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Assessment of cardio

Oxygenation needed for cells to live and function properly, when diseases or other problems of the CV system occur, oxygenation and perfusion decrease, often resulting in life-threatening events
Path of blood through the heart superior/inferior vena cava->right atrium->tricuspid->right ventricle->pulmonary valve-> lungs->pulmonary vein->left atrium->bicuspid->left ventricle->aortic valve->aorta->body
Mean arterial pressure (MAP) to maintain adequate blood flow through the arteries MAP must be at least 60mm Hg. A MAP of between 60-70mm Hg is necessary to maintain perfusion of major body organs, such as the kidneys and brain
Diastole normally about 2/3 of the cardiac cycle, consists of relaxation and filling of the atria and ventricles. Heart at rest filling of chambers. Most important
Systole consists of the contraction and emptying of the atria and ventricles
Cardiac Output CO=(heart rate)HR x (stroke volume)SV the amount of blood pumped from the LV each minute
Stroke Volume the amount of blood ejected by the left ventricle during each contraction. Variables influence SV-HR, preload, afterload and contractility
Pre-Load refers to the degree of myocardial fiber stretch at the end of diastole and just before contraction. Determined by the amount of blood returning to the heart from both the venous system (right heart) and the pulmonary system (left heart)
After-load pressure or resistance that the ventricles must overcome to eject blood through the semilunar valve and into the peripheral blood vessels. Resistance is directly related to arterial BP and the diameter of the blood vessels
Impedance : peripheral component of afterload, is the pressure that the heart must overcome to open the aortic valve
Myocardial contractility affects SV and Co and is the force of cardiac contraction independent of preload
Atrial system BP is the force of blood exerted against the vessel walls. BP is determined by the quantity of blood flow or CO, as well as by the resistance in the arterioles
Ejection fraction is % of blood being pumped- 55-75%
Baroreceptors the arch of the aorta and the origin of the internal carotid arteries are stimulated when the arterial walls are stretched by an inc. BP
Chemoreceptors 1-2mm collections of tissue in the carotid arteries and along the aortic arch. These receptors are sensitive to hypoxemia.
cardiovascular with aging SA node lose its rhythm.80% of older adults experience premature ventricular contractions.Hypertension. Orthostatic (postural) and postprandial changes. Changes may include BP dec of 10 mm Hg or more, dizziness and fainting, Nocturia,
Miocardial Infarction SOB, diaphoresis (sweating), CONFUSION, bilateral shoulder pain. mid-back pain. Chest pain radiating to the left arm in men. Abdomen/back pain (women)
At risk for MI Obesity, smokers, elderly, increased BP, black males, anyone who’s stomach is bigger than their hips
cardiovascular assessment Health perception, Nutrition-metabolic, Elimination, Sleep/rest, Cognitive/perceptual, Role/relationship
cardiovascular physical assessment LOC, SOB, appearance. Poor CO and decreased cerebral perfusion may. cool, pale and moist skin. Pallor. anemia. Look for cyanosis, dark-skinned pt is graying. clubbing.
Troponins T<0.20, I<0.03. elevations indicate myocardial injury or infarction
Creatine kinase (CK) female (30-135) male (55-170). Elevations indicate possible brain, myocardial and skeletal muscle necrosis or injury. CK-MD-0%. Elevations occur with myocardial injury or after percutaneous transluminal angioplasty and intracoronary streptokinase infusion
Myoglobin <90. Elevation indicates myocardial infarction
Cardiac catheterization Most definitive and most invasive test in the diagnosis of heart disease. complications:Right side-thrombophlebitis, pulmonary embolism, vagal response. Left side- myocardial infarction, stroke, arterial bleeding or thromboembolism, dysrhythmias.
Electrocardiography (ECG) a routine part of every cardiovascular assessment. Resting ECG provides info about cardiac dysrhythmias, myocardial ischemia and side and extent of MI
Electrophysiologic study (EPS) invasive procedure during which programmed electrical stimulation of the heart is used to cause and evaluate lethal dysrhythmias and conduction abnormalities. Have risks similar to catheterization
Exercise electrocardiography (stress test) assesses cardiovascular response to an increased workload. The stress test helps determine the functional capacity of the heart and screens for asymptomatic coronary artery disease.
Enchocardiography noninvasive, risk-free test, echocardiography is easily performed at the bedside or on an ambulatory care basis. Uses ultrasound waves to assess cardiac structure and mobility, particularly of the valves
Myocardial nuclear perfusion imaging cardiovascular abnormalities can be viewed, recorded and evaluated using radioactive tracer substances. The test is non-invasive; the small amount of radiation exposure is minimal.
Hemodynamic monitoring Invasive system used in critical care areas to provide quantitative information about vascular capacity, blood volume, pump effectiveness and tissue perfusion. Involves significant risks but complications are uncommon
Created by: smarti13