NU 170
EXAM 3 STUDY GUIDE
Maternal-Child Nursing
Galen College of Nursing
,Heart Disease
Risk factors:
- Non-modifiable
o Age (over 50), Gender (females, after menopause), Heredity
- Modifiable
o Smoking, diet, obesity, physical inactivity
o Problems from modifiable risks:
HTN, high cholesterol, diabetes, metabolic syndrome, inflammation,
elevated homocysteine
Assessment:
- Biographical and demographical (cultural, ethnicity), current health (medications, HTN)
- Chief complaint:
o What brought them to the hospital? Chest pain?
- Symptom analysis:
o What did we do about the chief complaint?
- 3 Most important assessments:
o General appearance, history, chief complaint
Clinical Manifestations of CVD:
- Chest pain
- Dyspnea (orthopnea)
o Sleep in recliner? How many pillows?
- Cyanosis
- Syncope
- Edema
o Check HR, urinary output, right sided heart issue?
- Epigastric discomfort
o Older pts, nausea
- Fatigue
o Women have several weeks of fatigue before a myocardial infarction, usually
how they present to the ER (EKG, blood tests)
Health history questions:
- Chest pain, dyspnea, orthopnea, cough, fatigue, cyanosis or pallor, edema, nocturia,
cardiac history (HTN, high LDL, heart murmur, congenital heart disease, rheumatic
fever, or unexplained joint pains as child or youth, recurrent tonsillitis, anemia), family
cardiac history (HTN, obesity, diabetes, CAD, sudden death)
Heart sounds:
- S1/S2, normal heart sounds
- S3 (Kentucky), heard on inspiration
- S4 (Tennessee), heard on expiration
, Cardiac cycle:
- Atrial Systole
o Depolarization of SA node (P wave)
- Ventricular Systole
o Depolarization of Ventricles (QRS)
- Ventricular Diastole
o Ventricles relax and fill
Cardiac output:
- Volume of blood ejected per minute by ventricular contraction
o CO = (EDV – ESV) x HR
o Normal cardiac output for adults 4-8 L/min
- EDV (end ventricular diastole)
o Approx. 140 ml of blood in ventricles after ventricular diastole
- ESV (end stroke volume)
o Volume of blood ejected with each ventricular contraction
- Preload
o Filling
o Diuretics decrease preload
- Afterload
o Amount of blood left in heart after contraction
o ACE inhibitors, ARB’s, calcium channel blockers
Age related cardiovascular changes
- Myocardium
o Decreased efficiency and contractility
o Increase exercise (walking)
- SA node
o Decreased number of pacemaker cells
- Left ventricle
o Hypertrophy: increased time for filling/emptying, hardest working part of heart
- Valves/blood vessels
o Valves are thicker, more rigid; decreased arterial elasticity; increased PVR
Cardiovascular Disease
Coronary Artery Disease (CAD)
- Caused by atherosclerosis, occlusion of coronary arteries by fibrous, fatty, plaque.
Atherosclerosis
- Abnormal accumulation of lipid deposits and fibrous tissue within coronary artery walls
- Blockages/narrowing of coronary vessels, reducing blood flow to myocardium
- Leads to myocardial ischemia
EXAM 3 STUDY GUIDE
Maternal-Child Nursing
Galen College of Nursing
,Heart Disease
Risk factors:
- Non-modifiable
o Age (over 50), Gender (females, after menopause), Heredity
- Modifiable
o Smoking, diet, obesity, physical inactivity
o Problems from modifiable risks:
HTN, high cholesterol, diabetes, metabolic syndrome, inflammation,
elevated homocysteine
Assessment:
- Biographical and demographical (cultural, ethnicity), current health (medications, HTN)
- Chief complaint:
o What brought them to the hospital? Chest pain?
- Symptom analysis:
o What did we do about the chief complaint?
- 3 Most important assessments:
o General appearance, history, chief complaint
Clinical Manifestations of CVD:
- Chest pain
- Dyspnea (orthopnea)
o Sleep in recliner? How many pillows?
- Cyanosis
- Syncope
- Edema
o Check HR, urinary output, right sided heart issue?
- Epigastric discomfort
o Older pts, nausea
- Fatigue
o Women have several weeks of fatigue before a myocardial infarction, usually
how they present to the ER (EKG, blood tests)
Health history questions:
- Chest pain, dyspnea, orthopnea, cough, fatigue, cyanosis or pallor, edema, nocturia,
cardiac history (HTN, high LDL, heart murmur, congenital heart disease, rheumatic
fever, or unexplained joint pains as child or youth, recurrent tonsillitis, anemia), family
cardiac history (HTN, obesity, diabetes, CAD, sudden death)
Heart sounds:
- S1/S2, normal heart sounds
- S3 (Kentucky), heard on inspiration
- S4 (Tennessee), heard on expiration
, Cardiac cycle:
- Atrial Systole
o Depolarization of SA node (P wave)
- Ventricular Systole
o Depolarization of Ventricles (QRS)
- Ventricular Diastole
o Ventricles relax and fill
Cardiac output:
- Volume of blood ejected per minute by ventricular contraction
o CO = (EDV – ESV) x HR
o Normal cardiac output for adults 4-8 L/min
- EDV (end ventricular diastole)
o Approx. 140 ml of blood in ventricles after ventricular diastole
- ESV (end stroke volume)
o Volume of blood ejected with each ventricular contraction
- Preload
o Filling
o Diuretics decrease preload
- Afterload
o Amount of blood left in heart after contraction
o ACE inhibitors, ARB’s, calcium channel blockers
Age related cardiovascular changes
- Myocardium
o Decreased efficiency and contractility
o Increase exercise (walking)
- SA node
o Decreased number of pacemaker cells
- Left ventricle
o Hypertrophy: increased time for filling/emptying, hardest working part of heart
- Valves/blood vessels
o Valves are thicker, more rigid; decreased arterial elasticity; increased PVR
Cardiovascular Disease
Coronary Artery Disease (CAD)
- Caused by atherosclerosis, occlusion of coronary arteries by fibrous, fatty, plaque.
Atherosclerosis
- Abnormal accumulation of lipid deposits and fibrous tissue within coronary artery walls
- Blockages/narrowing of coronary vessels, reducing blood flow to myocardium
- Leads to myocardial ischemia
