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The heart is located where?
in the medastinum
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What is the outer most pericardial membrane?
Fibrous
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What is the middle layer of the pericardial membrane?
Parietal
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What is the inner most layer of the pericardial membranes?
Visceral
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What is another name for the visceral pericardium?
Epicardium
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What is the function of the serous fluid between the parietal and visceral membranes?
Prevents friction
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Where is the serous fluid located in the heart?
Between the parietal and visceral membranes
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What are the muscular walls of the chambers of the heart called?
myocardium
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The name for the lining of the chambers of the heart is called?
endocardium
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The function of the myocardium is to ?
pump blood
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The function of the endocardium is to?
Prevent abnormal clotting
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The vein that returns blood from the lower portion of the body to the right atrium is called?
inferior vena cava
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What is the name of the vein that returns blood from the upper portion of the body to the right atrium?
the superior vena cava
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The veins that return blood from the lungs to the left atrium are called?
Pulmonary veins
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The function of ANP (atrial natriuretic peptide) is to?
lower the blood pressure by lowering blood volume
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The left ventricle pumps blood into the ____ which then is pumped to _____?
aorta, body
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The right ventricle pumps blood into the ____ which then goes to the ____?
pulmonary artery, lungs
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The general function of the valves of the heart is to ?
Prevent back flow of blood
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What is the function of the chordae tendonae and papillary muscles?
anchor the flaps of the AV valves
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The right and left AV valves prevent backflow of blood from the?
from the ventricles to the atria when the ventricles contract
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The semilunar valves prevent backflow of blood from the?
arteries to the ventricle when the ventricles relax
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The blood vessels that supply the heart itself are called?
coronary vessels
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For the heart muscle the most important substance in the blood is ?
Oxygen
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Sequence of events in one heart beat?
Cardiac Cycle
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Systole means?
Contraction
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Diastole means?
relaxation
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What is the correct sequence of blood flow?
Right heart to lungs to left heart to body to right heart
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Part of the heart that initiates the heart beat?
SA node
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The parts of the cardiac conduction pathway that brings about contraction of the ventricles are?
bundle of His, bundle branches, and purkinje fibersq
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The amount of blood pumped by the left ventricle in one minute is called?
cardiac output
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The amount of blood pumped by a ventricle in one beat is called?
Stroke volume
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How do you calculate cardiac output?
Stroke volume x HR
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What is the ejection fraction?
percent of blood within a ventricle that is pumped during systole
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The part of the brain that regulates HR is?
Medulla
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The vagus nerves carry impulses from where ___ to _______ (increase or decrease) HR?
the medulla, decrease
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Pressoreceptors are located where?
Carotid and aortic sinuses
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What is the purpose of the pressoreceptors?
The detect changes in blood pressure
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The cardiac accelerator center uses nerves from which nervous system?
Sympathetic
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The cardiac inhibitory center uses nerves from which nerve?
Vagus nerve
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A sensation of pain on the heart is caused by?
Lack of Oxygen
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Chemoreceptors are located where?
Carotid and aortic bodies
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What is the purpose of chemoreceptors?
To detect changes in the blood oxygen level
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When the blood decreases the kidneys kick in to secrete what?
renin
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Antidiuretic hormone is released by what gland?
Posterior pituitary gland
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What does ADH do?
increases water reabsorption by the kidneys thus increases blood pressure
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Weight gain in a patient can signify?
Right sided heart failure
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What happens to the cardio vascular system as a person ages?
- - Conduction is less effective
- - Artherosclerosis
- - Resting BP increases
- - Decreased HR
- - Vein valves are incompetent
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The older adult with cardiovascular problems is at risk for ?
orthostatic hypotension
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True or False: Older adults commonly have s & sx that are not typical of a disorder?
True
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Edema and Jugular vein distention can signify ?
Right sided heart failure
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Crackles and wheezes can signify?
Left sided heart failure
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Measurements that are taken with the patient lying and sitting and standing to detect abnormal variations with postural changes?
Orthostatic hypotension
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True or False: Edema can be palpated in the lower extremities and the sacrum
True
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What is a holter monitor?
A portable ECG that records for up to 48 hours
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What are some things that you should teach a patient who is going to where a holter monitor?
- To keep an accurate diary
- To push the event button if symptoms occur
- Not to take a shower or a bath
- Make sure you return
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What is an Echocardiogram?
it is an ultrasound of the heart
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What to teach the patient who is having a echo done?
There will be no discomfort and that gel will be applied
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What should you monitor on a patient that is going for a thallium imaging?
- Monitor kidney fxn
- and assess for allergies
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What does the CK MB measure?
any damage to heart muscle
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What can a CK MB help to diagnose?
A MI
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Cardiac Triponin measures?
cardiac cell protein
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Which test is most accurate in diagnosing cardiac disease?
Triponin
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Why would you monitor magnesium levels?
Because Mag is necessary to regulate heartbeat and blood pressure
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What can an decreased Mag level cause?
cardiac arrhythmias
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Uses dye injected into the vascular system to visualize the vessels on radiographs
Angiography
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e What is the necessary prep for angiography?
- Consent
- Assess for allergies
- NPO for 4 hours prior
- tell patient that dye might feel hot/burning when injected
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What is the post care for a angiography?
- Monitor vital signs
- monitor the injection site
- monitor pulses
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Catheter inserted into the heart for data on oxygen saturation and chamber pressure
Cardiac Cath
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What is the precare for a cardiac cath?
- Consent
- NPO
- Assess Allergies
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What should you teach the patient that will happen during the cath?
- The table is hard and cold
- The table might move around
- Might have alittle pain as the cath is inserted
- Dye might be used
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What is the post care for Cardiac Cath?
- VS
- Monitor circulation and sensation
- Monitor cath insertion site
- Apply pressure
- Immobilize extremity
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An xray procedure that produces real time images to help guide insertion of the cath into the heart.
Fluroscopy
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Therapeutic Measures for Cardio system?
- Diet -- decrease salt
- Oxygen-- relieve pain
- TEDS/SCDs
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What are two juices that might interact with Coumadin?
Cranberry Juice and Grapefruit juice
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When a patient is going for any cardiac surgery what medications might be with held?
Meds that will increase bleeding or reduce blood volume
such as anticoagulants
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What is considered a normal BP?
- Systolic less than 120
- Diastolic less than 80
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What is stage 1 hypertension parameters?
- 140 - 159 systolic
- 90 - 99 diastolic
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Stage 2 hypertension parameters?
- 160 and above systolic
- 100 and above diastolic
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Blood pressure is determined by?
cardiac output, peripheral vascular resistance, and viscosity
-
Primary hypertension pathophysiolgy
unknown cause
-
Secondary hypertension pathophysiology?
has a known cause usually a sign of another problem
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How is hypertension diagnosed?
Through laboratory test
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Risks that cannot be changed
non-modifiable risks
-
what are some non modifiable risks?
- family hx
- age
- gender
- ethnicity
- diabetes mellitus
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Risks that can be changed
Modifiable risks
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What are some examples of modifiable risks
- blood sugar levels
- activity level
- smoking
- diet
- alcohol intake
- sleep deficiency
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What is one of the most important lifestyle modification ?
Weight reduction
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What can you do with your diet to help lower BP?
- lower/reduce salt intake
- No salt substitutes
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Reduce blood pressure by decreasing blood volume
Diuretics
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Example of a thiazide diuretic?
hydrochlorothiazide (hydroDIURIL)
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Example of a loop diuretic?
Furosemide (Lasix)
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Example of a potassium sparing diuretic?
Spironlactone (aldactone)
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What are the side effects of diuretics, (loop and thiazide)
- hypokalemia
- fatigue
- hypotension
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What is a major side effect of a potassium sparing diuretic?
Hyperkalemia
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What should you teach patients who are taking potassium sparing diuretics to avoid?
potassium rich foods such as oranges, bananas, salt substitutes and dried fruits
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This drug decreases BP by decreasing impulses to the sympathetic nervous system
Beta Blockers
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What is an example of a Beta Blocker
Metoprolol (Lopressor)
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What are some side effects of Beta Blockers
- hypotension
- decreased HR
- fatigue
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This drugs blocks sympathetic nervous system on Alpha1
Alpha 1 blockers
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What is an example of an Alpha1 blocker
Minipress, Prazosin
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What is an example of a combination Alpha1 and beta blockers?
Coreg
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This drug blocks the production of angiotensin 2, and thus aldosterone cannot be produced?
ACE inhibitor
-
What is an example of an ACE inhibitor
Enalapril (Vasotec)
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What are some side effects of ACE inhibitors?
Edema in HF patients and angioedema
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What is an example of a Angiotensin 2 receptor Antagonist?
Losartan (Cozaar)
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What are some side effects of ARB?
Edema in HF patients and angioedema
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This drug blocks Calcium channels/movement which causes vasodilation
Calcium channel blocker
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What is an example of a CCB/
Amlodipine (Norvasc)
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What is a side effect of CCB?
Edema in lower extremities
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