36 cardio system

True or False

Men are more likely to have lung cancer over
True False


Hemorrhage of the nares or nostrils


Where is the heart located?

In the lower anterior area of the mediastinum

____ carry oxygenated blood away from the left side of the heart to the body tissues.


____ carry deoxygenated blood back to the right side of the heart


What is the function of the cardiovascular system?

To provide oxygen, nutrients, and hormones to cells and remove carbon dioxide and waste products from the body cells

The protective sac that encapsulates the heart is called ___


What are the three layers of the pericardium?

1. endocardium 2. myocardium 3. epicardium

The layer that lines the inside of the heart that is made up of epithelium cells


Layer that is made up of striated muscles and varies in thickness depending on the hearts chamber


The thickest chamber of the heart that pumps blood to the body is ___

left ventricle

Layer that surrounds the outside of the heart


The layer that is also called the epicardium that surrounds the heart and lines the great vessels

Visceral layer

The emptying of blood with each contraction


The cardiac recovery phase


The upper chambers of the heart are called ___


The lower chambers of the heart are called


Left ventricle pumps blood into the ____

Aorta and out to the body

Right ventricle pumps blood into the ____

Pulmonary arteries and on to the lungs

What are the 4 heart valves

1. tricuspid 2. bicuspid 3. pulmonic 4. aortic

Fibrous cords attached to the cusps of the tricuspid and mitral valves is called __

Chordae tendineae

___ keeps the valves from inverting when the ventricles contract thus preventing blood from flowing back into the atrium

Chordae tendineae

____ and ____ valves prevent blood from flowing back into the ventricles from the pulmonary artery and aorta during repolarization

Pulmonic and aortic

The volume of blood ejected from the left ventricle with each contraction or systole is known as ____?

stroke volume

The amount of blood ejected in 1 minute

Cardiac output

____ Supply nutrients and oxygen to the heart

Coronary arteries

The conduction system that controls the heartbeat consists of

1. sinotria node (SA node) 2. atrioventricular node (AV node) 3. bundle of His 4. bundle branches 5. purkinje fibers

Called the pacemaker of the heart that initiates electrical impulses and is Located in the right atrium

SA node

Located in the lower right atrium

AV node

Group of specialized conduction fibers located in the interventricular septum

Bundle of His

Fibersthat separate into right and left bundle branches and divides into smaller branches

Purkinje fibers

_____ is completed when an impulse has completely gone through the conduction system of the heart and the ventricles have contracted

Cardiac cycle

Factors that influence stroke volume

Preload, afterload, contractility and HR

Amount of pressure within the ventricle


The force that resists ejection of blood from the ventricles


The strength of cardiac contraction


Sound of the mitral and tricuspid valves closing simultaneously

Lubb (s1)

Sound heard on the right intercostal space. Simultaneous closing of the pulmonic and aortic valves.

Dubb (s2)

Low pitched sound that sounds like a gallop


Three layers of arteries

Tunica intima Tunica media Tunica adventitia

Single layer of smooth endothelial cells

Tunica intima

Middle layer composed of smooth muscle cells

Tunica media

Outer layer that consists of connective tissue sheaths and collagen fibers that hold the vessel in place

Tunica adventitia

Thin vessels that connect the smallest arterioles with the smallest venules


Excess fluid in the abdomen


Capillary refill should be less than ____ in fingers and toes

3 seconds

The leg will be ____if there is an arterial circulatory problem


The leg will be ____ if there is a venous circulatory problem


Inflammation of the skin caused by decreased circulation

Stasis dermatitis

A positive ____ is present in some cases of DVT and if there is pain in the calf or behind the knee it may indicate a venous clot.

Homan's sign

The firing of the SA node and the electrical impulse spreading across the atria yields a ___ wave in the ECG

P wave

Purkinje fibers transmit an electrical impulse to the _____ cells resulting in depolarization or contraction of ventricles


Waves that represent repolarization of the ventricles and are repeated after each heart beat

T wave

The wave that is not always present on an ECG strip

Q wave

complex that represents the electrical impulse from beginning to end

QRS complex

The pause after qrs complex that represents the period between contraction and repolarization or recovery

ST segment

Irregularity in the rate, rhythm or conduction of the electrical system of the heart


Irregular beats

ectopic beats

Most common causes of dysrythmias

1. myocardial infarction 2. coronary artery disease 3. CHF 4. electrolyte imbalance 5. drug toxicity

Administration of atropine is a treatment for ____?


Device that senses the dysrhythmia and automatically sends an electrical shock directly to the heart to defibrillate it.

Implanted cardiovascular defibrillator (ICD)

Occurs when the valves do not open and close properly

Valvular heart disease

When the valve does not close and leaks blood back into the chamber which it came from is called


True or False

The aortic valve is not repaired only replaced
True False


Narrowing and hardening of arteries


Fatty deposits on the inner lining of vessel walls also known as plaque


Chest pain that is a tempoarary inadequate blood and oxygen supply to the myocardial tissues is also called

Angina pectoris

Ischemic attacks that do not experience angina

Silent Myocardial infarction

Final stage of heart conditions

heart failure

HF usually begins on which side


_____ failure is caused by left ventricular myocardial infarction, aortic valve stenosis, prolapsed valve complications and hypertension

Left sided heart failure

when blood becomes congested in the inferior vena cava, causing edema first in the extremeties and then in the trunk of the body this is a liklyhood of ______.

right sided heart failure

enlargement of the liver


edema, hepatomegaly, and neck vein distention are all signs and symptoms of ________.

right sided heart failure

a localized dilation occuring in a weakened section of an artery's medial layer is called a(n):


an example of congenital congestion would be:

Marfan's syndrome

known as high blood pressure


a BP of 140/90 indicates


african american race, male gender, aging, post menopausal women, and family history are all_______ risk factors


smoking, lack of exercise, obesity, stress, low socioeconomic status, diet high in fat and sodium, alcohol intake, and oral contraceptives are all examples of ______ risk factors


cause of hypertension is unknown is called:

primary hypertension

when the cause of hypertension is another condition in the body such as renal artery stenosis, chronic renal disease, sleep apnea etc is also known as:

secondary hypertension

which step in the stepped care approach involves adding a diuretic or beta blocker to the clients care regimen

second step

this step in the stepped care approach is to increase the drugs, try another drug, or add a secondary hypertensive

third step

this step in the stepped care approach invilves encouraging the client to try some lifestyle changes such as diet adn exercise.

first step

inflammation in the wall of a vein without clot formation


formation of a clot in a vessel


clot that remains in the site where it formed


a clot (thromubus) that moves becomes an


pooling of blood, vessel trauma, and coagulation problems are all known as:

virchow's triad

true or false

is there are clinical signs of a thrombus homan's sign should not be assessed because the clot may be dislodged adn become an embolus
True False


when a clot is surgically removed is called:


value at a particular time taht serves as a reference point for future value levels

baseline level

destruction of red blood cells


involves injecting a chemicalinto the vein causing the vein to become hardened so blood no longer flows through it


involves introducing a wire into a vein is called:

vein stripping

visibly prominant, dilated, and twisted veins usually in the lower extremeties

varicose veins

varicose veins in the esophagus is also known as

esophageal varices

varicose veins in the anus is also known as:


tieing off an involved section of the vein with a suture is called

vein ligation

an intermitten spasm of the digital arteries and arterioles resulting in decreased circulation in the fingers and toes is called

raynaud's disease

dysrhythmia that occurs from electrical conduction disturbances in the atria. Not usually life threatening.

common causes: MI, CHF, electrolyte imbalance, stress, medication

atrial dysrhythmia

dysrythmia that is more life threatening and originates from the ventricles

ventriclar dysrhythmia

dysrhtymia when client has no BP, pulse or respiration


dysrythmia when client is unconscious, no pulse or resps


electrical conduction interrupted to some degree between atria and ventricles at AV node

AV block

inflammation or infection of inside lining of heart

infective endocarditis

what does the cardio system consist of

the heart and its vasculature and the peripheral vascular system

in a lifetime how much blood will the heart pump

80 million gallons

peripheral vascular system consists of:


how much blood volume do veins and venules contain


3 goals when obtaining health history

1. identify present and potential health problems

2. identify possible familial and lifestyle risk factors

3. involve client in planning long term health care

major risk factors associated with cardiovascular diseases

stressagegenderhereditysmokingdyslipidemiahigh BPphysical inactivityobesityDM

unalterable risk factors

agemale genderdiabetesheredityfamily Hx of chest painMI

3 objectives in assisting client toward healthier lifestyle

1. educate about risk factors

2. determine risk factors client wants to modify

typical concers expressed by a client with cardiac disorder

chest paindyspneaedemafaintingpalpitationsdisphoresisfatigue

a woman with cardiac disorder is most likely to experience:

SOBback or jaw painindigestionnauseavomiting

why do caridac cleints faint

bc of decreased CO causing decrease blood flow to brain

how to alleviate fatigue in cardiac clients

frequent rest periods

distended internal and external neck veins with HOB at 45 degrees can indicate:

right sided HF

if a heartbeat is heard but not felt through radial pulse this can mean?

Decreased CO to extremeties


�Heart rate of:


Heart rate of 60 beats per minute or less

Treatment: Atropine or pacemaker


�Heart rate of:


Heart rate of 100 to 150 beats per minute

Treatment depends on cause

dysrythmia Symptoms vary from:

none to cardiacarrest:Fainting, seizures, fatigue,decreased energy level, exertional dyspnea, chest pain, andpalpitations

most important thing a nurse should consider if tachycardic is

what was pt doing

Occur from electrical conduction
disturbances in atria resulting in

Premature atrial contractions
Atrial tachycardia
Atrial flutter
Atrial fibrillation

Atrial Dysrhythmias

paroxysmal supraventricular tachycardia occurs suddenly, what could the MD perform to help stop this dysrythmia

vagal stimulation/valsalva maneuver

rapid contraction ofthe atria yielding a HR of 250-350 bpm, sawtooth pattern requiring immediate intervention

atrial flutter

erratic electrical activity of the atria of 350-600 bpm. atria quivers bc of mitral valve disease, HF, CAD, MI, hyperthyroidism, hypertensive HD.


lifethreatning dysrythmia bc of the blood supply to lungs and body

ventricular dysrythmia

if PVC occurs without any other cardiac contractions what Tx should be done

remove cause such as stress or caffeine

dysrhythmia that can lead to pulmonary congestion and can result in low BP, weak body, and unconsciousness. rate may go as high as 140-240 bpm

ventricular tachycardia

cardioversion is delivered on ___ wave. why?


bc if given during ventricular depolarization it may cause ventricles to fibrillate

types of ventricular dysrythmia Treatment:

Oxygen, amiodarone (Cordarone), magnesium sulfate, lidocaine, cardioversion or defibrillation, CPR, andadvanced cardiac life support (ACLS) protocol

delivery of a synchorized electrical shock to change rythm circulate blood and oxygenate tissues


delivery of an unsynchornized, high energy electrical shock given in emergency situation. everyone stands clear of bed to prevent shock.


most common cause of ventricular fibrillation is _____


disorganized, chaotic, jagged unidentifiable waves with client having no BP, pulse, or respiratrion.

ventricular fibrillation

during ventricular fibrillation measures are to

initiate CPR and defibrillate immediately

electrical conduction is interrupted to some degree between atria and ventricles at the AV node

atrioventricular blcok

AV block degree with impulse that reaches ventricles but is delayed. requires no Tx bc it has no s/s

first degree

Tx for 2nd and 3rd degree AV block


nursing mgt for dysrythmia

monitor vitals = apicalprovide rest

Tx for atria dysythmia


Tx for ventricular dysrythmia


what do crackles indicate

lung is filling with fluid

A Complication of rheumatic fever with s/s such as polyarthritis, chorea, rash, carditis

Linked to group A streptococcus following
upper respiratory infection

occurs 2-3 weeks after inadequetly treated pharyngitis

rheumatic fever

main goal for rheumatic fever

�Treat inflammation, prevent cardiac complications, and prevent recurrence

what should be done for people with rheumatic heart disease before surgery or dental work

put on prophylactic antibiotic

rheumatic heart disease can be treated with

antibioticantiinflammatorycorticoseroidsbed rest

Inflammation or infection of inside
lining of heart Including valves

Clients may develop murmurs, dyspnea,
peripheral edema, or pulmonary congestion

�Acute symptoms: Tachycardia, pallor, diaphoresis,
and symptoms of infection

infective endocarditis

infective carditis is caused by


Tx for infective endocarditis

Surgery and antibiotics (penicillin, vancomcin, garamycin)

�Inflammation of myocardium

�Symptoms: Flu-like symptoms of fever,
pharyngitis, myalgias, GI complications, chest pain, and pericardial friction rub

Treatment: Digoxin, antibiotics, anti-inflammatories, oxygen, and bed rest to prevent congestive heart failure

can lead to CHF

usually caused by virus

prevelant in aids Pt


activity to prevent myocarditis

bed rest

�Inflammation of membranous sac surrounding heart

�Symptoms: Severe chest pain and pericardial
friction rub

�Complication: Cardiac tamponade


�Caused by myocardial ischemia

�Squeezing pain under sternum radiating to left or right shoulder, jaw, or ear

�Pain may be mild or immobilizing

�Treat to increase blood supply to affected area via medication or surgical procedures E.g., percutaneous transluminal coronary angioplasty (PTCA), stent, coronary artery bypass graft (CABG)

angina pectoris

vasodilator tx for angina

nitro then morphine

mona for angina


�Obstruction in coronary artery resulting
in necrosis to tissues supplied by artery

�Symptoms: Chest heaviness, lower sternal pain, dyspnea, diaphoresis, nausea, anxiety, vomiting, change in pulse and blood pressure, pallor, and cyanosis

�Women may have different symptoms

atherosclerosis common cause

left ventricle most affected


MI s/s for men

chest heaviness tightness griping pain in sternal area

pain in arm, neck, back, epigastric area

�Treat to reduce oxygen demands, increase oxygen supply, relieve pain, improve tissue perfusion, and prevent complications and further tissue damage

�Treatment: Medications, surgery, diet, and bed rest


�Develops when heart no longer capable of
meeting body�s oxygen needs

�Causes: Untreated left ventricular failure, right ventricular myocardial infarction, chronic obstructive coronary disease, cor pulmonale, and pulmonic valve stenosis

right side hf

Treatment of Heart Failure

�Treat to improve circulation to coronaryarteries and decrease workload of left ventricle
�Treatment: Medication, diet changes, fluid restriction, oxygen, and surgery E.g., ventricular assist device (VAD), intra-aortic balloon pump

�Heart affected because of lung condition
that interferes with exchange of carbon dioxide and oxygen in alveoli

�Symptoms and medical and nursing care
same as right-sided heart failure

cor pulmonale

�Done for cardiomyopathy, end-stage coronary artery disease, and valvular disease

�Recipient must remain on immunosuppressant medication for remainder of life

Cardiac Transplantation

�Localized dilation occurring in weakened
section of artery

�Symptoms depend on location:Hypotension, tachycardia, pallor, cool and clammy skin, and abdominal or back pain

�Treatment: Medications, surgery, and periodic

abdominal aorta common


�Inflammatory disease of small and medium
arteries and veins leading to vascular obstruction

�Symptoms: Numbness, burning, pain at rest,
and decreased sensation in hands and feet

Buerger�s Disease (Thromboangiitis Obliterans)

�Intermittent spasm of digital arteries and arterioles

�Results in decreased circulation to fingers and toes

�Symptoms: Fingers pale, cyanotic, red as
circulation returns, and with tingling or throbbing pain

Raynaud�s Disease/Phenomenon