Flow of blood through the heart - Answers Superior vena cava →Right atrium →Tricuspid Valve→ Right
Ventricle →Pulmonic Valve→ Pulmonary Artery →Lungs →Pulmonary Vein →Left Atrium →Mitral
Valve→ Left Ventricle →Aortic Valve →Aortic Arch →Descending Aorta
Assessment of cardiovascular system - Answers Common Sypmtoms (murmur, angina), Past health,
family & social Hx, All medications, Nutrition (24 hr recall), Elimination, Activity & exercise, Self-
perception & Self-Concept, Roles & Relationships, Sexuality & Reproduction, Coping & Stress Tolerance.
Chest pain - Answers (Treat as MI until you figure out its something else)
Histal Hernia, GERD, Spasm, PNA, Pulmonary Embolism, Unstable angina/MI, Pericarditis, Anxiety, Panic,
Costochondritis
Physical Assessment of Cardiovascular System - Answers General Appearance: Conscious, Mental Status,
BMI
Assessment of Skin & Extremities: 6 P's- Pain, Pallor, Pulse-less, Parathesia (numbness & tingling),
Poikilothermia (Cold), Paralysis
B/P: Pulse pressure, Orthostatic, MAP (65)
Arterial Pulses: Rate, Rhythm, Amplitude (2+), Contour
Jugular Venous Pulsations: 30 degree HOB v 45-90 (Pulsing-right sided HF)
Heart inspection and Palpation
Heart Auscultation - Answers Normal Heart Sounds- S1-Systole S2-Diastole
Abnormal Heart Sounds - Answers S3-"Kentucky"
S4-"Tennessee"
Snaps-Mitral Stenosis
Clicks-Mitral Prolapse
,Murmurs
Friction Rub-"walking on snow"
Other Physical Assessment - Answers Left sided- Lungs: Hemoptysis (cough up blood), Cough, Crackles,
Wheezes
Right sided- Abdomen: Distention, Hepatojugular Reflux, Bladder Distention
Admitting Patient- ED - Answers Hx of Chief complaint
EKG
Focused Assessment
Admitting Patient- ICU - Answers Telemetry
EKG
Physical Assessment
Health Hx
Admitting Patient- Telemetry - Answers Telemetry
EKG
Physical Assessment
Health Hx
Admitting Pt- Med/Surg - Answers Physical Assessment
Health Hx
Discharge
Diagnostics - Answers Labs, EKG, Long-term Heart Monitors, Echo, Stress test, Nuclear Studies, CT
angiogram, Right/Left Heart Catheterization, Electro-physiology Studies
Non-Cardiac specific Labs - Answers Potassium (3.5-5 meq/ml)
RBC (45%)
Cardiac Specific Labs - Answers CK-MB (0% of CK)
Myoglobin (<90 mcg/L)
, Troponin I (<0.03 ng/ml) (heart muscle damage)
Lipid Profile (<200 mg/dl)
LDL (<130 mg/dl)
HDL (>55 mg/dl)
Triglycerides (40-140)
BNP (<100 pg/ml) (How heart is stretched, HF)
EKG - Answers Hardwire, Telemetry, 3-Lead, 5-Lead, 12-Lead, Arrhythmias,ST Elevation or Depression,
Comparison studies
Longer Term EKG Monitors - Answers Holter Monitor (wear for 2 days to month)
-Worn around the neck
-Record EKG to be downloaded later
-Pts press button during "events"
Implantable Event Recorders (up to a year)
-Implanted under skin
-EKG can be downloaded often
-Can be retrieved
types of echocardiograms - Answers Transthoracic Echo (TTE)- ultrasound
Transesophageal Echo (TEE)- probe down throat, NPO p2400, Sedation, more accurate
Measurment of Echocardiograms - Answers Ejection Fraction (How much blood gets out of heart)
Valvular Function (Different heart sounds)
Nursing Interventions of Echocardiograms - Answers May need to hold cardiac meds (to see what heart
is like w/out heart meds)
Stress Test - Answers Treadmill
Pharmacological