Term
| Trace a drop of blood through the heart: |
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Definition
| right atrium- tricuspid valve- right ventricle- pulmonary valve- pulmonary artery- lungs- pulmonary veins- left atrium-bicuspid valve- left ventricle- aortic valve to the body |
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Term
| Electrical conduction pathway: |
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Definition
| SA-AV-bundle of his- left and right bundles- purkinje fibers |
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Term
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Definition
| % of blood in diastole that is ejected during systolic |
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Term
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Definition
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Term
| A normal cardiac output is ____L/min |
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Definition
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Term
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Definition
| tension that exists at end of diastole |
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Term
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Definition
| the force the ventricles must overcome to eject their volume |
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Term
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Definition
| ability to contract and relax (innate) |
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Term
| most heart medicines which slow or speed up the heart require us monitoring which electrolytes? |
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Definition
Potassium, Magnesium, and Sodium.
(Mostly Potassium!!) |
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Term
| A normal Cardiac Output is: |
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Definition
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Term
| The cardiac output associated with heart failure is: |
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Definition
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Term
| A cardiac output requiring a heart transplant is: |
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Definition
|
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Term
| characteristics of normal heart function: |
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Definition
rate
BP
Skin temp
skin color
cognition (worst finding) |
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Term
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Definition
chest pain (especially with exercise)
commonly associated with ischemia |
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Term
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Definition
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Term
| Factors affecting normal heart function: (6) |
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Definition
age
activity and exercise
gender
body position
coping and stress tolerance
lifestyle and habits |
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Term
| Heart failure symptoms in men: |
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Definition
nausea
sweating
SOB
chest pain |
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Term
| Heart failure symptoms in women: |
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Definition
feel like they have the flu
tired
SOB |
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Term
| types of altered heart function: |
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Definition
conduction
structural (valve)
myocardial perfusion (arteriosclerosis)
overworked
infammation |
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Term
|
Definition
disrhythmias
(electrical: atrial, ventricular, block rhythms)
atria and ventricles are not always synchronized |
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Term
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Definition
most common arrhythmia
lost synchrony (atria can fire up to 300x/min)
lose up to 40% of C.O.
clots can form from stasis of blood in atrea
benign or life threatening
treatment- keep HR slow and blood thin |
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Term
| Treatments for electrical problems with the heart: |
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Definition
careful monitoring
electrophysiology studies
drugs
countershock
pacemaker-permanent or temporary
automatic implantable cardioverter-defibullator |
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Term
| What is the difference between a pacemaker and a defibrillator? |
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Definition
All defibrillators are pacemakers.
NOT all pacemakers are defibrillators. |
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Term
myocardial perfusion abnormalities: muscle damage
(causes and risk factors) |
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Definition
Coronary artery disease
characterized by atheromas or plaques
Non-modifiable: gender age race genetics
Modifiable: weight HTN diabetes hyperlipidemia
Lifestyle: smoking nicotine (causes arterial constriction and limits perfusion) |
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Term
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Definition
angina pectoris- heart muscle becomes ischemic and subsides
obstruction of coronary vessels (muscle death necrosis and scarring)
Treatment- MONA |
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Term
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Definition
how we begin care of an MI
M-morphine
O-oxygen
N-Nitroglycerine
A-Aspirin |
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Term
| Perfusion: Atherosclerosis |
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Definition
progressive disease (plaque/atheromas)
Theory- beings with a clot on arterial wall (injury)
Eccentric or concentric |
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Term
| Risk factors for Atherosclerosis |
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Definition
diet
elevated cholesterol
smoking
HTN- elevates process |
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Term
| molecules that signal that a heart attack has occured: |
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Definition
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Term
| Valvular dysfunction interferes with: |
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Definition
| blood flow through the heart |
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Term
| Valvular dysfunction can be: |
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Definition
1. Regurgitation: back flow of blood floppy valves
2. Stenosis: valve leaflets fuse harden valves-unable to open and close fully |
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Term
| Inflammation: Endocarditis |
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Definition
effects valves
ususally an underlying cardiac disesse
IV drug abuse
Valvular prosthesis
Si/sx: Murmor cough sob malaise |
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Term
| how to document a prosthetic heart valve sound: |
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Definition
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Term
| inflammation: Pericarditis |
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Definition
causes: virus, fungi syphilis, parasites
Non-infectious: myocardial injury, drugs, post-cardiac injury
si/sx: low grade fever, friction rub
Complications:pericardial effusion (fluid in sac), cardiac tamponade (failure to pump), pulsus pardadoxus |
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Term
|
Definition
causes: MI, Left ventricular damage, cardiomyopathy, valve disorder, and inflammatory conditions
Leading causes: HTN and coronary artery disease |
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Term
| Compensatory mechanisms of heart failure |
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Definition
1.Frank-Staling Mechanism
2.Neuroendocrine response
3.Myocardial hypertrophy |
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Term
|
Definition
| greater the stretch of the muscle, the greater the force of contraction will be |
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Term
|
Definition
| renin-angiotensin mechanism retains water |
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Term
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Definition
| ventricles dilate as heart gets larger |
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Term
| What is the most common cause of hospitalization of people >65 |
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Definition
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Term
| What are the 2 types of heart failure? |
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Definition
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Term
| Symptoms of heart failure: |
|
Definition
paroxysmal nocturnal dyspnea: SOB when laying down
orthopnea- can only breath in an upright position
DOE: dypsnea on exertion
decreased exercise tolerance
fatigue/weakness
dry hacking cough (especially when laying flat)
abdominal discomfort
unexplained confusion in late stage |
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Term
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Definition
elevated jugular venous pressure (distention)
positive hepatojugular reflux (backup into liver)
pulmonary rales- fluid in lungs
peripheral edema: legas and feet mostly |
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Term
| what are the 4 categories of heart failure? |
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Definition
class 1: no problem with activity
class 2: DOE (some sob)
class 3: More DOE and symptoms (cant do tasks as well)
class 4: SOB without any exertion |
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Term
| Review of A&P of the heart |
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Definition
Moves blood throughout the body, removing wastes and nourishing cells
Deficits affect all tissues
Changes in rate, output, or rhythm affect all human functions |
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Term
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Definition
Chronic Stable Angina - occurs over prolonged period; episodic; triggered by exertion, emotion; relieved with rest, NTG
Acute Coronary Syndrome
Unstable-at rest; pain refractory to NTG
Myocardial Infarction
Coronary Vasospasm (Printzmetal’s Angina) – occurs at rest; may occur with CAD or in absence of CAD. |
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Term
| Evaluating chest pain (angina) |
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Definition
Assessing symptoms (N&V; fatigue; SOB)
Precipitating Factors (4Es + 3S)
Quality (crushing; tightness; squeezing)
Radiating, Region, Risk Factors
Severity (1-10 scale)
Timing |
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Term
| Medicines given for M.I.'s |
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Definition
Heparin, Beta-blockers, Clopidogrel, IV Antiplatelets ,Fibrinolytics
(along with MONA) |
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Term
|
Definition
Cardiac dysrhythmias – 80% of pts.
Heart Failure – pumping has diminished; dyspnea, restlessness, pulmonary congestion on Chest X-Ray
Cardiogenic Shock
Papillary Muscle Dysfunction
Ventricular Aneurysym
Pericarditis (Dressler’s Syndrome) |
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Term
| Coronary Angiography and Revascularization |
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Definition
Cardiac catheterization
visualize CAs- locate area and extent of stenosis; presence of collateral arteries
** use of dye, check for allergy to iodine or shellfish
Percutaneous Coronary Intervention (PCI)
Coronary Bypass Surgery (CABG)
Intravascular ultrasound (IVUS) |
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Term
| Nursing diagnoses for CAD |
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Definition
Acute Pain (Chest Pain/Angina)
Ineffective Tissue Perfusion
Anxiety
Activity Intolerance
Ineffective Therapeutic Regimen Management
Knowledge Deficit: Disease process, Compliance |
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Term
|
Definition
clinical syndrome,
impaired cardiac pumping |
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Term
|
Definition
HTN
CAD- Ischemia and infarction
(others include: cardiomyopathy, myocarditis, hyperthyroidism, ) |
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Term
| precipitating causes of heart failure |
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Definition
| anemia, infection, thyrotoxicosis, hypothyroidism, dysrhythmia, bacterial endocarditis, nutritional deficit, hypervolemia |
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Term
| 3 types of Cardiomyopathy |
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Definition
1. Dilated (stretched rubber band)
2. Hypertrophy (muscle gets larger)
3. Restrictive (stiff) |
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Term
| Counter-regulatory mechanisms |
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Definition
The body tries to maintain balance; heart produces hormones (ANP & BNP) that causes vasodilation to reduce after load and preload.
a. BNP- (b-type) natriuretic peptide-increases in HF patient. Release when pressure increases in left ventricle.
b. ANP- atrial natriuretic peptide; in atria and ventricles
c. cardiac compensation -occurs when compensatory mechanisms keep cardiac output (CO) up enough to maintain tissue perfusion.
Decompensation-mechanisms fail to maintain enough CO for tissue perfusion. |
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Term
|
Definition
LV can't pump blood out
LV hypertrophy
DECREASED EJECTION FRACTION |
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Term
|
Definition
Stiff left ventricle
normal heart size
inability to fill
more common in women
concentric hypertrophy
common cause HYPERTENTION! |
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Term
| Therapy for Heart Failure |
|
Definition
Nitrates, Morphine, Nipride, Beta Blockers
ACE inhibitors/ARB
Diuretic therapy
Digitalis therapy
Monitoring therapy
Anticoagulation therapy
Exercise rehab |
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Term
| Assess Heart failure with: |
|
Definition
F- fatigued easily with usual activity?
A- altered activity?
C- comfortable walking flight?
E- edema?
S- sob? |
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Term
|
Definition
Recognize and identify HF
Decrease cardiac workload
Improve/maintain cardiac output
Monitor the response to therapy
Slow progression of disease
Client teaching |
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Term
| Nursing care may/will include: (HF) |
|
Definition
Monitor EKG
Assess level of consciousness
Monitor vital signs
Serum electrolyte levels
Administer medications
Defibrillator operation
Strict intake and output
Monitor respiratory status
Oxygen therapy
Rest/Activity
Anxiety
Daily weights
Teaching/discharge |
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Term
| Nursing Diagnosis for Heart failure? |
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Definition
Cardiac output
Altered tissue perfusion
Pain
Activity intolerance
Anxiety
Knowledge deficit
Fluid volume excess or deficit |
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