Cardiovascular System I
>
- anatomy of the heart -
organization of circulatory system
• pulmonary circulation - blood through lungs for
gas exchange
- right heart, pulmonary artery, pulmonary
capillaries, pulmonary veins
- low pressure and resistance (effective gas
exchange)
• systemic circulation - supplies tissues of body
with blood
- left heart, aorta, capillaries, systemic venous
system, vena cava
- complex, high pressure
↳ heart valves
• atrioventricular (AV) - prevent backflow from
ventricles during systole
- bicuspid (mitral)
- tricuspid
• semilunar (SL) - prevent backflow from aorta/
pulmonary arteries during diastole
- aortic
- pulmonary
>
- cardiac cycle - rhythmic pumping action
• systole - ventricular contraction
• diastole - ventricular relaxation and filling
↳ regulation of cardiac performance
• cardiac output (CO) - amount of blood pumped
each minute
- CO = HR X SV
- varies with body size, metabolic needs (increase
with physical activity, decrease during rest and sleep)
• cardiac reserve - max % of increase in CO above
normal resting level
• CO depends on preload, ventricular filling, afterload,
resistance, contractility, HR
, Cardiovascular System 2
> Renin-Angiotensin-Aldosterone System (RAAS)
• when BP drops, RAAS works to increase
>
- loop diuretics - furosemide
• therapeutic use
- HTN, pulmonary edema, fluid volume overload
(HF)
• complications
- dehydration, OS hypotension, ototoxicity
(harsh on liver)
- electrolyte imbalances - hyponatremia,
hypokalemia, hypovolemia
• contraindications
- not est. in preg/lactation
- anuria
- caution in liver disease, DM, electrolyte
> blood pressure ranges
depletion
• normal (less than 120/80) • interactions
• elevated (120-129 and less than 80) - digoxin, antihypertensives, lithium, ototoxic
agents
• hypertension stage 1 (130-139 or 80-89)
• hypertension stage 2 (higher than 140 or 90) > thiazide diuretics - hydrocholorothiazide
-
↳
• hypertensive crisis (higher than 180 and/or 120) • therapeutic use
clinical manifestations of HTN - HTN, fluid volume overload, DI, postmenopausal
• HA, dizziness, blurred vision, nose bleeds, NV osteoporosis
• tinnitus (indication of impaired kidney function) • complications
• anxiery, confusion, chest pain, SOB, cardiac - hyponatremia, hypokalemia, hyperglycemia
dysrhythmias - dehydration
• can be asymtomatic - silent killer • contraindications
↳
nonpharm treatment
• address modifiable risk factors - exercise, healthy diet, - some risks to newborn
weight loss - renal impairment
• limit smoking, alcohol, drug use, stress - caution in CVD, DM, electrolyte abnormalities
electrolyte levels
>
- • interactions
• potassium: 3.5-5 mEq/L - digoxin, antihypertensives
• sodium: 135-145 mEq/L >
- potassium-sparing diuretics - spironolactone
• creatinine: 0.6-1.2 mg/dL • therapeutic use
• BUN: 5-20 mg/dL - HTN, edema, HF, hyperaldosteronism
diuretics •
- action sites complications
- hyperkalemia, metaholic acidosis
• loop diuretics (strongest) - loop of henle
- endocrine - voice change, impotence,
• thiazides (weak) - distal convoluted tubule gynecomastia
• potassium sparing diuretics (weakest) - most distal • contraindications
convoluted tubule
↳ considerations - glove when handling
• monitor electrolyte level, fluid volume, urine output, - hyperkalemia, potassium supplements, anuria
cardiac status, blood glucose (DM) - caution in kidney/liver disease, metabolic
• potassium wasting diuretic - consume potassium rich acidosis
food • interactions
• potassium sparing diuretic - maintain intake - ACEi, ARB, potassium
>
- anatomy of the heart -
organization of circulatory system
• pulmonary circulation - blood through lungs for
gas exchange
- right heart, pulmonary artery, pulmonary
capillaries, pulmonary veins
- low pressure and resistance (effective gas
exchange)
• systemic circulation - supplies tissues of body
with blood
- left heart, aorta, capillaries, systemic venous
system, vena cava
- complex, high pressure
↳ heart valves
• atrioventricular (AV) - prevent backflow from
ventricles during systole
- bicuspid (mitral)
- tricuspid
• semilunar (SL) - prevent backflow from aorta/
pulmonary arteries during diastole
- aortic
- pulmonary
>
- cardiac cycle - rhythmic pumping action
• systole - ventricular contraction
• diastole - ventricular relaxation and filling
↳ regulation of cardiac performance
• cardiac output (CO) - amount of blood pumped
each minute
- CO = HR X SV
- varies with body size, metabolic needs (increase
with physical activity, decrease during rest and sleep)
• cardiac reserve - max % of increase in CO above
normal resting level
• CO depends on preload, ventricular filling, afterload,
resistance, contractility, HR
, Cardiovascular System 2
> Renin-Angiotensin-Aldosterone System (RAAS)
• when BP drops, RAAS works to increase
>
- loop diuretics - furosemide
• therapeutic use
- HTN, pulmonary edema, fluid volume overload
(HF)
• complications
- dehydration, OS hypotension, ototoxicity
(harsh on liver)
- electrolyte imbalances - hyponatremia,
hypokalemia, hypovolemia
• contraindications
- not est. in preg/lactation
- anuria
- caution in liver disease, DM, electrolyte
> blood pressure ranges
depletion
• normal (less than 120/80) • interactions
• elevated (120-129 and less than 80) - digoxin, antihypertensives, lithium, ototoxic
agents
• hypertension stage 1 (130-139 or 80-89)
• hypertension stage 2 (higher than 140 or 90) > thiazide diuretics - hydrocholorothiazide
-
↳
• hypertensive crisis (higher than 180 and/or 120) • therapeutic use
clinical manifestations of HTN - HTN, fluid volume overload, DI, postmenopausal
• HA, dizziness, blurred vision, nose bleeds, NV osteoporosis
• tinnitus (indication of impaired kidney function) • complications
• anxiery, confusion, chest pain, SOB, cardiac - hyponatremia, hypokalemia, hyperglycemia
dysrhythmias - dehydration
• can be asymtomatic - silent killer • contraindications
↳
nonpharm treatment
• address modifiable risk factors - exercise, healthy diet, - some risks to newborn
weight loss - renal impairment
• limit smoking, alcohol, drug use, stress - caution in CVD, DM, electrolyte abnormalities
electrolyte levels
>
- • interactions
• potassium: 3.5-5 mEq/L - digoxin, antihypertensives
• sodium: 135-145 mEq/L >
- potassium-sparing diuretics - spironolactone
• creatinine: 0.6-1.2 mg/dL • therapeutic use
• BUN: 5-20 mg/dL - HTN, edema, HF, hyperaldosteronism
diuretics •
- action sites complications
- hyperkalemia, metaholic acidosis
• loop diuretics (strongest) - loop of henle
- endocrine - voice change, impotence,
• thiazides (weak) - distal convoluted tubule gynecomastia
• potassium sparing diuretics (weakest) - most distal • contraindications
convoluted tubule
↳ considerations - glove when handling
• monitor electrolyte level, fluid volume, urine output, - hyperkalemia, potassium supplements, anuria
cardiac status, blood glucose (DM) - caution in kidney/liver disease, metabolic
• potassium wasting diuretic - consume potassium rich acidosis
food • interactions
• potassium sparing diuretic - maintain intake - ACEi, ARB, potassium
