Cardiovascular Nursing part 2 Flashcards by MANILAB12 CALANOG HERSHE ANNE M.

Atrioventricular valves close

S1 (LUB)

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Semilunar valves close

S2 (DUB)

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Rapid ventricular filling / ventricular gallop

S3 (LUB-DUB-DUB)

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atrial systole / atrial gallop

S4 (LUB-LUB-DUB)

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4th ICS Left Parasternal

Tricuspid Valve

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2nd ICS Right Parasternal

Aortic Valve

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5th ICS Left Midclavicular line
- point of maximal impulse (PMI)

Mitral (Apex) Valve

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2nd ICS Left Parasternal

Pulmonic Valve

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inability of valves to close completely

Valvular Insufficiency / Valvular Regurgitation

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ballooning of valve, with systolic click

Mitral Valve Prolapse

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inability of the valves to open completely; asymptomatic (bc heart can compensate)

Valvular Stenosis

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complication of Mitral Valve Prolapse

mitral regurgitation
dysrhythmia

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visceral part of heart

epicardium

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layers of heart

endocardium
myocardium
epicardium
pericardium

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inflammation of pericardium

pericarditis

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Most COMMON cause of Myocarditis

VIRAL disease

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Most important symptom of Pericarditis

(+) Chest pain

worsens with deep inspiration, lying down or turning
relieved by sitting and leaning forward (orthopneic)

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leathery, scratching, creaky sound heard best at the END OF EXPIRATION

Friction Rub

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most common sign of pericarditis

Friction Rub

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where to auscultate friction rub in pericarditis?

4th ICS Left Parasternal (Tricuspid Valve)

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BQ concept:
Which is more definitive MRI or biopsy?
- Biopsy bc more accurate if one can see

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heart is compressed due to swelling

Constrictive Pericarditis

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2 Complications of Pericarditis

Pericardial effusion
Cardiac Tamponade

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Cardiac Tamponade:
Beck’s Triad

-hypotension
-distended neck veins / JVD
-muffled (distant) heart sounds

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(+) Beck Triad management

Call the doctor! to do pericardiocentesis

aspiration of fluid from the pericardium, performed by the physician and assisted by a nurse

Pericardiocentesis

procedure that allows the doctor for proper placement of needle before pericardiocentesis to avoid puncturing of heart

Chest X-Ray

nursing action in pericardiocentesis

connect patient to ECG and it must be normal abnormal: possible punctured

inflammation of the endocardium

endocarditis

etiology of Infective Endocarditis

Bacteria (GABHS)

Signs of Systemic Inflammation

-intermittent fever -night sweats -fatigue -weakness - malaise

S/sx of Embolization: -painful nodules on fingers, pads, and toes

-Osler's nodes

S/sx of Embolization: -white centered retina hemorrhages

-Roth's spots

S/sx of Embolization -bleeding under nails

- Splinter Hemorrhages

S/sx of Embolization: -painless macules on palms and nodes

- Janeway Lesions

Endocarditis: FROM JANE

Fever Roth Spots Osler nodes Murmur Janeway Lesions Anemia Nailbed hemorrhage Emboli

Prevention/ Prophylactic Medication for Endocarditis

Antibiotic (Penicillin) if (+) allergy: Erythromycin / Amoxicillin/ Azithromycin

disease of heart muscle associated with cardiac dysfunction

Cardiomyopathy

most common significant dilation (nabanat) without hypertrophy and systolic dysfunction

Dilated Cardiomyopathy

Diffused Necrosis (Dilated Cardiomyopathy)

1. alcohol 2. viral infection 3. Pregnancy

autosomal dominant disorder, interventricular septum thickens ; may have sudden death Parent (+): 50% child to acquire

Hypertrophic Cardiomyopathy

least common cardiomyopathy, caused by rigid ventricular walls; may lead to sudden death

Restrictive Cardiomyopathy

infiltration of fibrous and adipose tissue from Right ventricle until entire heart is affected

Arrythmogenic Right Ventricular Cardiomyopathy

what to assess for cardiomyopathy?

Family History!

diagnostic test for cardiomyopathy

2DEcho

only surgery and cure for cardiomyopathy

Heart Transplant -Ventricular Assistive Device (VAD) assist heart fx, if no HT yet

Average BP

110/70

<120 / <80

Normal BP

AHA: 120-129 / <80

Elevated

<120-139 / 80-89

Prehypertension

140-159 / 90-99 AHA: 130-139 / 80-89

Stage 1 HPN

≥ 160 / ≥ 100 AHA: >140 / >90

Stage 2 HPN

Hypertension is a disease - idiopathic

Primary Hypertension

Hypertension is a SIGN of a disease (e.g. DM, Renal Dse, pheochromocytoma)

Secondary Hypertension

most important risk factor of HPN

Familial History

silent killer disease (asymptomatic)

Hypertension

Diet for HPN

low salt low fat, low sugar

Nursing Actual/Risk Diagnosis for HPN

Acute Pain related to -headache Disturbed sensory/visual perception - blurred vision Risk for fall/injury -dizziness Risk for aspiration - epistaxis Risk for ineffective airway clearance (Asymptomatic) Knowledge Deficit Ineffective Health Maintenance Non-compliance

Exercise for HPN

3x a week 30 mins per day

tumor in the adrenal gland (medulla) ↑epinephrine/adrenaline ↑norepinephrine/noradrenaline leading to ↑SNS

Pheochromocytoma

↑HR Bronchodilation Pupil dilation Vasoconstriction ↓Digestion Urinary retention

Sympathetic Nervous System

↓HR Bronchoconstriction Pupil constriction Vasodilation ↑Digestion Bladder Emptying

Parasympathetic Nervous System

Nervous System (+) acetylcholine (+) epinephrine

Sympathetic Nervous System

Nervous System (+) acetylcholine

Parasympathetic Nervous System

No Pulse Irregular, No P Wave, No QRS

Ventricular Fibrillation

No Pulse Regular, No P Wave, No QRS

Ventricular Tachycardia

Irregular, No P Wave, Wide QRS

Torsade de Pointes (Type of Ventricular Tachycardia) -No Pulse & Premature Ventricular Contraction -w/ pulse

Rate: Very fast (150-250bpm) Regular, P Wave Hidden, Normal QRS

Supraventricular Tachycardia

Regular or Irregular, P Wave, ST Elevated

STEMI (ST Elevation Myocardial Infarction)

Erratic waves, QRS normally narrow but not always Irregular, No P Wave, Normal QRS

Atrial Fibrillation

"Sawtooth" Pattern Regular or Irregular, No P Wave, Normal QRS

Atrial Flutter

Rate: Fast (>100bpm) Regular, P Wave, Normal QRS

Sinus Tachycardia

Rate: Slow (<60bpm) Regular, P Wave, Normal QRS

Sinus Bradycardia

Rate: Normal (60-100bpm) Regular, P Wave, Normal QRS

Normal Sinus Rhythm

Shockable Rhythms

-Ventricular Fibrillation -Ventricular Tachycardia -Torsade de Pointes (Type of VTach)

Atrial Depolarization

P wave

Ventricular Depolarization

QRS Complex: 0.04 - 0.1 second

-time it takes an impulse to travel from the atria through AV node, BoH, and to the Purkinje fibers -AV Depolarization

PR Interval: 0.12 - 0.20 second

early ventricular repolarization

ST Segment

ventricular repolarization and ventricular diastole

T Wave

ventricular refractory time or the total time required for ventricular depolarization and repolarization

QT interval: 0.32 - 0.40 second

each small square in ECG strip represents

0.04 second

each large square in ECG strip represents

0.20 second

Cardiovascular Nursing part 2 Flashcards

Conduction system, Valvular diseases, Pericarditis, Endocarditis, Cardiomyopathy, Hypertension, SNS vs PNS, ECG (83 cards)