Cardiovascular system

MEDICAL Prepared by: Mrs.

NURSING Emanuel RN/BSN

Date: 04 April 2023
 OBJECTIVES

• Define key terms

• Describe the anatomy and physiology of the
cardiovascular system
• Identify common diagnostic test for cardiovascular
diseases
• Discuss common dysthymias
• Explore the concept of arteriosclerosis
• Assessment of the Cardiovascular system
 Key Terms
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• Arteriosclerosis
• Bradycardia
• Necrosis
• Aneurysm
• Palpitation
• Ascites
• Dyspnea
• Tachycardia
 Anatomy and Physiology of the heart
• The cardiovascular system consists of the heart and its vasculature and
the peripheral vascular system.
• The heart is located in the lower anterior area of the mediastinum with
the apex near the diaphragm. The heart apex tips forward and to the left
of the client’s chest cavity.
• The heart is a hollow, muscular organ about the size of a closed fist.
• In an average lifetime, the heart will pump 80 million gallons of blood.
• The cardiovascular system delivers oxygenated blood to tissues and
removes waste products.
• The heart is controlled by the autonomic nervous system,
• Arteries and veins (the vascular system) carry blood throughout the
body, keep the heart filled with blood, and maintain blood pressure.
 Two types of circulation
• Pulmonary circulation- . When the atria contract, blood is forced into
the ventricles. Contraction of the right ventricle pumps blood into the
pulmonary arteries and on to the lungs.
• Systematic circulation- Contraction of the left ventricle pumps blood
into the aorta and out to the entire body.
 How does blood circulate?
• Blood enters the heart through veins and leaves the heart through arteries.

• When the right ventricle contracts, blood is forced through the pulmonic valve into the pulmonary artery.

• Blood circulates through the pulmonary circulatory system ( this involves oxygenation of blood/ where co2 is
exchanged for o2).

• The blood then returns to the left atrium through the pulmonary veins, providing oxygenated blood for
systemic circulation.

• When the left ventricle contracts, blood is forced through the aortic valve into the aorta, beginning systemic
circulation.

• Blood is then distributed throughout the body and returns to the right atrium of the heart through the inferior
and superior vena cava.
 Understanding pressure reading
Systolic pressure-
represents
ventricular
contractions

Diastolic
120/80
pressure-
represents the
relaxation of
the Ventricles
 Common diagnostic test for cardiac
diseases
• Laboratory test includes:

• ABGs- Arterial Blood gasses

• Cardiac biomarkers – Creatine Kinase (CK), CK-MB, Troponin

• Complete blood count (CBC)

• Prothrombin time(PT)

• Partial thromboplastin Time (PTT)

• Lipid Profile
• Radiologic test- Chest X-ray

• Other diagnostic test-Echocardiogram, Electrocardiogram (ECG), Magnetic Resonance

Imaging (MRI), stress test.
 Dysrhythmias
• A dysrhythmia is an irregularity in the rate, rhythm, or conduction of the electrical
system of the heart.
• What happens? : Specialized cells in the heart muscle have the ability to generate an
electrical impulse. Under certain conditions these cells start sending impulses to
other cells in the heart, causing irregular beats (Honan, 2019)
• Causes: electrolyte imbalances, drug toxicity, CHF, MI, CAD (coronary artery
disease)
• Symptoms of dysrhythmias includes fainting, seizures, fatigue, decreased energy
level, exertional dyspnea, chest pain, and palpitations.
 Two Common Dysrhythmias
• Sinus bradycardia is a HR of 60 beats per minute or less.
• Causes: myocardial ischemia, electrolyte imbalances, vagal stimulation, beta
blockers, heart block, drug toxicity, intracranial tumors, sleep, and vomiting.
• Tachycardia is a sinus rhythm with a HR ranging from 100 to 150 beats per minute.
(Less blood is pumped out the heart because there is not enough time for complete
ventricular filing).
• Causes: exercise, emotional stress, fever, medications, pain, anemia,, pericarditis,
excessive caffeine intake, and tobacco use.
• Potter et al. (2018)
 ATHEROSCLEROSIS
• Atherosclerosis | Circulatory System and Disease | NCLEX-RN | Khan Academy - YouTube
 Assessment of the Cardiovascular
system
• Subjective data

Current heath history

Previous health history

Family history

Lifestyle patterns
 Objective data
Vital signs
Physical appearance (weight, skin color, energy level)
Fingernails normally appear pinkish with no markings. A bluish color in
the nail beds indicates peripheral cyanosis.
Assess the capillary refill in the fingernails or toenails by applying
pressure to the nail for 5 seconds, then assessing the time it takes for
color to return. In a patient with a good arterial supply, color should
return in less than 3 seconds.
 Associated Nanda labels
• Activity intolerance

• Related to an imbalance between oxygen supply and demand, Activity intolerance may be associated with such
conditions as acute MI, valvular disorders, heart failure, peripheral vascular disorders, and other ailments.

• Expected outcome:

Patient states a desire to increase his activity level.

Patient identifies controllable factors that cause fatigue.

Patient demonstrates skill in conserving energy while carrying out activities of daily living (ADLs) to
tolerance level
 Interventions

 Identify activities the patient considers desirable and meaningful to enhance their positive
impact.

 Encourage the patient to help plan activity progression. Make sure you include activities he
considers essential to help compliance.

 Instruct and help the patient to alternate periods of rest and activity to reduce the body’s
oxygen demand and prevent fatigue.

 Identify and minimize factors that diminish exercise tolerance to help increase activity level
 Knowledge deficient

• Can apply to a particular disorder or the risk factors related to cardiovascular disease.

Expected outcomes

Patient expresses an interest in learning new behaviors.

Patient sets realistic learning goals.

Patient practices new health-related

Interventions

Help the patient develop goals for learning. Involving him in planning meaningful goals will encourage follow-
through.
 REFERENCE

• Honan, L. (2019). Focus on adult health: Medical-surgical nursing. Wolters Kluwer.

• Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. (2018). Fundamentals of nursing (8th
ed.). Elsevier.

• U.S. Department of Health and Human Services. (n.d.). Atherosclerosis. National Heart
Lung and Blood Institute. Retrieved September 27, 2021, from
https://www.nhlbi.nih.gov/health-topics/atherosclerosis.