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Care of Cardiovascular System Disorders

Care of Cardiovascular System Disorders. Unit 2. Cardiovascular System Disorders. Know your terms! A & P Review The four chambers The muscle The arteries The lymph system The conduction system Heart sounds. Cardiovascular System Disorders. Assessments found with altered cardiac output

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Care of Cardiovascular System Disorders

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  1. Care of Cardiovascular System Disorders Unit 2 Med-Surg 2

  2. Cardiovascular System Disorders • Know your terms! • A & P Review • The four chambers • The muscle • The arteries • The lymph system • The conduction system • Heart sounds Med-Surg 2

  3. Cardiovascular System Disorders • Assessments found with altered cardiac output • Dyspnea • Chest pain • Chest palpitations • Edema • Fatigue • Dizziness • Skin color and temperature • Abdominal pain Med-Surg 2

  4. Cardiovascular System Disorders • Coronary Artery Disease (CAD)-any pathologic condition which obstructs the myocardial blood supply • Angina Pectoris-chest pain resulting from insufficient blood flow and oxygenation of the myocardium • Myocardial Infarction (MI)-sudden blockage of coronary artery blood flow to the myocardium, resulting in tissue ischemia and death Med-Surg 2

  5. Cardiovascular System Disorders • Dietary Considerations • Reduction of body weight • Decreased fat and increased fiber • Caffeine • Sodium • Potassium Med-Surg 2

  6. Cardiovascular System Disorders • Medications • Nitroglycerin • Adrenergics-vasopressors • Epinephrine (adrenalin) • Intropin (dopamine) • Isuprel (isoproterenol) • Levophed (norepinephrine) Med-Surg 2

  7. Cardiovascular System Disorders • Heart Failure • Congestive Heart Failure (CHF)-heart ceases to be an effective pump. Many causes. • Pulmonary Edema-excess fluid accumulation in the lung • Cor Pulmonale-right ventricular failure Med-Surg 2

  8. Cardiovascular System Disorders • Inflammatory and Infectious Diseases • Rheumatic Heart Disease-inflammatory disease affecting the tissues of the heart • Endocarditis-infection or inflammation of the endocardium/heart valves • Pericarditis-inflammation of the pericardium Med-Surg 2

  9. Cardiovascular System Disorders • Valvular Diseases and Disorders • Mitral Stenosis-thickening of bicuspid leaflets causing a narrowing of the opening • Mitral Insufficiency-damage to the valve causes insufficient closure and regurgitation • Aortic Stenosis-thickening of the three valve leaflets causing a narrowed opening • Aortic Insufficiency- damage to the valve causes insufficient closure • Tricuspid Stenosis-rare, the valve leaflets thicken and fuse together Med-Surg 2

  10. Cardiovascular System Disorder • Basic Peripheral Assessment • Pain • Skin color and temperature • Pulse • Capillary refill • Trophic changes Med-Surg 2

  11. Cardiovascular System Disorders • Hypertension • Primary hypertension (or essential hypertension)-asymptomatic, no apparent cause • Secondary hypertension-associated with other disease process • Malignant hypertension (accelerated hypertension)-severe, rapid progression Med-Surg 2

  12. Cardiovascular System Disorders • Antihypertensives • Diuretics • Vasodilators • ACE Inhibitors (angiotensin converting enzyme inhibitors) • Calcium Channel Blockers • Beta Blockers Med-Surg 2

  13. Cardiovascular System Disorders • Diseases of the Arteries • Arterial Embolism or Thrombus-mass which inhibits blood flow • Arteriosclerosis-vessels lose elasticity, harden • Atherosclerosis-plaque build-up in arteries • Raynaud’s Disease-arterial spasms and constriction • Buerger’s Disease-arterial inflammation Med-Surg 2

  14. Cardiovascular System Disorders • Medications • Bile Acid Sequestrants • Antihyperlipidemics Med-Surg 2

  15. Cardiovascular System Disorders • Diseases of the Veins • Phlebitis-inflammation of the walls of the veins • Thrombophlebitis-inflammation with clot formation • Varicose Veins-chronic, progressive disease resulting in dilated, tortuous veins Med-Surg 2

  16. Cardiovascular System Disorders • Diseases of the Veins • Stasis Ulcers-vascular insufficiency leading to loss of skin integrity and open sores • Aneurysms(aortic)-blood vessel wall becomes weakened • Lymphangitis-inflammation of lymph vessels Med-Surg 2

  17. Cardiovascular System Disorders • EKG’s • Review of the Conduction System • EKG or ECG-electrical activity of the heart is recorded • Lead placement • Apolarization-baseline, resting state • Depolarization-atria and ventricles contract • Repolarization-process of returning to resting state Med-Surg 2

  18. Cardiovascular System Disorders • Measurements • 1 small block is 1 square mm = 0.04seconds • 1 large block is 5 square mm = 0.20 seconds • It is the same going upwards • 30 big boxes will equal a six second strip • 6 seconds times 10 will give you one minute Med-Surg 2

  19. Cardiovascular System Disorders • The Basic Electrocardiogram- every deflection from baseline is a waveform and has a name • P wave – Atrial contraction (depolarization) • PR interval (0.12-0.20) • QRS complex – Ventricular contraction (depolarization) (0.06-0.12) • ST segment • T wave – Ventricular repolarization • QT interval (0.36-0.44) • One cardiac cycle is the pqrst (0.8) Med-Surg 2

  20. Cardiovascular System Disorders • Basic steps for EKG interpretation • What is the atrial rate? And the ventricular rate? • What is the R-R rhythm? And the P-P rhythm? Are they regular? • Look at the P waves. Are they the same? Is there one for every QRS? • Is the PR interval normal? Is the QRS interval normal? • Look at the T wave. Is the QT interval normal? Med-Surg 2

  21. Cardiovascular System Disorders • Normal Sinus Rhythm 60-100. All other criteria must be met or it is called a Sinus Rhythm. • Atrial Dysrhythmias • Sinus Bradycardia-rate 40-60. (5th page, #6). • Sinus Tachycardia-rate 100-160. (2nd page, #31). Above 160 is called Supraventricular Tachycardia. (3rd page, #30). • Atrial Fibrillation-atrial rate 400-600 and irregular. (3rd page, #34 and 4th page, #4). • Atrial Flutter-similar to Afib, sawtooth in appearance. (4th page, #26). Med-Surg 2

  22. Cardiovascular System Disorders • Junctional Dysrhythmias • The Heart Blocks • 1st degree AV Block-delay through AV node, PR > 0.20. (5th page, #6 again) • 2nd degree AV Block-type I, Wenkebach. PR progressively lengthens. (5th page, #7). • 2nd degree AV Block-type II. P-P constant. Not all P’s are conducted. (6th page, #8). • 3rd degree AV Block or Complete Heart Block. The atria work separately from the ventricles. (6th page, #21). Med-Surg 2

  23. Cardiovascular System Disorders • Ventricular Dysrhythmias • Pacemakers (last page #24, and 38) with demo and h/o • Premature Ventricular Contractions (PVC)-early ventricular ectopic beats. (7th page, #3 and 16) • Ventricular Tachycardia-regular ventricular rhythm of 100-220. (8th page, #17 and 29, 9th page, #18). • Ventricular Fibrillation-rapid,disorganized. No recognizable rate. (9th page, #18 top and bottom). • Torsades De Pointes-rare. (9th page, #37). • Idioventricular or agonal-dying heart. • Antiarrhythmics • DONE! Med-Surg 2

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