Assessment of cardio
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| 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
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| 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
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| 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
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| 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
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| Systole | consists of the contraction and emptying of the atria and ventricles
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| Cardiac Output | CO=(heart rate)HR x (stroke volume)SV the amount of blood pumped from the LV each minute
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| Stroke Volume | the amount of blood ejected by the left ventricle during each contraction. Variables influence SV-HR, preload, afterload and contractility
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| 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)
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| 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
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| Impedance | : peripheral component of afterload, is the pressure that the heart must overcome to open the aortic valve
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| Myocardial contractility | affects SV and Co and is the force of cardiac contraction independent of preload
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| 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
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| Ejection fraction | is % of blood being pumped- 55-75%
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| 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
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| Chemoreceptors | 1-2mm collections of tissue in the carotid arteries and along the aortic arch. These receptors are sensitive to hypoxemia.
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| 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,
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| 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)
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| At risk for MI | Obesity, smokers, elderly, increased BP, black males, anyone who’s stomach is bigger than their hips
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| cardiovascular assessment | Health perception, Nutrition-metabolic, Elimination, Sleep/rest, Cognitive/perceptual, Role/relationship
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| 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.
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| Troponins | T<0.20, I<0.03. elevations indicate myocardial injury or infarction
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| 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
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| Myoglobin | <90. Elevation indicates myocardial infarction
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| 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.
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| Electrocardiography (ECG) | a routine part of every cardiovascular assessment. Resting ECG provides info about cardiac dysrhythmias, myocardial ischemia and side and extent of MI
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| 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
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| 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.
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| 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
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| 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.
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| 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
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