Wilton Norman S.

Jumantoc RN, MAN,

Care of Clients with
CARDIOVASCUL
AR DISORDERS
Is the blood adequately circulated?

Wilton Norman S. Jumantoc RN, MAN,

Cardiovascular Disorders

Wilton Norman S. Jumantoc RN, MAN,

 Cardiovascular Disorders
Cardiac Atherosclerosis
Tamponade
Endocarditis Arteriosclerosis
Myocarditis Aortic Stenosis
Pericarditis Aortic
Regurgitation
Atrial Mitral Valve
Dysrhythmias Stenosis
Ventricular Mitral Valve
Dysrhythmias Regurgitation
Congestive Heart Mitral Valve
Failure Cardiomyopathy Prolapse
Angina
Pectoris
Septal DefectsMyocardial
Infarction

CARDIAC = Stroke Volume x

OUTPUT Heart Rate
Wilton Norman S. Jumantoc RN, MAN,
 Cardiovascular Disorders
Cardiac Atherosclerosis
Tamponade
Endocarditis Arteriosclerosis
Myocarditis Aortic Stenosis
Pericarditis Aortic
Regurgitation
Atrial Mitral Valve
Dysrhythmias Stenosis
Ventricular Mitral Valve
Dysrhythmias Regurgitation
Congestive Heart Mitral Valve
Failure Cardiomyopathy Prolapse
Angina
Pectoris
Septal DefectsMyocardial
Infarction

CARDIAC = Stroke Volume x

OUTPUT Heart Rate
Wilton Norman S. Jumantoc RN, MAN,
 Cardiovascular Disorders
Cardiac Atherosclerosis
Tamponade
Endocarditis Arteriosclerosis
Myocarditis Aortic Stenosis
Pericarditis Aortic
Regurgitation
Atrial Mitral Valve
Dysrhythmias Stenosis
Ventricular Mitral Valve
Dysrhythmias Regurgitation
Congestive Heart Mitral Valve
Failure Cardiomyopathy Prolapse
Angina
Pectoris
Septal DefectsMyocardial
Infarction

CARDIAC = Stroke Volume x

OUTPUT Heart Rate
Wilton Norman S. Jumantoc RN, MAN,
 Cardiovascular Disorders
Cardiac Atherosclerosis
Tamponade
Endocarditis Arteriosclerosis Aneurysms
Myocarditis Aortic Stenosis
Pericarditis Aortic
Regurgitation
Atrial Mitral Valve
Dysrhythmias Stenosis Raynaud’s
Ventricular Mitral Valve
Disease
Dysrhythmias Regurgitation
Congestive Heart Mitral Valve
Failure Cardiomyopathy Prolapse
Angina
Pectoris
Septal DefectsMyocardial Peripheral Arterial Occlusive
Infarction Disorder
Thromboangitis
Obliterans

Varicose Veins
Wilton Norman S. Jumantoc RN, MAN,
Cardiac Disorders
CARDIAC
Stroke 4900 mL per Heart Rate
OUTPUT
4000 - minute
5000 mL per
Volume minute

70 beats per
minute

70 mL per
stroke/pump

Wilton Norman S. Jumantoc RN, MAN,

Cardiac Disorders
Atheroscler
osis
Arterioscler
Aortic Stenosis Atrial
osis Aortic Dysrhythmia
Atrial Fibrillation
Regurgitation
Cardiomyopat Atrial Flutter
Junctional Rhythm
hy
Asystole
Septal
Mitral Valve Stenosis Pulseless Electrical
Defects
Mitral Valve Activity
Regurgitation
Atrioventricular
Mitral Valve Heart
Congestive Prolapse First Degree AV Block
Blocks
Failure Second Degree AV Block
Cardiac Tamponade Type I
Endocarditis Second Degree AV Block
Myocarditis Type II
Pericarditis Third Degree AV Block
Ventricular
Angina Pectoris Premature Ventricular
Dysrhythmia
Myocardial Infarction Contractions
Ventricular Tachycardia
Ventricular Fibrillation Wilton Norman S. Jumantoc RN, MAN,
Cardiac Disorders

Wilton Norman S. Jumantoc RN, MAN,

Diagnostics

Magnetic Resonance Imaging

2D Echocardiography

Wilton Norman S. Jumantoc RN, MAN,

Diagnostics

Amount of

%
blood
PUMPED =
Amount OUT
of
blood
IN THE
CHAMBER

Ejection
Fraction
Wilton Norman S. Jumantoc RN, MAN,
Diagnostics

Amount of
blood 70 ml
PUMPED
Amount OUT
of 100 ml
= 70
blood
IN THE
%
CHAMBER

Ejection
Fraction
Wilton Norman S. Jumantoc RN, MAN,
Diagnostics

Amount of 50 – 70 Normal
blood 41%– 49 Borderli
PUMPED
Amount OUT
of % % Reduced
< 40 ne
blood
IN THE
CHAMBER

Ejection
Fraction
Wilton Norman S. Jumantoc RN, MAN,
Cardiac Disorders

Wilton Norman S. Jumantoc RN, MAN,

Valvular Disorders of the Heart

Wilton Norman S. Jumantoc RN, MAN,

 Mitral Valve / Aortic Valve Stenosis &
Regurgitation
Pulmonic Aortic valve Results when the leaflets fuse and partially
close the opening between the heart and
Valve Aortic Valve
stenosis the aorta
Results when the leaflets do not completely seal
Aortic valve
the aortic orifice, allowing backflow of blood from
regurgitation aorta into the left ventricle
Etiology
Valvular heart disorders result from
congenital defects, trauma, ischemic damage,
degenerative changes, and inflammation.
Rheumatic endocarditis is the most common

Results in progressive thickening and contracting

Mitral stenosis
of the mitral valve cusps, which causes narrowing
and obstruction of blood
Results when flow. tendineae shorten and
the chordae
Mitral regurgitation
prevent complete closure of the leaflets, causing
Mitral Valve backflow of blood from the left ventricle into the left
atrium the mitral valve from closing completely,
Prevents
Tricuspid Mitral valve resulting in valvular regurgitation in which blood
Valve prolapse from the left ventricle seeps back into the left atrium
Wilton Norman S. Jumantoc RN, MAN,
Mitral Valve / Aortic Valve Stenosis &
Regurgitation Assessment
Mitral regurgitati
Findings
Aortic valve Aortic valve Mitral stenosis Mitral valve
stenosis
Dyspnea regurgitation
Increased force of the Progressive prolapse
Mitral Click
Angina Pectoris heartbeat fatigue
Loud, Rough Systolic Arterial pulsation in the Hemoptysis
Murmur over the Aortic neck Dyspnea on
Medical/SurgicalExertional
area Dyspnea
Breathing Difficulties
exertion

Management
Antibiotics
Valvuloplasty Repair of the affected
Commissurotomyvalve
Procedure performed to separate
Annuloplasty Repair of the junction of the valve leaflets and the
fused leaflets
muscular
Chordoplasty Repair of heart wall tendineae
the chordae
Xenografts Tissue valves from pigs or cows
Homografts Human valves obtained from cadaver tissue donations
Autografts Client’s own pulmonic valve and portion of the pulmonary artery for the
Nursing use as the aortic valve
Educate client on the need for prophylactic
Management
antibiotics Wilton Norman S. Jumantoc RN, MAN,
Cardiomyopathy

Wilton Norman S. Jumantoc RN, MAN,

Cardiomyopathy

Wilton Norman S. Jumantoc RN, MAN,

Cardiomyopathy Primary : starts by itself
Secondary : Hypertension or Valve Disease
Heart muscle disease associated with cardiac
dysfunction
Hypertroph Dilated Restrictive
ic

Wilton Norman S. Jumantoc RN, MAN,

Dilated Cardiomyopathy
Characteristics Treatment
Distended heart muscleACE Inhibitors (-pril)
Heart valves loose away
Beta Blockers (-lol)
Causes Calcium Channel Blockers (-dipine,
Diminished
-zem, -amil)
contractile proteins
Digoxin
Diuretics
Teachings(loop or thiazide)
Diet
Rest
Exercise
Smoking Cessation
Stress Reduction

Wilton Norman S. Jumantoc RN, MAN,

Restrictive Cardiomyopathy
Characteristics Treatment
“Rock hard” heart Heart transplant
Heart muscle is very stiff
muscle
Heart muscle does not
and hard
allow the ventricles to
Refill
stretchproblems
Causes
Radiation
Amyloidosis : protein deposits
Sarcoidosis : inflammatory cell
Hemochromatosis
deposits : iron deposits

Wilton Norman S. Jumantoc RN, MAN,

Hypertrophic Cardiomyopathy
Characteristics Treatment
Huge trophy-like heart Myectomy
Diagnosed
muscle early in
Big fat trophy-like septum Beta Blockers
childhood
Refill problems Calcium Channel Blockers
Blocks aortic valve

Causes
Myofibril disarray

Wilton Norman S. Jumantoc RN, MAN,

Coronary Artery Disease

Wilton Norman S. Jumantoc RN, MAN,

Arteriosclerosis & Atherosclerosis
Arterial wall becomes Hardening of any artery which is
thicker, harder, less elastic caused by the build-up of
than normal ATHEROMATOUS PLAQUE in
tunica intima (endothelium)

Wilton Norman S. Jumantoc RN, MAN,

 Arteriosclerosis & Atherosclerosis
Pathophysiology
Dead
LDL LDL More
Endothel Monocyt monocytes Dead
Endotheli Smoking enters Monocytes monocytes
ial es breaks (foam cells) monocytes
um Hypertensi endothelia die come and
Damage LDL deposit under release
on l wall eat more
damaged cytokines
LDL
The growing smooth muscle PGF encourages Platelets Platelets endothelium
Fatty streaks
Fatty Foam
secretes collagen, proteoglycans smooth muscle release gather at the are cells
thrombogenic, streak
and elastin fibrous cells that form a growth to the platelet- damaged build-up
wall around the fatty streak tunica intima derived endothelium blood can clot
growth on it
Accumulation of factor of
Buildup Calcium fibrous cap can
Fatty streaks cause the underlying blood clot start to
plaque in the vessel calcium occurs in deposit crack and expose
smooth muscle in the blood vessel form within the
messes up the ability the vessel wall stiffens the the underlying
wall to also start depositing calcium already partially
of HDL to remove and it crystalizes walls of the thrombogenic foam
into the plaque creating crystals occluded artery
calcium from the arteries cells to blood
vessel

Wilton Norman S. Jumantoc RN, MAN,

Angina Pectoris

Wilton Norman S. Jumantoc RN, MAN,

Angina Pectoris

Wilton Norman S. Jumantoc RN, MAN,

Wilton Norman S. Jumantoc RN, MAN,