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NSC 386 > Cardiac Assessment > Flashcards

Cardiac Assessment Flashcards

(60 cards)

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1
Q

3 Layers of the Heart

A

Endocardium - inner
Myocardium - muscle itself
Epicardium - outer layer

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2
Q

Pericardium is

A

Sac around the heart

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3
Q

2 Layers of the Pericardium

A 
Visceral = inner
Parietal = outer
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4
Q

Pericardial fluid purpose

A

Lubricate pericardial space

Prevent friction as the heart contracts

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5
Q

Coronary arteries

A
  1. Left coronary artery

2. Right Coronary artery

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6
Q

2 branches of the LCA and what do they supply

A
  1. Left Anterior Descending (LAD)
  2. Left Circumflex (Main) Artery (LCA)
    Both supply LA, LV, interventricular septum, portion of RV
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7
Q

What does the RCA supply?

A

RA, RV, and part of the wall of LV

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8
Q

What is the widow maker?

A

LCA = 100% blocked

LCA blockage = ischemia to left side of heart = muscle death = no CO = death

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9
Q

Conduction though the heart

A

SA Node -> Atria -> AV Node -> Bundle of His -> Bundle Branches -> Purkinje Fibers (ventricular contraction)

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10
Q

How does cardiac impulse control heart rate?

A

Further down the impulse starts, the slower the heart rate

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11
Q

What is the formula for Cardiac Output (CO)

A

CO = Stroke volume (SV) x Heart Rate (HR)

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12
Q

What is normal cardiac output?

A

4-8 L per minute

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13
Q

Cardiac Index is

A

CO divided by body surface area (BSA)

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14
Q

Normal Cardiac Index (CI) =

A

2.5 - 4 L/min

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15
Q

Factors that affect cardiac output

A

Starling’s law
Preload
Contractility
After load

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16
Q

Starling’s law

A

More the heart fibers are stretched the greater the force of contraction

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17
Q

Preload

A

Volume issue; amount of blood in th ventricles at the end of diastole

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18
Q

Decreased preload can indicate?

A

Dehydration

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19
Q

Increased preload can indicate?

A

Hypertension or Heart failure

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20
Q

Contractility of the heart is

A

How effectively does it contract

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21
Q

Afterload is

A

Pressure/Resistance issue; resistance agains what the left ventricle must pump to the body

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22
Q

Regulation of the cardiovascular system is controlled by

A

Autonomic Nervous System; more importantly the sympathetic nervous system (SNS)

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23
Q

What is the function of the sympathetic nervous system

A

Increase HR and atrial and ventricular contraction

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24
Q

Alpha andrenergic receptors

A

Leads to vasoconstriction

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25
Beta adrenergic receptors
Increase heart rate and contractility
26
What is blood pressure?
Measures force of blood ejected from the heart
27
Formula for BP
BP = CO X SVR (systemic vascular resistance)
28
What is systolic BP
Pressure in the arteries when the heart is beating (depolarization of the ventricles)
29
What is diastolic BP
Pressure in the arteries when heart is at rest (repolarization of ventricles)
30
Average pressure in the arterial system that is felt by organs in the body
Mean Arterial Pressure (MAP); also can be perfusion pressure
31
MAP Formula
MAP = (SBP + 2DBP)/ 3
32
What is the normal range for MAP
60-100 mmHg
33
What is pulse pressure
Difference between SBP & DBP
34
Occurs when tricuspid and mitral valves close
S1
35
Occurs when aortic and pulmonic valves close
S2
36
S3 Heart sound
Ventricular gallop (abnormal)
37
S4 Heart Sound
Atrial Gallop (abnormal)
38
Graded from I - IV and an indication of valvular problems in the heart
Murmurs
39
3 Cardiac Biomarkers (Cardiac Enzymes)
1. CKMB 2. Troponin 3. Myoglobin
40
CKMB (Creatinine Kinase Myocardial Band)
Elevated in 3-6 hours Peaks in 12-14 hours Return to baseline in 12-48 hours
41
Bio marker of choice for MI diagnosis and why?
Troponin; lasts 10-14 days in blood after MI (longer than CKMB)
42
Troponin values
Elevated w/in 4-6 hrs after MI Peaks 10-24 hours Detectable 10-14 days
43
Lipid profile test
Must be fasting | Looking at LDL, HDL, Triglycerides
44
Chest X-ray as a cardiovascular diagnostic tool shows
How big the heart is and if there is fluid in the chest
45
What are the responsibilities of the nurse when pt is ordered for chest x-ray
Ask about pregnancy Remove jewelry Lead shielding
46
ECG Nursing responsibilities
Patient must be still | Proper positioning of leads
47
Holter monitor is used for
24-48 hours as ambulatory ecg monitoring
48
Nursing responsibilities for Holtor monitor
Ask pt to keep diary of activity | No bathing or showering while wearing monitor
49
Nursing responsibilities for Stress testing
Educate patient to wear comfortable shoes; NPO after midnight; watch for chest pain; no caffeine/smoking; may need to hold meds
50
Nursing Responsibilities Echocardiogram
Patient must be on left side
51
Nursing Responsibilities: TEE
NPO 4-6 hours IV Sedation Throat numbed - NPO until return of gag reflex Monitor v/s and SpO2 on every patient that gets sedated q15 for the 1st hour
52
Complications of TEE
Esophageal tear, hemorrhage, hypoxemia, vasovagal reaction (not common but possible)
53
Nuclear Cardiology: Nursing Responsibilities
IV Line | No Radiation precautions (dependent on dose)
54
Cardiac catherization entry locations
Right Side of heart = vein | Left Side of heart= artery
55
Nursing Responsibilities: Cardiac Cath
``` Check allergies (particularly iodine) Renal Function - dye is harsh on kidneys NPO at least 6 hours before IV Sedation - patent; functioning IV Establish baseline v/s; Educate patient - IV dye = warm feeling, catheter placed = fluttering feeling ```
56
Nursing responsibilities s/p cardiac cath
``` Positioning - lay flat Circulation check to extremity Hematoma check ECG, V/S Increase PO fluids to flush dye; Watch for complications ```
57
What are some complications s/p cardiac cath
Bleeding at site; allergic reaction to die; infection; dysrhythmias; stroke; embolism
58
EP Study: Nursing Responsibilities
Same as heart catheterization: V/S, continuous ECG monitoring, watch puncture site, circulation checks
59
Normal BUN values
7-21
60
Normal Creatinine values
0.6-1.2

NSC 386 (11 decks)

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