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NFH 372 Study Guide - Coronary Artery Bypass Surgery, Holter Monitor, Train Event Recorder


Department
Nursing (Family)
Course Code
NFH 372
Professor
All

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Caring for the Patient with Acute Cardiovascular Disorders
Chapter 35
Patients are treated with their specific dysrhythmias
o A patient that is unstable with a fast a fib they will be treated 911 unlike someone who has a fib that is
tolerating it
o Sinus bradycardia is okay in some peoplefor example athleteshowever elderly patients cannot tolerate a
heart rate less than 60
o Tachycardia treat with calcium channel blockers, digoxin, beta blockers but these meds can cause a brady
heart
Assessment of the Cardiovascular System…A QUICK Review!
Blood Flow Through the Heart
Unoxygenated blood comes from through the superior and inferior vena cava to right atria
o Right sided heart failure: backs up into the tissues and the hepatic portal system
Left sided heart failure we get pulmonary edema
o Fluid in the vascular beds of the pleural space
Blood Supply to the Myocardium
Blood flow to the myocardium occurs primarily during diastole when coronary vascular resistance is minimized
Mean Arterial Pressure must be maintained at least 60 mm Hg to maintain adequate blood flow through the arteries
Must be between 60 and 70 to supply the major body organs
We need to worry about the heart perfusing itselfif notMI occurs
Right Circumflex
Left anterior Decending
Two really big arteries that if these went out it knocks out blood flow to the rest of the heart
“small MI” means an MI that doesn’t occur at a place that supplies the heart very much
Can live through a few small MI’s
Matters where the MI occurs
Atrial infarction: atrial dysrhtymias
Remember electrical occurs before mechanical

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Electrocardiogram: a flash in time from 12 different places in the heart since we use 12 leads
Can pin point where the infarction has occurred
Always done to help diagnose MI
Mechanical System
CO = SV X HR
Cardiac output: amt of blood that is being pumped out of the left ventricle in one minute
o Average: 5-6L
Stroke volume: the amount that is pushed out of the LV in one contraction
Heart Rate: how many times the heart contracts in a minute
If CO goes up, SV and HR go up vice versa
What are some conditions that may affect SV?
Preload
o Hypovolemia affects it b/c it is the amount of volume you have available
Afterload: the amount of work the heart has to do
o Blood pressure affects thishigh BP higher Afterload

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o High BP low SV
Contractility: how good the muscle is bad muscle bad contractility
Structures and Functions of the Cardiovascular System
o Heart: each beat supplies 5 L/min
o Right Atrium: receives deoxygenated blood venous blood from the body through the superior and inferior vena cava
and delivers blood to lungs
Tricuspid valve: AV valve that separates RA from RV
Pulmonic valve: semilunar valve separates right ventricle from the pulmonary artery
o Left Atrium: re-oxygenated blood flows through the four pulmonary veins into LA and supplies the body with blood
Mitral valve: AV valve that separates LA from LV
Aortic valve: semilunar valve separates left ventricle from the aorta
Blood pressure
o Measurement of arterial blood pressure
BP = CO X SVR
Goes up when the other goes up
o Pulse pressure
SBP DBP
The pressure in which the pulse can break through
Needs to be at least 30there needs to be a range between the two
BP: 120/80 so PP: 40
o Mean arterial pressure
(SBP + 2 DBP) / 3
If it is less than 60 you are not perfusing the organs (brain, kidneys, etc)
Med cal question
Relationship of Electrocardiogram, Cardiac Cycle, and Heart Sounds
S1: marks the beginning of systole “contraction
o AV valves must close for the blood to get out so there is no “regurgitation
o You want the aortic and pulmonic valves to open
Diagnostic Studies of the Cardiovascular System
o Lab Values
CK: elevation indicates possible brain, myocardial, and skeletal muscle necrosis or injury
CK MM: elevation occurs with muscle injury
CK MB: elevations occur with myocardial injury or after percutaneous transluminal angioplasty and
intracoronary streptokinase infusion
CK BB: occurs with brain tissue injury
Total lipids: elevation indicates increased risk of CAD
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