y2poe liskanray Nursing Care of Clients ‘With Alterations in CARDIAC FUNCTION Pegay Kearney RN, MSN. Structures and Functions of the Cardiovascular System we forte pulmonic. yoitral tricuspid Review of Cardiovascular System Structure & Funetion of the Cardiovaseular System. -—_ = yy Ter pes Cesaht funps Stfmn op blood Y to @ Pfbeat can da” ‘het phys actvity Peer Blood Flow thru the Heart + Blood Flow Right atom 1 Bara ystemicCrelatonReview A*P 1/16/2013 ) electrical Sysien Surface Anatomy of the Heart Structures and Functions of the Cardiovascular System TessbeAce 1s Mon mie wag aqieeg Wood ew Ours proce, Lay tiaiieke en tases bor MAP 6O-7ommig to main tu? pethusre, + Coronary Circulation {ett ian Coronary Arteries apply tothe RS urn Blood Supply tothe HAS. 8 Myocardium = “ery Right Coronary Artery + ROA Lett Coronary Artery (Left Main artery) * Let Anterior Sescending suo (blk dage + Len creumtenanry BV ocks oh neds ste Phy Bfeetyie pstention that Leaps eltcholyte lealance dependent Funetion: Conduction System Events of the Cardiac Cycle ig 35-4. KY )lt@r balance cgravacmodk Places > C&t pump Contrnuhan > ca vel ed in Wire tele umped ovt Cystole) “Alesis 2V pormal He > 60-100 bpra 1/16/2013 o> ‘The Impulse Function: Mechanical System + Depelarzaton ——=> Mecherical Activy co=HRx SV ear gates Beigel sires veces conracemiate 1a CHEE aw fom tne rt ets the yeni teria \, Be erwmaeae OF, Specie astm nmin Factors Affecting CO Hart Rate (HR) & Stroke Volume (SV) + HR; Extringeally regulated by Autonomic Nervous an aR eh «+ Pyeload: Volume of blood inthe ventricles atthe end Of insole, before the mext contraction + Afterload; The peripheral resistance against which the Re eae cake pap . + Myocardial Contractility: The ability ofthe prdine doc pes or coateact at 2 given fiber length Endependest of Preloed oe Cardiac Reserve ‘The abllty to respond to situations affecting HEALTH & ILLNESS: by altering CO threefold or fourfold f CARDIAC RESERVE Prwodar TAK Purr taster, pulp hard Vascular System + Purposes: "Provides route for blood to travel frm Heart to Bey + Corres cau waste + Meine ont rn tsue baci + Reruns boos to the Hear for Recreation + Divided into Arterial & Venous systems Arterial System + copies Eis Coronas) civeulection 2 fe gt (3:9) @ arenes Pe x Pervphgrial uasetlar sys Cody TES bain hearHatack Bom cononony Cirmlahen not (33) arf failure Pelad-tnprclond Ja Herloed im inside heat= (MSS ans Ls I Kidmy TL Extent systems a t ANS § Cxcitesor inhiouls SNS 1/16/2013 Blood Pressure + Measure the pressure exerted by blood against the walls of the arterial system "systole Diastolic + BP = Cardiac Output (Ci Be) Regulation of the CV System + Beroreceptors Oates resnre win heer 2D arcf the Aertacndat he On the iced std + Ee ees htt acinetr ae iia cop ok + Chemereceptors Secheonad Yaw MRA voscelar sy s%m Cardiac Cobh v/ Argroploddy — portal Cardiac Catheterization Stent Procedure (Wither Wit aronayAngognty) ae + Purpose "Obtain Information Sea 1 Congenital Hear Disease ‘Valvular Disease YVetrieular function + Itracerioe Pressures {Obtain oz eves "Measure CO meen eee iO" For bleealing outs Cormnany Syrdvorre é Cotheber — forking ot beg Cptzer Bat) atfherectorny — PAD (mother) = als ruuro checks : ce ee es eee a ae1/16/2013 Diagnostic Studies of the Cardiovascular System Diagnostic Studies of the Cardiovascular System Tet tg: dransesiphage (through thnand, jpace (ogram Diagnostic Studies of the Cardiovascular System Re / er 14! Ah eset Coronary Artery Disease (CAD) + Atheroscleratic Blood Vessel Disorder *nargening Of The Arteries” “alss termed neo + Broad term that includes: Chron stable ‘angina + peut coronary Synaromes Could hove 4rese does 9p, oouke MI ain ZO trl longer / ( OF reot 3 mo S min Gpart —n6 rescive endartre Coniorilta + angina of eaerton tral-gees a + Deposits OF Cholesterol & Lipids Plague evelops Over Years sages OF Development Paty Streak 1 Rese rou Pague Etiology of cAD + Unmodifiable Risk Factors: + Etiety 1 Footy & Maret + Modifiable Ri waditable Ri st Fry tnectivty inPlammatery marker terol make nds te: Tike nn drug at night)1/16/2013 Decreasing Risk Factors ‘Health Promotion (www.healthynsepie.cov) thy People 2220 cAD + Angina Pectoris: “Chest Pain” Clinical Manifestations of see sch gai Clete na -rienerat ot Grae Cans Fy rescvethtosdorit a V4 rineal equeseonTn Schools Rested wine teed + Nutrition Ay ate set yest bfetyleChonges LC et) « acute Coronary Syndrome TIRES Th, oecion vation aod unease Arana Tea sousedsine/eolertee) Wine Etiology of Clinical pate Diagnosis of MI Manifestations of CAD 8) «/ST-elevation ME (STEMI), 6 5) fo soe + Supply & Demand Myocardial Oxygen Needs > Supply to the Heart 4 soc same "Ro See ACT mo ns ional manfestaion 2054 «+ Non-ST-elevation MI (NSTEMI) “common inwonen Ne Gs CLice + Unstable Angina ~ Aerator wth exertion + Severe activity tmtations 75% parrovng, Catheter toon Maly Surgeon, EKG Changes Associated with MI fe WAN Fane lvepgon erehon anermna wan NIN alone Q wwe Sse handour wean a epig asin 5 bedigix, Aap oF yor pores! ors,collateral Urakahen duvclogaunt in older peeps, Young pespl mag 1/16/2013 & not hawt Yel hous Por entire ae oF Veert becomes rucrohc Youtiae: whol hoppers ducing & heat attack. Myocardial Infarction On) Response to MI + ML occurs when myocardial tissue is deprived of oxygen + Extent of the Zones of Infarction Injury Depends On: * Colatera relation 1 Anaerobic metabolism {Work oad demands onthe Myocardium + May Involve: Transmurel Ho (Eve Myocardial Thickness voted + Obvious physical changes to the heart 6 hours after MI sues swolen 48 hours “Gaya yelow scenked O days: ‘eanulaton tissue +23 months, + Gear tazue that permanently changes the size 8 Prape of he verices ~. Rlahbielaraemoceing® NSeeuaues uncon een dermis “of Mb mown +é Bais fe bie? ae ss” Patient-Centered Collaborative Care + Assessment to Ny fave to matt symptomatic + RagidAseseenc of Cen anf {Ti signe—tarp elevation for sever Reick mont syste rss her aur « iastere sie el ost, + Chart 40-3 Emergency Care of Pt with Chest Clinical Manifestations of MI PAIN PAttaleved wines, oon change, oF stes Eines Pressure ‘ronyress Se ace Conmeten ER iauses & Vorting iS Stmulaton: 4 Epes. of Beshea Biood Vessels Fever due to Inflgmmatory Response fal sqncuarges Slicomfor eal resantaton== ; Babee —reurepattuy siket M TBR con fubroncelow ed mrentahehy oe para fy ton, slow ed fe he nas Complications of MI eaves fregeen + ac aaa sparc on ham acs fuascle dame Wat . chtiegene steel case SCALIA" POMGTy cart omen ae CP care! Pagan use DrSuneteN] | Cm jg Nach cue Df | ssentetoraneurem se omy ae \Y Srercortes potable ae fess ; “anisaraphy (pce) 4 L essler Syndrome tice neat oer ME i [eesie hk ere Het a a1/16/2013 Treatment + Rapid Dlagnosis & Treatment Are CRITICAL + Reperfusion Therapy ‘Remaiyte rempy (eer if cara eat uavaiabe) (arcaeCsinatenaion TCA) Health Promotion and Maintenance +855 hfe reaching ogg! because set chetel seq + Efforts are directed toward altering/controliing Modifiable Risk Factors for CAD Serum Ups Levels iGgeie= assess RE, GP (10, /076)) za prices eee eB) irony 1 ESSEASSSeIB ee enor a mma ae : Ripmyee sae? oe Sateen Seeaty GES opps ot (80) 5 ese om tae Brett clot as soon a3 ossiby Elevated Serum Lipid Levels Smoking + Cholesterol Lowering Drug Therapy # Statin Drugs + Exposure to Passive Smoking rescs UngpreteinProeyeton "penand a o*hena ‘eeceiee depts COgre Feduces Row to coronary arteries Sate ay yrergy Per bert |rrwssk| — « Accounts for 1/3 of CAD deaths se ane a Enhances the process of Atherosclerosis 1 Poseoes nov 8 ones Ue (gos eo) + Nicotine begins the release of Saetmecs: “ccrcaeywes cone] | | Catecholamines ‘iver Garage ae (ie; ra Production of Carbon Monoxide we Nursing Interventions + Direct Care “Basessment& Monitoring {Pan & Ancety Management “Rest Comfor + Counseling (support groups) «TEACHING + Collaborative Care with Health Team ‘Sudden Cardiac Death + Unexpected Death from Cardiac Causes + Low Survival Rate + Soi Dcherges Without Neurological mpalemers + Caused sy Latha Ventreuir Dyernymios ° eae sapentveroe i nitrates = head a che gue Tyne (6xr9> usually on clecticat burn oie sc bara! 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