Cardiac Disorders Notes

CARDIAC DISORDERS NOTES Symptoms of cardiac disorders 1) Fatigue 2) Edema 3) Palpitations 4) Dyspnea 5) Pain Diet Therapy ● Cholesterol intake should be limited to 200mg/day ● Sodium restricted to 1,500mg/day if patient has fluid retention Arteriosclerosis - Abnormal thickening, hardening, loss of elasticity of arterial walls Effects of Arteriosclerosis ● Hypertension ● Impaired tissue perfusion ● Aneurysms Atherosclerosis - Form of arteriosclerosis; inflammatory disease that begins w/ endothelial injury and progresses to the complicated lesion in advances Mitral regurgitation: (INSUFFICIENCY) allows blood to flow back into the LA during diastole. The valve does not close completely because one or both of the valve leaflets becomes rigid and shortens. Heart failure right side: Swelling of leg,hands,liver,weight gain,edema,jugular venous distention,tired,irregular HR (afib),nocturia, Heart failure left side:Dyspnea,crackles,orthopnea,weakness,nocturnal paroxysmal dyspnea, Increased HR, nagging cough,Gaining weight Lesions S1: Lub; when ventricles contract S2: Dub; relaxation, the closing of aortic valves SA Node: Pacemaker (60-100BPM) AV Node: (Alternative) (40-60BPM) Coronary Sinus: The largest coronary vein Collateral arteries: Small capillary like branches of an artery; that form overtime in response to a narrowed coronary artery. Helping to restore blood flow. Lunar valves: Aortic and pulmonic For the heart to pump blood through the chambers the nurse must stimulate muscle contractions in order. If out of order they won’t be able to pump properly. Older Adults: SA Node isn’t as effective. Cardiac dysrhythmias are more common Medical history: Hypertension, kidney disease, pulmonary disease, stroke, rheumatic fever, streptococcal sore throat, and scarlet fever. Family history: Assess whether immediate relatives have had hypertension, coronary artery disease (CAD), other cardiac disorders, or diabetes mellitus Myocardial oxygen consumption: tissue routinely needs 70-75% of the oxygen delivered to it by the coronary arteries. The semilunar valves separate the ventricles from the aorta and the pulmonary artery. Cardiac output: amount of blood (in liters) ejected per min Cardiac cycle: contraction and relaxation of the heart make up one heartbeat Factors that affect stroke vol: preload, contractility and afterload Stable angina: occurs w/ exercise or activity and subsides w/ rest Unstable angina: pain more severe, occurs at rest or minimal excretion often not relieved by nitroglycerin or requires more frequent NTG administration Variant angina/Prinzmetal angina: caused by coronary artery spasm; not associated with CAD; unpredictable and often occurs at rest Medical treatment for angina: Aspirin, antianginal therapy, ACE inhibitor, Beta blocker and blood pressure, Cigarette smoking and cholesterol, Diet and diabetes, Education and exercise and flu vaccine Myocardial infarction (MI) : Death of myocardial tissue caused by prolonged lack of blood and O2 supply Risk factors: smoking, obesity, high fat diet, hypertension, diabetes mellitus, physical inactivity, stress Signs and symptoms: pain, heavy or constrictive pain located below or behind the sternum, as described with angina. It may radiate to the arms, back, neck, or jaw. The pain may begin with or without exertion and lasts for more than 20 min. The pain is described as more severe than the pain of angina. The patient becomes diaphoretic and lightheaded and may experience nausea, vomiting, and dyspnea. The skin is frequently cold and clammy. The patient experiences great anxiety and often a feeling of impending doom. Women, older adults, and diabetic patients often have atypical symptoms. Women may report fatigue, sob, and atypical chest pain. Older adults and diabetic patients may experience chest pain, sob, dizziness and nausea. Sign and symptoms of MI: Chest pain,Radiating chest pain to L arm, haw, back, unrelieved by nitrogen or rest, sweating (cold), SOB, increased bp and HR or irregular HR Nausea and vomiting,anxious and scared Acute Myocardial infarction:Pathophysiology Begins with occlusion of a coronary artery Over 4 to 6 hours, ischemia, injury, infarction develop Ischemia results from a lack of blood and oxygen to a portion of the heart muscle If ischemia is not reversed, injury occurs Deprived of blood and oxygen, the affected tissue becomes soft and loses its normal color Continued ischemia: infarction of myocardial tissue • Ischemia lasting 20 minutes or more is sufficient to produce irreversible tissue damage