ENTIRE CARDIAC SYSTEM
MEDICAL SURGICAL NURSING
(IVY TECH COMMUNITY
COLLEGE OF INDIANA)
, Cardiac System
Assessment of Cardiac System
❖ Stroke volume (SV) Diagnostic Test
▪ Preload
Labs ❖ Cardiac Stress test
▪ Afterload ❖ Cardiac biomarkers ➢ Uses
❖ Cardiac output (CO)=SV X HR ▪ CK ➢ Contraindications
❖ Factors that influence blood flow ▪ CK-MB ➢ Pt instructions
❖ Physical assessment ▪ Troponin and ➢ How test is performed
❖ Palpation and auscultation myoglobin ➢ 2 Types of tests
❖ Nutrition ❖ BNP ▪ Exercise
❖ Activity ❖ Lipid profile ▪ Pharmacologic (adenosine &
❖ Sleep/rest ❖ C-reactive protein Dipyridamole)
❖ VS ❖ Electrolytes ❖ Echocardiograph
❖ Medications ❖ Coagulation ▪ Transthoracic
❖ Family hx and prevention strategies ❖ H&H ▪ TEE (Transesophageal)
❖ Electrical conduction of Heart ❖ Platelet ❖ Radionuclide imaging
❖ SA Node ❖ ECG
❖ Depolarization=stimulation=systole
❖ Repolarization=relaxation=diastole ECG-handout
❖ ECG ❖ Reading an ECG
➢ Small box 0.04 seconds
➢ Big box 0.2 seconds
➢ 6 second strip (30 boxes) 0.2 sec X
30=6seconds
➢ 6 seconds X 10=60 seconds (1 minute)
➢ P wave
➢ QRS complex
➢ T wave
➢ ST segment
▪ MI=above
▪ Myocardial Ischemia=below
➢ HR determination
▪ Normal sinus
▪ Dysrhythmia
• Sinus Brady cardia
Atropine 0.5 mg IV q 3-5 min
• Sinus Tachycardia
Synchronized cardioversion
Vagal maneuvers
Adenosine 6mg IV then 12mg
Complications
❖ PVD
❖ PAD
❖ DVT
Medical Management Dysrhythmias ❖ CAD
❖ PTCA (percutaneous transluminal angioplasty) ❖ Assessment ❖ Hypertension
❖ Cardiac catheterization ➢ Cause of dysrhythmia ❖ Angina
➢ Measure cardiac chamber pressure ➢ Physical assessment ❖ MI
➢ Assess patency of coronary arteries ❖ Diagnoses ❖ CHF
➢ Prior to procedure ➢ Decreased CO ❖ Valvular Disorders
➢ During procedure ➢ Activity intolerance ❖ Inflammatory heart disease
➢ Post procedure ❖ Decreased tissue perfusion ❖ Dysrhythmia
❖ Medications ❖ Anxiety
❖ Oxygen ❖ Deficient knowledge
❖ DASH Diet ❖ Complications
❖ Smoking cessation and weight loss ➢ Cardiac arrest
❖ Rest with progressive exercise ➢ HF
❖ Balloon valvuloplasty and annuloplasty rings ➢ Thrombolytic event
❖ Valve replacement ❖ Goals
❖ CABG ➢ Maintain CO & stop dysrhythmia
↓anxiety & ↑Knowledge
MEDICAL SURGICAL NURSING
(IVY TECH COMMUNITY
COLLEGE OF INDIANA)
, Cardiac System
Assessment of Cardiac System
❖ Stroke volume (SV) Diagnostic Test
▪ Preload
Labs ❖ Cardiac Stress test
▪ Afterload ❖ Cardiac biomarkers ➢ Uses
❖ Cardiac output (CO)=SV X HR ▪ CK ➢ Contraindications
❖ Factors that influence blood flow ▪ CK-MB ➢ Pt instructions
❖ Physical assessment ▪ Troponin and ➢ How test is performed
❖ Palpation and auscultation myoglobin ➢ 2 Types of tests
❖ Nutrition ❖ BNP ▪ Exercise
❖ Activity ❖ Lipid profile ▪ Pharmacologic (adenosine &
❖ Sleep/rest ❖ C-reactive protein Dipyridamole)
❖ VS ❖ Electrolytes ❖ Echocardiograph
❖ Medications ❖ Coagulation ▪ Transthoracic
❖ Family hx and prevention strategies ❖ H&H ▪ TEE (Transesophageal)
❖ Electrical conduction of Heart ❖ Platelet ❖ Radionuclide imaging
❖ SA Node ❖ ECG
❖ Depolarization=stimulation=systole
❖ Repolarization=relaxation=diastole ECG-handout
❖ ECG ❖ Reading an ECG
➢ Small box 0.04 seconds
➢ Big box 0.2 seconds
➢ 6 second strip (30 boxes) 0.2 sec X
30=6seconds
➢ 6 seconds X 10=60 seconds (1 minute)
➢ P wave
➢ QRS complex
➢ T wave
➢ ST segment
▪ MI=above
▪ Myocardial Ischemia=below
➢ HR determination
▪ Normal sinus
▪ Dysrhythmia
• Sinus Brady cardia
Atropine 0.5 mg IV q 3-5 min
• Sinus Tachycardia
Synchronized cardioversion
Vagal maneuvers
Adenosine 6mg IV then 12mg
Complications
❖ PVD
❖ PAD
❖ DVT
Medical Management Dysrhythmias ❖ CAD
❖ PTCA (percutaneous transluminal angioplasty) ❖ Assessment ❖ Hypertension
❖ Cardiac catheterization ➢ Cause of dysrhythmia ❖ Angina
➢ Measure cardiac chamber pressure ➢ Physical assessment ❖ MI
➢ Assess patency of coronary arteries ❖ Diagnoses ❖ CHF
➢ Prior to procedure ➢ Decreased CO ❖ Valvular Disorders
➢ During procedure ➢ Activity intolerance ❖ Inflammatory heart disease
➢ Post procedure ❖ Decreased tissue perfusion ❖ Dysrhythmia
❖ Medications ❖ Anxiety
❖ Oxygen ❖ Deficient knowledge
❖ DASH Diet ❖ Complications
❖ Smoking cessation and weight loss ➢ Cardiac arrest
❖ Rest with progressive exercise ➢ HF
❖ Balloon valvuloplasty and annuloplasty rings ➢ Thrombolytic event
❖ Valve replacement ❖ Goals
❖ CABG ➢ Maintain CO & stop dysrhythmia
↓anxiety & ↑Knowledge
