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Cardiovascular Flashcards

(91 cards)

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1
Q

Formula for cardiac output

A

stroke volume x heart rate

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2
Q

Systemic vascular resistance (SVR)

A

amount of force exerted on blood (pipeline)

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3
Q

Afterload

A

the pressure/force pushing blood out; squeeze

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4
Q

Preload

A

the volume of blood that fills ventricles, heart is relaxed; stretch

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5
Q

Pathway of blood through heart

A

(DEOXYGENATED) Body tissues - Superior and inferior vena cava - Right atrium - Tricuspid AV valve - Right ventricle - Pulmonary semilunar valve - Pulmonary arteries - Lungs - (OXYGENATED) - Pulmonary veins - Left atrium - Bicuspid/mitral valve - Left ventricle - Aortic semilunar valve - Aorta - Body tissues

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6
Q

Systole (S1, lub)

A

Ventricles contracting

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7
Q

Diastole (S2, dub)

A

Ventricles relaxed, filling with blood

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8
Q

What situations would cause preload to increase?

A

hypervolemia, regurgitation of cardiac valves, heart failure

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9
Q

What situations would cause afterload to increase?

A

hypertension, vasoconstriction (narrowed vessels)

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10
Q

An increase in afterload would cause…

A

increase in cardiac workload

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11
Q

What two factors affect cardiac output?

A

stroke volume and heart rate

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12
Q

What 3 factors affect stroke volume? (Stroke volume is the amount of blood pumped out of ventricle)

A

preload, afterload, contractility

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13
Q

What two factors affect preload?

A

end-systolic volume (fullness) and venous return (how much blood is coming back to body)

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14
Q

What two factors affect afterload?

A

aortic pressure (how wide is the aorta? any blockage?) and total peripheral resistance (vasoconstriction? clogged?)

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15
Q

What three factors affect contractility?

A

end-diastolic volume, sympathetic stimulation, and myocardial oxygen supply (needs oxygen)

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16
Q

What five factors affect heart rate?

A

central nervous system (pons, medulla), autonomic nervous system (increase in SNS, decrease in PNS), neural reflexes, atrial receptors, hormones (epinephrine - fight or flight)

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17
Q

Sustained elevation of arterial blood pressure

A

Hypertension
- primary risk factor for cardiovascular disease
- leading cause of morbidity/mortality

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18
Q

Normal blood pressure

A

systolic less than 120 and diastolic less than 80

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19
Q

What systolic and diastolic numbers represent elevated blood pressure

A

systolic 120-129 and diastolic less than 80

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20
Q

High blood pressure (hypertension stage 1)

A

systolic 130-139 OR diastolic 80-89

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21
Q

High blood pressure (hypertension stage 2)

A

systolic 140 or higher OR diastolic 90 or higher

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22
Q

Hypertensive crisis

A

systolic higher than 180 AND/OR diastolic higher than 120

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23
Q

Non-modifiable risk factors for hypertension

A

age, sex (estrogen protects heart), race (African Americans are at greater risk), family history/genetics

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24
Q

Modifiable risk factors for hypertension

A

diet (watch cholesterol levels), blood lipid levels, tobacco/alcohol consumption, activity/fitness level, weight, blood glucose control

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25
What factors affect blood pressure?
blood volume, cardiac output (HRxSV), total peripheral resistance
26
What five organs of the body does high blood pressure target and damage?
1. Brain (stroke, confusion, headache, convulsion) 2. Retina of eye 3. Heart (heart attack, heart failure) 4. Blood (elevated sugar levels) 5. Kidneys (chronic renal failure)
27
Plaque buildup in arterial walls
Atherosclerosis
28
Risk factors for atherosclerosis
Hypercholesterolemia, elevated LDL, age, family history, biological males, smoking, obesity, diabetes, hypertension
29
Effects of cigarette smoke on cardiovascular system
1. increased sympathetic response (fight or flight, increase HR, increase systolic and diastolic) 2. increase risk for thrombosis (clots); platelet aggregation, platelet adhesiveness, plasma fibrinogen, blood viscosity, decreased clotting time
30
Coronary artery disease (CAD)
fatty deposits that buildup in wall of arteries; most common heart disease
31
Peripheral artery disease (PAD)
narrowing of blood vessels caused by buildup of plaque reduce blood flow to limbs; circulatory problems
32
Risk factors for CAD and PAD
family history, age, smoking, high cholesterol, diabetes, obesity
33
What stage of progression of coronary artery disease would cause a person to have relief of chest pain after ceasing activity and resting?
stable angina
34
What stage of progression of coronary artery disease would cause a person to experience chest pain while sitting?
acute coronary syndrome, can be further split into unstable angina, NSTEMI, STEMI
35
Stable angina
angina pain develops when theres an increase in demand and the vessel is unable to dilate enough to allow adequate blood flow to meet demand - ECG shows normal - troponin levels may reveal heart damage
36
Unstable angina
plaque ruptures and thrombosis forms around ruptured plaque, causing partial occlusion of vessel, pain can occur at rest or progress over period of time - ECG can show normal, inverted T waves, or ST depression - normal troponin levels
37
NSTEMI
plaque ruptured and thrombus formation causes partial occlusion to vessel that results in injury and infarct - ECG shows elevation - related to ST elevation have myocardial infarction
38
STEMI
complete occlusion of blood vessel lumen, results in injury and infarct to myocardium - elevated ECG (elevated ST) - tissue death, impaired activity
39
1. Pain that is sudden onset, crushing, substernal, tight, severe, may radiate to back, neck, jaw, shoulder, arm 2. Dyspnea (difficult breathing) 3. syncope (fainting) 4. nausea/vomiting 5. diaphoresis (excessive sweating) 6. increase HR
Symptoms of myocardial infarction
40
Diagnosing acute myocardial infarction
clinical representation, serial 12-lead ECG's, lab findings (cardiac enzymes)
41
Complications of myocardial infarction
impaired contractility (diminished heart pumping), tissue necrosis (lack of O2), electrical instability (arrhythmias), pericardial inflammation (pericarditis)
42
Inflammation of the pericardium
Pericarditis
43
Inflammation of the pericardium causes...
pain, exudate (buildup of serous fluid) can result in cardiac tamponade which is when exudate compresses the heart, fibrous friction rub
44
Restriction due to pericarditis may result from
serous exudate filling the pericardial cavity, fibrous scar tissue making pericardium stick to heart
45
Consequences of pericardial effusion (fluid in pericardial cavity)
restricts heart expansion (left ventricle cant accept enough blood), decreased cardiac output (right ventricle cant accept enough blood, decreased blood pressure and shock, increase in venous pressure, jugular distension)
46
What are the two valve disorders?
stenosis and regurgitation
47
What valves are open during systole?
semilunar valves, aortic and pulmonary
48
What valves are open during diastole?
AV valves, mitral and tricuspid
49
Which valve disorder causes the narrowing of valves, doesn't open fully, not enough blood passes through
Stenosis
50
Which valve disorder causes blood to leak backwards
regurgitation
51
Where does blood back up into if someone has aortic or mitral stenosis? what would a pt present with?
into lungs; coughing, shortness of breath
52
Mitral valve stenosis signs and symptoms
pulmonary congestion, orthopnea (breathlessness when lying, may ask for more pillows), nocturnal paroxysmal dyspnea (shortness of breath that wakes pt), palpitations, fatigue
53
Aortic valve stenosis signs and symptoms
angina, syncope (fainting), easily tired, dyspnea, peripheral cyanosis (blue in color)
54
Regurgitation can be caused by...
mitral valve prolapse (improper closure), damaged tissue cords, rheumatic fever, endocarditis, heart attack, abnormality of heart muscle, trauma, congenital heart disease
55
Mitral valve regurgitation signs and symptoms
may not develop symptoms for years, pulmonary congestion, dyspnea on exertion (difficult breathing), orthopnea (breathlessness)
56
Aortic valve regurgitation signs and symptoms
exertional dyspnea (running out of air, not being able to breath deep enough), drop in diastolic pressure, widening arterial pulse pressure
57
When do systolic murmurs occur?
during ventricular squeeze - aortic stenosis - mitral regurgitation - pulmonic stenosis - tricuspid regurgitation
58
When do diastolic murmurs occur?
during ventricular filling - aortic regurgitation - mitral stenosis - pulmonic regurgitation - tricuspid stenosis
59
Progressive and often fatal mortality resulting from decreased cardiac output and tissue perfusion and increased fluid retention - peripheral edema, shortness of breath, exercise intolerance
Heart failure
60
How does the body compensate for heart failure, decrease in cardiac output?
cardiac remodeling (dilating ventricles and increasing wall thickness), increased fluid and Na+ retention (increasing BP), activating the SNS (force of heart beat and HR)
61
What are two main consequences of compensation?
Dilation and Hypertrophy
62
Dilation of heart
Enlarges chambers occurs when pressure in left ventricle is elevated, initially an adaptive mechanism, but eventually becomes inadequate and CO decreases
63
Hypertrophy of heart (buildup of muscle wall)
increase in muscle mass and cardiac wall thickness in response to chronic dilation, which results in impaired filling, higher O2 needs, poor coronary artery circulation, risk for ventricular dysrhythmias
64
Diastolic heart failure is an issue with?
filling
65
Systolic heart failure is an issue with?
pumping
66
Based off these characteristics would this pt have systolic or diastolic HF? - normal ejection fraction - concentric remodeling or hypertrophy - elderly - female - S4 heard
Diastolic heart failure
67
Based off these characteristics would this pt have systolic or diastolic HF? - reduced ejection fraction - chamber dilation and eccentric remodeling (big heart) - all ages - often male - S3 heard
Systolic heart failure
68
S3 heart sound "Kentucky"
heard during early diastole, low pitched, suggests poor systolic function/volume overload, occurs when mitral valve opens and blood enters overfilled ventricle
69
S4 heart sound "Tennessee"
heard during late diastole, low pitched, suggests poor diastolic function, occurs from atrial kick squeezing blood into stiff ventricle
70
Where do symptoms manifest for left-sided heart failure?
pulmonary congestion and pressure, failure leads to low organ perfusion and hypoxia since left side of heart supplies body organs
71
Where do symptoms manifest for right-sided heart failure?
venous congestion of body organs, failure occurs bc of increase in pulmonary vascular pressure
72
Clinical manifestations of acute decompensated heart failure
pulmonary edema (alveoli fill with fluid) signs and symptoms: - anxious - pale - clammy and cold skin - severe dyspnea (difficult breathing) - wheezing, coughing - crackles, rhonchi (bubbling) - rapid HR, BP variable
73
What are natriuretic peptides?
natural substances released by the heart
74
What are the two natriuretic peptides?
ANP (atrial natriuretic peptide) secreted from atria and BNP (B-natriuretic peptide) secreted from ventricles (gives good indication that heart is being stretched too much)
75
What do higher levels of natriuretic peptides indicate?
heart is stretched too much and releasing high levels of ANP and BNP
76
Which natriuretic peptide should you monitor to reveal cardiac health?
BNP levels
77
Higher BNP indicates
poor cardiac health (low chance survival)
78
Lower BNP indicates
better cardiac health (levels below 100 pg/mL = no heart failure)
79
Natural pacemaker of heart
SA node
80
Electrical system of the heart consists of
SA node, AV node, Bundle of His, Right and left bundle branches, Purkinje fibers
81
Abnormal conduction and/or formation of cardiac impulses
Arrhythmias
82
Common causes of arrhythmias
abnormal structures, inadequate O2, fluid/electrolyte/pH disturbance, injury, excessive demand
83
What abnormal structures can change rhythm?
Hypertrophy and Dilation
84
Common arrhythmias include
second-degree partial block, atrial fibrillation, ventricular tachycardia, ventricular fibrillation, third-degree block
85
Which arrhythmia can cause blood clots and stroke?
atrial fibrillation
86
Which arrhythmia can cause cardiac arrest, muscle quivering, straight line (asystole)
Ventricular fibrillation
87
Sudden cardiac death usually result from
ventricular dysrhythmias: ventricular tachycardia and ventricular fibrillation, asystole
88
Which term is used to describe the amount of stretch on the myocardium at the end of diastole?
preload
89
The pt reports shortness of breath, tachycardia, productive cough, and orthopnea (breathlessness in resting position). These symptoms are consistent with...
left ventricular failure
90
The pt arrives in the ED with a diagnosis of right-sided heart failure. What clinical manifestations should the nurse expect?
Distended neck veins, pitting edema in the feet and ankles, abdominal ascites (fluid collects in spaces of abdomen)
91
What three conditions would likely lead to diastolic heart failure?
cardiac hypertrophy from long-standing hypertension, cardiac tamponade (space around heart fills with blood or other fluid putting pressure on heart), restrictive cardiomyopathy

Nursing School (9 decks)

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