ADULT I L13-14 PPP W16.pptx - NUR 1211C ADULT HEALTH NURSING LECTURE 13-14 CARDIOVASCULAR SYSTEM THE HEART 8th Edition Ch 33 34 35 7th Edition Ch 35 36

ADULT I L13-14 PPP W16.pptx - NUR 1211C ADULT HEALTH...

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NUR 1211C ADULT HEALTH NURSING LECTURE 13-14 CARDIOVASCULAR SYSTEM: THE HEART 8 th Edition: Ch. 33, 34, 35 7 th Edition: Ch. 35, 36, 37
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Chapter (33) (35) Assessment of the Cardiovascular System
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Surface Anatomy of the Heart
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Blood Flow Through the Heart
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Cardiac Valves 1. Tricuspid valve 2. Mitral valve 3. Pulmonic valve 4. Aortic valve
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Mean Arterial Pressure (MAP) Must be at least 60 mm Hg to maintain adequate blood flow through coronary arteries and perfuse major organs (brain) Formula: SBP + 2DSP 3 For example: If a patient’s BP is 110/70, the MAP is: 110 + 2(70) = 110 + 140 = 250 = 83 3 3 3
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Sequence of Events During the Cardiac Cycle
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Mechanical Properties of the Heart Stroke volume Heart rate Cardiac output Preload : venous return and heart compliance (elasticity) Afterload : Impedance: peripheral vascular resistance Myocardial contractility
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Mechanical Properties of the Heart (cont’d) Cardiac Index (CI) = Cardiac Output ÷ Body Surface Area (BSA) CI normal range = 2.7 to 3.2 L/min/m 2 BSA
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Cardiac Output Amount of blood pumped from left ventricle per minute Heart Rate × Stroke Volume
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Arterial System Blood pressure is force of blood exerted against vessel walls
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Blood Pressure Regulation Autonomic nervous system: Baroreceptors Chemoreceptors—hypercapnia Renal system Endocrine system External factors also affect BP
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Cardiovascular System Assessment Patient history Nutritional history Family history and genetic risk Modifiable and nonmodifiable risk factors for cardiovascular disease Current health problems Pain, discomfort Dyspnea, DOE, orthopnea, PND Fatigue Palpitations Edema Syncope Extremity pain
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Point to Remember… Best indicator of fluid balance is weight 2.2 lb = 1 kg = 1 L of fluid
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Cardiovascular System Physical Assessment General appearance Skin Cyanosis, rubor; pallor Extremities Clubbing, edema Blood pressure Hypotension and hypertension Postural (orthostatic) hypotension
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Precordium Assessment: Inspection: point of maximal impulse Palpation and percussion: not done by the nurse Auscultation Normal heart sounds: S 1 and S 2 caused by closure of atrioventricular valves and semilunar valves; indicate the beginning and end of systole Paradoxical splitting: (S 2 ) early closure of pulmonic valve or delay in aortic valve closure; caused by MI, left bundle-branch block, aortic stenosis, aortic regurgitation, and right ventricular pacing. Pericardial friction rub: Sign of friction between both layers of pericardium, indicate pericarditis, and can be heard despite the patient hold breath (if it stops while holding breathing, it is a pleural rub). Usually heard on precordium.
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Precordium (cont’d) Assessment (cont’d) Auscultation Gallops and murmurs: S 3 is a ventricular gallop, heard at the beginning of diastole, caused by fast ventricular filling in a noncompliant ventricle; it is a normal finding in people younger than 35, and a sign of heart failure in older people.
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  • Summer '19
  • Cardiology, heart rate, Nursing Considerations

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