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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
Heart sounds: Diastolic murmur
- 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
Heart sounds: Other Causes of murmurs?
- Fever - Exercise - Pregnancy - Low red blood cell count (anemia) - Overactive thyroid gland - During times of rapid growth in children - ASD, PDA, TOF (infants)
27
Valvular diseases: what is it?
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
Classification of valve problems (2)
- Stenosis - Insufficiency/regurgitation
29
Valvular heart disease (2)
- Congenital - Acquired
30
Diagnostic Procedures for heart structural issues such as murmurs and valve issues
- Chest x-ray - 12-lead ECG - Echocardiogram - Transesophageal Echocardiography (TEE)
31
Medications and procedures for heart structural issues such as murmurs and valve issues
- Diuretics - Afterload-reducing Agents - Inotropic Agents - Anticoagulants - Therapeutic Procedures - Percutaneous balloon valvuloplasty - Valve replacement
32
Client education: Murmurs & Valve issues
- Important of prophylactic antibiotic - Weigh daily - Coordinate activities with rest periods - Encourage cardiac diet - Monitor anything out of the ordinary (fever, worsening symptoms)
33
Heart Failure: 2 types
Congestive HF & Pulmonary Edema
34
Heart Failure
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
Heart Failure: Different Classifications
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
Heart Failure: Assessment
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
HF: Expected Findings for Left & Right sided HF and cardiomyopathy
- 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
HF: manifestations
- 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
HF: Lab tests & proceures
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
HF: Diagnostic Procedures
- 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
HF: Medications
- 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
Inflammatory Disorders (4 types)
Related to the heart can lead to the destruction of healthy tissue. 4 types: - Pericarditis - Myocarditis - Rheumatic endocarditis - Infective endocarditis
43
Inflammatory Disorders: Risk Factors
- Congenital heart defect/cardiac anomalies - IV drug use - Heart valve replacement - Immunosuppression - Rheumatic fever or other infections - Malnutrition - Overcrowding - Lower socioeconomic status
44
Inflammatory Disorders: Pericarditis
- Follows respiratory infection - Can be due to an MI - Findings include: pericardial friction rub auscultated at the left lower sternal border chest pain
45
Inflammatory Disorders: Myocarditis
- Inflammation of the myocardium. - Can be viral, fungus, or bacterial. - Findings include: tachycardia, murmur, friction rub, cardiomegaly
46
Inflammatory Disorders: Rheumatic Endocarditis
- 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
Inflammatory Disorders: Infective Endocarditis
- Infection of endocardium due to streptococci, streptococci, fungi, or other infectious organism
48
Inflammatory Disorders: Tests and Diagnostic Procedures
- Blood cultures and WBC - Cardiac Enzymes - Elevated ESR and CRP - Throat Cultures - ECG - ECHO
49
Inflammatory Disorders: Nursing Care
- 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
Aneurysms: What are they?
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
Types of Aneurysms
- Abdominal aortic aneurysm (AAA)- most common, related to atherosclerosis - Thoracic aortic aneurysm - Aortic dissections
52
Aneurysm: Patient care (nursing care, medications, and therapeutic procedures)
- 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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