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Cardiac part 1

  1. The right side of the heart has _____ flowing through it?
    Deoxygenated blood from the body
  2. The left side of the heart has _____ flowing through it?
    Oxygenated blood from the lungs?
  3. Blood arrives in the heart from the _____&_____
    • Superior vena cava
    • And
    • Inferior vena cava
  4. What is the SMALLEST blood vessel where gas exchange occurs?
    Capillaries
  5. Which blood vessels take blood TO the heart against the flow of gravity?
    Veins
  6. What are the four functions of the heart?
    • 1. Move gases
    • 2.Move nutrients and waste
    • 3.regulate body temp
    • 4. Produces and stores hormones
  7. Where is the tricuspid valve
    Right side of the heart separating the r. atrium and r. ventricle
  8. What does the tricuspid do?
    Prevents backflip from the right ventricle back into the right atrium
  9. Where is the pulmonic valve
    Right side of the heart in the right ventricle leading into the pulmonary arteries
  10. What does the pulmonic valve do?
    Prevents back flow from entering into the right ventricle from the pulmonary arteries
  11. Where is the biscuspid valve
    Light side of the heart separating left atrium and left ventricle
  12. What does the bicuspid do
    Prevents blood from flowing back into the left atria from the left ventricle
  13. Where is the aortic valve
    Left ventricle
  14. What does the aortic valve do
    Allows blood to enter the aorta and prevents back flow into the left ventricle
  15. What causes the normal sounds of the heart
    Closing of the heart valves
  16. What causes the “LUBB” sound
    Closing of the tricuspid and mitral valves
  17. What causes the “DUBB” sound
    Closing of the aortic and pulmonary valves
  18. Where is the apex of the heart
    Tip of the left ventricle

    For auscultation: under the left breast
  19. S1 sound is which part of the LUBB -DUBB/ heart cycle.
    LUBB
  20. The S2 sound is which part of the LUBB-DUBB/ Heart Cycle
    DUBB
  21. Where do you listen for S3 and S4 sounds
    the apex
  22. If you have a difficult time auscultating the heart beat, what can you instruct the pt to do?
    • 1. Lean forward to bring the heart closer to the chest call
    • 2. Lay on left side “ “
  23. S3 is normal in what populations
    • 1. Children
    • 2.young adults
    • 3. Women in third trimester of pregnancy
  24. S3 is a sign of _____ in most adults
    Heart failure
  25. What causes S3?
    Rapid ventricular filling
  26. S3 can be heard if association with what conditions?
    Left sided heart failure

    Fluid volume overload

    Mitral valve regurgitation
  27. When during is heart beat is S3 heard?
    After S2 (DUBB)

    Has eee sound

    Lubb-dubb-eee
  28. When during the heart cycle is S4 heard?
    Before S1

    Sounds like “ten”

    Ten-lubb-dubb
  29. What causes S4
    Slow ventricular filling
  30. S4 occurs in what conditions
    HTN

    CAD

    Pulmonary and Aortic Stenosis

    Hx of MI

    Think older people have heart attacks- older people have S4
  31. What causes Murmurs
    Turbulent blood flow caused by narrowed valve openings or by valves that don’t close tightly
  32. Murmurs only children are caused by
    Congenital septal defects
  33. What are the three pericardial membranes of the pericardial sac
    • 1. Fibrous pericardium
    • 2. Serous parietal pericardium
    • 3. Serous visceral pericardium lining the surface of the heart
  34. What causes a pericardial friction rub
    Inflammation of the pericardium caused by MI or chest trauma
  35. Describe a friction rub
    Grating sound like sandpaper

    Occurring as pericardial surfaces rub together
  36. What are the three layers of the heart wall
    • 1.epicardium
    • 2.myocardium
    • 3.endocardium
  37. What determines the thickness of the heart walls
    The amount of high-pressure work the chamber does
  38. What supplies the heart with it’s own blood?
    • First branches of the ascending aorta:
    • Right and left coronary arteries
  39. What is the bodies largest vein?
    The coronary sinus
  40. Why is the coronary sinus important
    It open directly into the right atrium

    Most major CARDIAC veins empty into it.
  41. Where does the conduction system I’d the heart begin
    • The sinoatrial node (SA)
    • Located in the right atria
  42. What are the components of the conduction system
    • 1. SA node
    • 2.AV node
    • 3. Bundle of HIS/ right and left bundles branches
    • 3 Purkinje fibers
  43. What is sinus rhythm
    Heart rhythm that follows the normal conduction pathway and has 60-100bpm
  44. What is sinus Brady?
    Heart rhythm that follows the normal conduction pathway and has less than 60bpm
  45. What is sinus tachy?
    Heart rhythm that follows the normal conduction pathway and has more than 100 bpm
  46. What is asystole
    • Cardiac standstill
    • No contraction
    • No depolarization
    • No systole
  47. Sa node causes the heart to beat at __bpm
    60-100
  48. Av node causes the heart to beat at ___bpm
    40-60
  49. Bundle of HIS/Purkinje Fibers cause the heart to beat at ___bpm?
    20-40
  50. What other systems can control heart rate in response to the environment?
    • 1. Sympathetic Nervous System (SNS)
    • 2. Parasympathetic Nervous System (PNS)
  51. What does the SNS do?
    • Increases HR, BP, Cardiac Output, and Force of contractions.
    • Caused by epinephrine or adrenaline
  52. What does the PNS do?
    Decreases HR
  53. What’s another name for depolarization?
    Systole
  54. What’s another name for repolarization?
    Diastole
  55. What does cardiac output refer to?
    The amount of blood the heart pumps in ONE minute from the LEFT ventricle.
  56. What’s the average rest HR and cardiac output?
    • Hr= 75bpm
    • Co=5-6 liters per minute
  57. What is the usual ejection fraction?
    60%
  58. Normal potassium level? (K+)
    3.5-5.0
  59. Normal sodium level? Na+
    135-145
  60. Normal calcium level? Ca++
    8.2-10.2
  61. Normal magnesium level? Mag++
    1.5-2.6
  62. Normal BNP?
    <100
  63. Normal ANP?
    20-77
  64. Where is aldosterone released from and what does it do?
    • 1. Adrenal Correx
    • 2. Regulates levels of sodium and potassium
  65. Where is ANP releases and what does it do?
    • 1. Atrial tissue
    • 2. Acts as natural diuretic and antihypertensive in response to ACUTE increase in fluid volume and BP
  66. Where is BNP released from and why?
    • 1. Ventricle tissue
    • 2. Released in response to prolonged fluid volume overload or increased BP

    Think CHRONIC
  67. What do BNP levels help determine?
    They diagnose and grade heart failure severity
  68. What actions occur in the capillaries
    Nutrient and gas exchange

    Filtration of fluid

    Filtration of the plasma
  69. What is the excess fluid from the capillaries called and where does it go?
    Lymph

    Returns to blood via lymph vessels from the lymph capillaries
  70. What causes edema
    Increased pressure in the blood capillaries leading to excess tissue fluid, over loading the lymph vessels
  71. How are arteries built to accommodate the high speed and pressure of blood flow?
    They have very thick muscular walls
  72. Describe the structure and function of arterioles
    Walls are thinner than arteries and they control blood flow (slow it down) so it can pass into the capillaries
  73. Describe the structure and function of the capillaries
    Microscopic walls and have capillary sphincter that causes blood cells to enter in a single file line.

    Gas exchange and fluid filtration
  74. Nursing assessment of a cardiovascular PT include...?
    Health Hx and physical exam
  75. What subjective data would be included in the assessment of a cardiovascular PT?
    Past and current symptoms

    Medications taken

    Drug use

    Current treatment

    Diet/activity

    Tobacco use

    Recent stressors

    Medical Hx

    Family Hx
  76. What objective data would be included in the assessment of a cardiovascular PT?
    • Physical assessment
    • bp
    • Pulses
    • Respirations
    • Inspection
    • Clubbing
    • Palpation
    • Percussion
    • Auscultating
  77. What causes clubbing?
    • Occurs from oxygen deficiency overtime.
    • Caused by congenital heart defects or long term use of tobacco products.
  78. When assessing oxygen status on ANY pt, what do you assess?
    • Nail beds
    • Lips
    • Ear lobes
    • Extremities
  79. What are the factors associated with orthostatic hypotension?
    • HTN
    • Dehydration
    • Pain
    • Pain meds
    • Diuretics
  80. What does decreased arterial blood flow to the extremities cause?
    • Paleness
    • Loss of hair
    • Thick, brittle nails
    • Shinny, taut,dry skin.
  81. How do you assess for Jugular Vein Distention (JVD)?
    Lay patient flat and slowly elevated HOB to 45-90 degrees and watch the jugular vein. Normally this would not cause any bulging of the vein.
  82. How do you accurately measure edema?
    Measure both legs and label all finding left or right.

    • Measure:
    • 2in above the knee
    • 2in below the knee
    • @ the widest part
    • 1in above ankle
    • At in step
    • Then compare
  83. What is included in cardiac enzyme lab work?
    • Creating kinase (ck)
    • Troponin I
    • Ck-mb
    • Myoglobin
  84. Describe troponin I
    Is an indicator of myocardial damage used to diagnose MI

    • levels increase within 4-6 hr
    • Peak @ 10-24hr
    • Remain elevated for 10-14 days (1-2weeks; notes say 7 days)
  85. Describe CK levels
    In found in brain, skeletal, and cardiac muscle

    • Ck-mb levels rise in 4-6 hr after cell damage
    • Peak 12-24 hr
    • Return to normal after 48-72 hr
  86. Describe myoglobin
    Protein in skeletal and cardiac muscle that is released when cell damage occurs and can only provide estimate of damage.

    • Increase within 1 hr of MI
    • Peak 4-12hr
    • Return to norm within 18hr after onset of chest pain
  87. Ck/cpk normal levels
    <150
  88. Troponin I normal levels
    0-0.1
  89. Ck-mb normal levels
    0-5
  90. Myoglobin normal levels
    Male= 10-95

    Female=10-65
  91. Triglyceride normal level
    <150
  92. Cholesterol normal level
    <200
  93. HDL normal level
    > 60
  94. CDL normal level
    <100
Author
Raganfears
ID
350760
Card Set
Cardiac part 1
Description
Updated

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