Presentation on theme: "Cardiovascular System"— Presentation transcript:
1Cardiovascular System Chapter 36Cardiovascular System
2Anatomy and Physiology Review Heart, its vasculature, and peripheral vascular systemFunctions:Provides oxygen, nutrients, and hormones to cellsRemoves carbon dioxide and waste products from cellsMaintains body temperature by distributing heat produced by metabolic activity
35Ventricular Dysrhythmias Treatment depends on cause:Oxygen, amiodarone (Cordarone), magnesium sulfate, lidocaine, cardioversion or defibrillation, CPR, and advanced cardiac life support (ACLS) protocol
36AV BlocksElectrical conduction interrupted to some degree between atria and ventricles at AV nodeDegrees:FirstSecondThird(continued)
37AV Blocks Treatment: First degree Second and third degree None Pacemaker
38Rheumatic Heart Disease Complication of rheumatic feverLinked to group A streptococcus following upper respiratory infectionTreat inflammation, prevent cardiac complications, and prevent recurrence(continued)
39Rheumatic Heart Disease Clients require prophylactic antibiotic therapy before dental procedures or invasive surgery
40Infective Endocarditis Inflammation or infection of inside lining of heartIncluding valvesAcute symptoms:Tachycardia, pallor, diaphoresis, and symptoms of infection(continued)
41Infective Endocarditis Subacute symptoms:Low-grade fever, malaise, weight loss, and anemiaClients may develop murmurs, dyspnea, peripheral edema, or pulmonary congestionTreatment:Surgery and antibiotics
42Myocarditis Inflammation of myocardium Symptoms: Treatment: Flu-like symptoms of fever, pharyngitis, myalgias, GI complications, chest pain, and pericardial friction rubTreatment:Digoxin, antibiotics, anti-inflammatories, oxygen, and bed rest to prevent congestive heart failure
43Pericarditis Inflammation of membranous sac surrounding heart Symptoms:Severe chest pain and pericardial friction rubComplication:Cardiac tamponade(continued)
45PericarditisTreatment:Pericardiocentesis, surgery, and medications
46Valvular Heart Diseases Occurs when valves do not open and close properlyStenosis and insufficiencyMitral valve prolapseTreatment:Prophylactic antibiotics before dental procedures, surgery, medications, and valve replacement
48Arteriosclerosis Narrowing and hardening of arteries Causes decreased perfusion to cells beyond narrowed or hardened areaVessels lose elasticityResults in arteriosclerotic heart disease, angina, myocardial infarction, stroke, and peripheral vascular disease
53Angina PectorisTreat to increase blood supply to affected area via medication or surgical proceduresE.g., percutaneous transluminal coronary angioplasty (PTCA), stent, coronary artery bypass graft (CABG)
66Prioritize the five nursing interventions as you would do them initially: A – Take the vital signs.B – Assist to commode.C – Perform a body systems assessment.D – Check oxygen saturation level.E – Talk with Mrs. T.
67Myocardial Infarction Obstruction in coronary artery resulting in necrosis to tissues supplied by arterySymptoms:Chest heaviness, lower sternal pain, dyspnea, diaphoresis, nausea, anxiety, vomiting, change in pulse and blood pressure, pallor, and cyanosisWomen may have different symptoms(continued)
70Myocardial Infarction Treat to reduce oxygen demands, increase oxygen supply, relieve pain, improve tissue perfusion, and prevent complications and further tissue damageTreatment:Medications, surgery, diet, and bed rest
76Treatment of Heart Failure Treat to improve circulation to coronary arteries and decrease workload of left ventricleTreatment:Medication, diet changes, fluid restriction, oxygen, and surgeryE.g., ventricular assist device (VAD), intra-aortic balloon pump
77Cor PulmonaleHeart affected because of lung condition that interferes with exchange of carbon dioxide and oxygen in alveoliSymptoms and medical and nursing care same as right-sided heart failure
78Pitting edema in the lower extremities. The nurse admits a 69-year-old male with HF. The physician orders furosemide 60mg IV stat, digoxin 0.25mg po and KCl 20mEq po now. Which assessment finding is most indicative of an ineffective response 2 hours after the administration of all the medications?Pulse 89, irregular.Urine output 60mL.Pulse oximetry 94%.Pitting edema in the lower extremities.
79B is the answerAlthough output falls within the parameters of renal function, the client received furosemide IV and diuresis is the desired effect.Options A, C and D are expected findings in a client with HF.
80The home health nurse visits a client with HF The home health nurse visits a client with HF. In reviewing the client’s medications, the nurse notes that the client takes the following daily oral medications: digoxin 0.25mg, furosemide 10mg and captopril 0.625mg. After speaking to the client and wife, the nurse suspects digitalis toxicity. Which question helps the nurse gather more information specific to digitalis toxicity?“Do you get light-headed when you get out of bed?”“Do you need to sleep with more than one pillow?”“Do you have to get up to urinate more frequently?”“Have you had a nausea, vomiting or diarrhea?”
81D is the answerAlthough these signs and symptoms are frequently seen with all drug therapy, they are frequently early side effects of digitalis toxicity.Options A, B and C relate to the action of the other drugs.
82Assess capillary refill. Take the pulse oximetry. The nurse is assigned to a client with HF. The nurse’s morning lung assessment indicates crackles and wheezes in the mid to lower lung bases, R 32, client restless. Which nursing intervention is of priority initially?Assess capillary refill.Take the pulse oximetry.Limit client activity.Assess fluid intake.
83B is the answerClient assessment indicates rapid breathing and possible hypoxia. To fully assess the respiratory status of the client, it is important to take the pulse oximetry.Options A, C and D are important – but not priority – interventions.
85Prioritize the five nursing interventions as you would do them initially: A – Assess respiratory rate.B – Obtain urinary output data.C – Assess rate/rhythm and quality of pulse.D – Assess complaints of visual disturbances.E – Check current lab data.
86Cardiac Transplantation Done for cardiomyopathy, end-stage coronary artery disease, and valvular diseaseRecipient must remain on immunosuppressant medication for remainder of life