Unit 4 Problems Of Cardiac Output And Tissue Perfusion
Unit 4 Problems of CardiacOutput and Tissue PerfusionLemone and Burke Ch 30-32Objectives Review the anatomy andphysiology of the cardiovascularsystem. Identify normal heart sounds andrelate them to the correspondingevents in the cardiac cycle. Explain cardiac output andexplain the influence of variousfactors in its regulation.2More Objectives Describe normal variations inassessment findings for the olderadult. Identify manifestations of CardiacEmergency, Permanent Pacemakers,Chronic CHF, Inflammatory HeartDiseases and Shock. Compare and contrast thepathophysiology and manifestations ofCardiac Emergency, PermanentPacemakers, Chronic CHF,Inflammatory Heart Diseases andShock.31
The rest of the objectives Relate the outcomes of diagnostic tests andprocedures to the pathophysiology of CardiacEmergency, Permanent Pacemakers, Chronic CHF,Inflammatory Heart Diseases and Shock andimplications of client responses to the disorder andassociated nursing care for each.Discuss nursing implications for medications andtreatments used in the prevention, treatment andmanagement of Cardiac Emergency, PermanentPacemakers, Chronic CHF, Inflammatory HeartDiseases and Shock.Explain risk factors and preventive measures forCardiac Emergency, Permanent Pacemakers, ChronicCHF, Inflammatory Heart Diseases and Shock.4Cardiovascular A & P5Right vs Left heart Right side Low oxygenationLow pressureLight workloadGoes toward thelungs Left side High oxygenation Thick walled highpressure Heavier workload Carries oxygenationblood to organs62
Heart Sounds http://www.youtube.com/watch?v 2aO0HKIP3vI7What is Cardiac Output? CO HR x SV CO cardiac output HR heart rate SV stroke volume Factors that affect SV: HRPreloadAfterloadContractility8Assessing CV status Other than physical assessment HistoryFamily HistoryGenetic RiskPersonal HistoryDiet HistorySocioeconomic Status93
Risk Factors Modifiable HTNDiabetesHyperlipidemiaCigarette smokingObesityPhysical inactivityDiet Nonmodifiable Age Gender Genetic FactorsThe text also discusses Metabolic Syndrome and Riskfactors unique to women on page 96410Risk Factors and PreventiveMeasures for Cardiac Disorders Heart Failure Risk factors Coronary artery diseaseCardiomyopathiesHypertensionCongenital and valvular heart diseaseprevention Education regarding coronary arterydisease and diabetes11CV Assessment Focused physical assessment General appearance Integumentary system Color Temperature Extremeties Blood pressure Edema Venous flow and arterial pulses124
CV Diagnostic exams Lab tests: CBC Serum electrolytes Mark cardiac damage Troponin CK-MB Myoglobin13Cardiac lab tests14Diagnostic exams Chest x-rayAngiographyCardiac CatheterizationECGNursing interventions?155
Diversity concerns CV client Clients often fear diseases r/tcardiovascular system Require good education, opportunityfor client and family to voiceconcerns/fears Support groups Cardiac rehab referral16Chapter 32Nursing Care ofClients with CardiacDisordersPathophysiology of CommonCardiac Disorders Heart Failure Pulmonary Edema Rheumatic Fever/Rheumatic HeartDisease Infective Endocarditis Myocarditis Pericarditis186
Pathophysiology of CommonCardiac Disorders19Pathophysiology of CommonCardiac Disorders20Right vs Left heart failure Right Peripheral edema Weight gain anorexia Left SOB Fatigue Crackles onauscultation ofbreath sounds217
Clinical manifestations ofInflammatory Heart Disease Types of inflammatory diseases: MyocarditisInfective endocarditisPericarditisRheumatic Carditis22Risk Factors and PreventiveMeasures for Cardiac Disorders Myocarditis Risk factors are any thing that altersimmune response Advanced ageMalnutritionAlcohol useImmunosuppressionExposure to radiationStress23Anatomy, Physiology, andFunctions of the Heart The Pericardium Double-layered fibroserous membranesurrounding the heart Anchors the heart to surrounding structures Space between layers is filled withpericardial fluid Lubricates heart muscle Helps to cushion the heart248
Anatomy, Physiology, andFunctions of the Heart25Infective endocarditis An infection of the endocardium Common in clients who abuse drugs,had valve replacements, systemicinfections or structural cardiac defects26Risk Factors and PreventiveMeasures for Cardiac Disorders Infective Endocarditis Risk factors Congenital deformities Tissue damage due to ischemic disease Valve prosthesis Intravenous drug use Invasive catheters Dental procedures or poor dental health Recent heart surgery Prevention Education is key Prophylactic antibiotics279
Infective endocarditis Most common complication is heart failure 50% have embolic complications due tovegetation Common to have clients with petechia andsplinter hemorrhages Diagnosed with positive blood culture orechocardiogram Treat with antibiotics Often need antibiotics before dentalprocedures28Petechiae and splinter hemorrhage29Pericarditis vs endocarditis3010
Pericarditis Often follows a respiratory infection Often presents with pain in supine positionreleived by sitting or leaning forward May hear friction rub with stethoscope Treated with NSAIDS relieved within 48hrs. depends on cause for further treatment Short term course of illness (2-6 weeks) foracute Chronic may require surgery31Pericardiocentesis32Risk Factors and PreventiveMeasures for Cardiac Disorders Rheumatic Fever and Rheumatic HeartDisease Risk factors Crowded living conditions Malnutrition Immunodeficiency Poor access to health care Genetic factor may be present Prevention Prompt identification, treatment Importance of finishing medications3311
When the heart can’t keepup, we may need to pace itPacemakers Clients who experience lifethreatening dysrhythmias mayrequire surgical treatment for short orlong-term management Small device with a long battery life(20 years or longer)35Coronary Circulation andElectrical Properties of the Heart3612
Coronary Circulation andElectrical Properties of the Heart37Care of the client with a pacemaker 1012 has a great table for teachingthe client with a pacemaker.38Ultimately when the heart fails,the patient will have shockChapter 11 Lemone and Burke13
Cellular Homoeostasisand Basic Hemodynamics Homeostatic regulation maintainedprimarily by cardiovascular system Four physiologic components Sufficient cardiac output Uncompromised vascular system Sufficient blood volume and bloodpressure Tissues that are able to extract and useoxygen40Types of Shock Hypovolemic Shock Affects all body systems Most common type of shock Cardiogenic Shock Loss of pumping action of the heart Obstructive Shock Impaired diastolic filling (pericardial tamponade,pneumothorax) Distributive Shock Also known as vasogenic shock41Shock Hypovolemic Too little circulating blood causesdecrease in MAP thus not meeting thebody’s total need for oxygen Internal hemorrhage GI bleed External hemorrhage trauma Dehydration4214
Shock Cardiogenic Heart muscle is unhealthy or pumping isimpaired Causes a decrease CO, afterload andreduces MAP This is seen with an MI43Shock Obstructive Affects the heart muscles ability topump effectively The heart itself is normal howevermanifestations outside the heartaffect filling or contraction Cardiac tamponade Tension pneumothorax Pulmonary embolism44Shock Distributive Loss of sympathetic tone Vasodilation Leaky capillariesSpinal cord injurySepsisAnaphylaxis4515
Interventions for ClientsShock Medications Inotropic: increases cardiac contractility Vasopressors: used to treat neurogenic,septic, or anaphylactic shock Opioids: used to treat pain Immunizations: tetanus prophylaxis46Shock Look at the patient Compensated vs uncompensated Blood pressureUrine outputHRRR Mental status47Questions?Mid Term Exam Next Week.Cumulative to include everything to now.You will have the whole class time to takethe exam.16
Unit 4 Problems of Cardiac Output and Tissue Perfusion Lemone and Burke Ch 30-32 2 Objectives Review the anatomy and physiology of the cardiovascular system. Identify normal heart sounds and relate them to the corresponding events in the cardiac cycle. Explain cardiac output and explain the i
7 Introduction UHS Cardiac ICU Handbook – Second edition 2016 dependency unit, the coronary care unit (both on D-level), and cardiothoracic theatres, cardiac pre and post-op wards and cardiac catheter laboratories (all on E level). Familiarisation with Equipment There is a large array of equipment used on the cardiac intensive care unit.
Advanced cardiac life support (ACLS) is a two day course that teaches students to recognize and treat cardiac arrest, arrhythmias, acute coronary syndromes, stroke, cardiac arrest in the pregnant woman, and cardiac arrest in situations involvi
Cardiac rhythm & heart failure, cardiac catheter ablations, and cardiac diagnostic services . This highlights the percent of change in payment for major cardiac rhythm and heart failure, and cardiac catheter ablation therapies between OPPS 2021 payment . "Lifecycle of a Code: How the CPT and RUC Process Works." American Medical .
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THE CARDIAC CYCLE 1. The cardiac cycle is the sequence of events in one heartbeat. In its simplest form, the cardiac cycle is the simultaneous contraction of both atria, followed a fraction of a second later by the simultaneous contraction of both ventricles. 2. The heart consists of cardiac muscle cells that connect with each other – they are branched – and
Our cases demonstrate that cardiac sarcoidosis may manifest for the first time during pregnancy. Reports on cardiac sarcoidosis related to pregnancy are rare. 1,2 Cardiac sarcoidosis, a potentially Fig. 1. ECG of case 1, performed when the patient was 16 weeks pregnant, showing intermittent atrial fibrillation.
Cardiac monitoring is a useful diagnostic tool for managing patients with cardiac arrhythmia or acute ischaemic changes (actual or potential). However, it has no therapeutic value unless the clinicians supervising the patient are skilled
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