Mnemonic – ARMS
    AR = Aortic Regurgitation
    MS = Mitral Stenosis
    AORTIC STENOSIS

Generally, diastolic murmurs are MORE concerning than systolic

26
Q

Heart sounds: Other Causes of murmurs?

A
  • Fever
  • Exercise
  • Pregnancy
  • Low red blood cell count (anemia)
  • Overactive thyroid gland
  • During times of rapid growth in children
  • ASD, PDA, TOF (infants)
27
Q

Valvular diseases: what is it?

A

An abnormality or dysfunction in any of the heart’s four valves
- Mitral (left side)
- Aortic (left side)
- Tricuspid (right side)
- Pulmonic (right side

28
Q

Classification of valve problems (2)

A
  • Stenosis
  • Insufficiency/regurgitation
29
Q

Valvular heart disease (2)

A
  • Congenital
  • Acquired
30
Q

Diagnostic Procedures for heart structural issues such as murmurs and valve issues

A
  • Chest x-ray
  • 12-lead ECG
  • Echocardiogram
  • Transesophageal Echocardiography (TEE)
31
Q

Medications and procedures for heart structural issues such as murmurs and valve issues

A
  • Diuretics
  • Afterload-reducing Agents
  • Inotropic Agents
  • Anticoagulants
  • Therapeutic Procedures
  • Percutaneous balloon valvuloplasty
  • Valve replacement
32
Q

Client education: Murmurs & Valve issues

A
  • Important of prophylactic antibiotic
  • Weigh daily
  • Coordinate activities with rest periods
  • Encourage cardiac diet
  • Monitor anything out of the ordinary (fever, worsening symptoms)
33
Q

Heart Failure: 2 types

A

Congestive HF & Pulmonary Edema

34
Q

Heart Failure

A

Occurs due to heart muscles being unable to pump effectively, resulting in:
- Inadequate cardiac output
- Myocardial hypertrophy
- Pulmonary/systemic congestion

Can be an acute or chronic cardiopulmonary problem
- Systemic hypertension
- Dysrhythmias
- Valvular heart disease
- Pericarditis
- cardiomyopathy

35
Q

Heart Failure: Different Classifications

A

New York Heart Association’s functional classification scale
* Class I: No symptoms with activity
* Class II: has symptoms with ordinary exertion.
* Class III: has symptoms with minimal exertion
* Class IV: has symptoms at rest

36
Q

Heart Failure: Assessment

A

Risk factors
- Systolic blood pressure elevated in older adults

  • Some medications can increase CHF or worsen manifestation in older adult clients.
  • Left-sided: see hypertension, CAD, angina MI, Valvular disease (Mitral and Aortic)
  • Right-sided: left ventricular failure, right ventricular MI, Pulmonary problems (COPD, pulmonary fibrosis)
  • High-output heart failure: Increased metabolic needs, Septicemia (fever),
    anemia, hyperthyroidism
  • Cardiomyopathy: CAD, Infection or inflammation of heart muscle, various cancer tx, prolonged alcohol use, Heredity
37
Q

HF: Expected Findings for Left & Right sided HF and cardiomyopathy

A
  • Left-sided failure: Dyspnea, orthopnea, nocturnal dyspnea, fatigue, S1 heart sound, frothy sputum (blood-tinged), altered mental status.
  • Right-sided failure: Jugular vein distention, ascending dependent edema, abdominal distention, fatigue, weakness, nausea polyuria at rest, enlarged liver.
  • Cardiomyopathy: four types Dilated (most common), Hypertrophic,
    arrhythmogenic right ventricular, restrictive
38
Q

HF: manifestations

A
  • Fatigue, weakness
  • Heart failure (left dilated type, right restrictive type)
  • Dysrhythmias (heart block)
  • S1 gallop
  • Cardiomegaly more severe with dilated type
  • Angina (hypertrophic type)
39
Q

HF: Lab tests & proceures

A

Human B-type natriuretic peptides (BNP)
- Less than 100 no heart failure
- 100 to 300 present
- Greater than 300 mild heart failure
- Greater than 600 moderate heart failure
- Greater than 900 severe heart failure

40
Q

HF: Diagnostic Procedures

A
  • Hemodynamic monitoring- monitor CVP between 4-8
  • Ultrasound- checks left ventricular ejection function (volume of blood
    being pumped into arteries from left ventricular
  • Right ventricular ejection fraction volume of blood pumper from right to the lungs upon each beat.
  • Transesophageal Echocardiography (TEE)-checks for clots and cardiac
    structures.
  • Chest x-ray checks for cardiomyopathy and pleural effusions
41
Q

HF: Medications

A
  • Diuretics
  • Afterload-reducing agents’ helps the heart pump easily by altering resistance to
    contraction.
  • Angiotensin-converting enzyme (ACE)- captopril
  • Angiotensin receptor II blockers- losartan
  • Calcium channel blockers – diltiazem
  • Phosphodiesterase-3 inhibitors- milrinone
  • Inotropic agents
  • Beta-adrenergic blockers (beta blockers)
  • Vasodilators
42
Q

Inflammatory Disorders (4 types)

A

Related to the heart can lead to the destruction of healthy tissue.
4 types:
- Pericarditis
- Myocarditis
- Rheumatic endocarditis
- Infective endocarditis

43
Q

Inflammatory Disorders: Risk Factors

A
  • Congenital heart defect/cardiac anomalies
  • IV drug use
  • Heart valve replacement
  • Immunosuppression
  • Rheumatic fever or other infections
  • Malnutrition
  • Overcrowding
  • Lower socioeconomic status
44
Q

Inflammatory Disorders: Pericarditis

A
  • Follows respiratory infection
  • Can be due to an MI
  • Findings include: pericardial friction rub auscultated at the left lower sternal border chest pain
45
Q

Inflammatory Disorders: Myocarditis

A
  • Inflammation of the myocardium.
  • Can be viral, fungus, or bacterial.
  • Findings include: tachycardia, murmur, friction rub, cardiomegaly
46
Q

Inflammatory Disorders: Rheumatic Endocarditis

A
  • Infection of endocardium due to complication of rheumatic fever.
  • Findings include: Causes lesions on the heart, chest pain, joint pain, tachycardia, shortness of breath, rash on trunk and extremities, and muscle spasms.
47
Q

Inflammatory Disorders: Infective Endocarditis

A
  • Infection of endocardium due to streptococci, streptococci, fungi, or other infectious organism
48
Q

Inflammatory Disorders: Tests and Diagnostic Procedures

A
  • Blood cultures and WBC
  • Cardiac Enzymes
  • Elevated ESR and CRP
  • Throat Cultures
  • ECG
  • ECHO
49
Q

Inflammatory Disorders: Nursing Care

A
  • Listen to heart sounds
  • Review ABG’s
  • Administer oxygen
  • Monitor vital signs
  • Monitor ECG
  • Monitor for cardiac tamponade and heart failure
  • Administer antibiotics
  • Administer pain medication
  • Provide emotional support
50
Q

Aneurysms: What are they?

A

It is a bulge in a blood vessel!

They can occur in two forms.
- Saccular – only affecting one side
- Fusiform – involving the complete circumference
- Aortic dissection – occurs accumulation of blood within the artery wall (hematoma) following the tear in the lining of the artery (due to HTN)

51
Q

Types of Aneurysms

A
  • Abdominal aortic aneurysm (AAA)- most common, related to
    atherosclerosis
  • Thoracic aortic aneurysm
  • Aortic dissections
52
Q

Aneurysm: Patient care (nursing care, medications, and therapeutic procedures)

A
  • Nursing care - Vital signs, assess the onset, Oxygen, IV access,
    medications
  • Medications: reduce systolic between 100-120 mm Hg; long-term
    maintain systolic at or less than 130-140.
  • Therapeutic procedures:
    - Abdominal aortic aneurysm resection
    - Percutaneous aneurysm repair
    - Thoracic aortic aneurysm repair

Adult Health II (1 decks)

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