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The cardiac system which is also known as the circulatory system is composed of the:

  • Heart
  • Blood
  • Blood Vessels

Heart:

  • Is located in the mediastinum
  • Composed of the Pericardium (parietal layer & visceral layer)
  • Hearwall (myocardium & endocardium)
  • Valves: Atrioventricular Valves
  • Pulmonary Semilunar Valve

Blood Vessels

  • Arteries
  • Veins
  • Capillaries

Understand that the heart has four chambers.  The upper chambers are called the atria and the lower chambers of the heart are called the ventricles.  The septum is in the middle, which separates the left side of the heart from the right side of the heart.

  • The atrioventricular (AV) valves control the blood flow from top to bottom.
  • The tricuspid valve is on the right side of the heart.
  • The mitral valve controls the blood flow on the left side.

Diagnostic Tests and Procedures

Cardiac Enzyme Tests

  • Troponin
  • Myoglobin
  • CK-MB
  • Lactate Dehydrogenase (LDH)

Procedures:

Cardiac Catheterization

Coronary artery bypass grafting (CABG)

Percutaneous Transluminal Coronary Angioplasty (PTCA)

Diagnostics

♣ B- type natriuretic peptide (BNP)

– is released when the atrium and ventricles are stressed.

  • B type natriuretic peptide (BNP) is the marker for Congestive Heart Failure (CHF)

Magnetic Resonance Imaging (MRI)

Electrocardiography

Holter Monitoring

Exercise Electrocardiography Testing (Stress Test)

Chest X Ray

Cardiac Enzymes

  • CK- MB (Creatinine Kinase)
  • Troponin
  • LDH (lactate dehydrogenase)
  • Myoglobin


Diseases

  • Hypertension
  • – when pressure inside blood vessels exceeds 140 mmHg systolic and 90 mmHg diastolic .
  • – Lifestyle Changes is always important: No Smoking * Reducing Alcohol Intake.

♣ Pharmacology Drugs for Hypertenstion:  (Remember for NCLEX)

  • Coronary Artery Disease
  • – occurs when there is a significant deposit of fats such as cholesterol and calcium in the walls of the coronary artery, resulting in the narrowing of the arteries.

Pharmacology Drugs:

  • Calcium Channel Blockers
  • Beta Adrenergic Blockers
  • Platelet Inhibitors
  • Angina Pectoris
  • – pain caused by inadequate blood flow through the blood vessels of the heart.
  • ♣ It’s very important to know the difference between Angina Pectoris and MI.

Pharmacology Treatment:

  • Nitrates (Nitroglycerin *sublingual or topical)
  • Beta Adrenergic Blocker- Decreases the cardiac workload.
  • Aspirin (antiplatelet effects)
  • Pericarditis
  • – The pericarditis membrane of the heart is inflamed
  • – Mostly associated with viral infections. Is acute or chronic.
  • – NSAIDS (Non Steroidal anti-inflammatories) can be used to
  • decrease the inflammation.
  • Myocardial Infarction
  • – insufficient oxygenation of the cardiac muscle due to decreased blood supply to the myocardium.
  • ECG: T wave inversion, ST segment (elevated or depressed)

Interventions (Need to KNOW)

  • Administer Morphine (1st Priority)
  • Administer oxygen and aspirin
  • Administer Atiarrythmics (as ordered) which includes Lidocaine and Amiodarone
  • Beta Adrenergic Blockers may be given
  • Calcium Channel Blockers may be given
  • Heart Failure
  • – the heart is unable to pump enough blood throughout the circulation.
  • – these complications will result in backup or pooling of blood which can result
  • in backup of blood to the lungs (left sided heart failure) or backup to the systemic
  • circulation (right sided heart failure).

Treatment is towards treating the underlying cause such as ischemia and arrhythmia.

  • Cardiomyopathy
  • – refers to diseases of the heart muscle. These diseases enlarge your heart muscle or make it thicker and more rigid than normal. In rare cases, scar tissue replaces the muscle tissue.
  • Pulmonary Edema
  • Dysrythmias
  1. Sinus Rhythm
  2. Sinus Bradycardia
  3. Sinus Tachycardia
  4. Atrial Fibrillation
  5. Ventricular Fibrillation (VF)
  6. Ventricular Tachycardia (VT)
  7. Premature Ventricular Contraction (PVC)
  8. First Degree AV Block
  9. Second Degree AV Block
  10. Third Degree AV Block

Hemodynamic Monitoring

– Measure the cardiac output and intracardiac pressures through hemodynamic monitoring.

  • A catheter is inserted into the pulmonary artery starting from the femoral artery and through the heart vessels and into the chambers.

Side Note: FOR THE NCLEX

* When giving Digitalis (lanoxin) tell patient to consume a moderate amount of potassium to avoid toxicity.

* If pulse rate is less than 100 in infants: Immediately Report findings and call Physician.

* To treat Premature Ventricular Contractions (PVC) :  give pt. Lidocaine, Amiodarone (Cordarone) and Magnesium Sulfate.

* For pts. w/ possible thrmbophlebitis: No more assessment of Homan’s Sign, put the client on Bedrest

* Digitalis Toxicity:

  • Halos around lights
  • Bradycardia
  • Nausea and Vomiting

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