NURS190 Midterm Study Guide

NURS190 Midterm Study Guide NURS190 midterm study guide Cardiovascular System: Cardiac Output • Stroke volume – Amount of blood that is ejected with each heartbeat • Cardiac output – Amount of blood ejected from the left ventricle over 1 minute Stroke volume x HR = CO Preload is related to the amount of blood and stretching of the ventricular myocardial fibers Afterload is the pressure that the ventricle must overcome in order to open the aortic and pulmonic valve MI signs/symptoms • Male - Complaints of chest pain that is prolonged, dull, and radiates to the shoulder or jaw. • Female - Experience nausea and vomiting, indigestion, shortness of breath, or extreme fatigue, without actual chest pain. Positioning for cardiac assessment 1. Supine 2. Sitting 3. Left lateral 4. Sitting forward Murmur assessment (how it is done and what is malfunctioning) • S3 • S4 – Occurs when ventricle reaches elastic limit – Patients with heart failure and S3 often have a poor prognosis. – Associated with active atrial contractions that cause late ventricular filling • Friction rubs • Harsh murmurs • Harsh, blowing sounds cause by disruption of blood flow Five landmarks for auscultation: 1. Pulmonic areas 1 and 2 2. Aortic area 3. Tricuspid area 4. Mitral area 5. Apex Cardio or respiratory problem in someone of darker color  Assess their lips • Infants and children – Fetus receives oxygen and nutrients from the mother. – Changes occur in the newborn's cardiovascular system in the first few days of life – Infant's heart rate initially as high as 160–180 bpm • The pregnant female – Heart is displaced to the left and upward. – Blood volume increases 30% to 50%. – Cardiac output and stroke volume increase. – Resting pulse may increase. – Murmurs may be auscultated. • The older adult – Loss of ventricular compliance and vascular rigidity – Conduction system loses automaticity Splinter hemorrhages – Bc of blood pressure or trauma • What causes a splinter hemorrhage? Splinter hemorrhages can occur with infection of the heart valves (endocarditis). They may be caused by vessel damage from swelling of the blood vessels (vasculitis) or tiny clots that damage the small capillaries (microemboli). Carotid artery assessment 1. Inspect the neck for carotid pulsations. - With the patient in a supine or sitting position, inspect the neck from the hyoid bone to the clavicles. Bilateral pulsations will be seen between the trachea and sternocleidomastoid muscle. 2. Palpate the carotid pulses. - Place the pads of your first two or three fingers on the patient's neck between the trachea and the sternocleidomastoid muscle below the angle of the jaw. - Ask the patient to turn the head slightly toward your hand to relax the sternocleidomastoid muscle. - Palpate firmly but not so hard that you occlude the artery. - Palpate one side of the neck at a time. If you are having difficulty finding the pulse, try varying the pressure of your fingers, feeling carefully below the angle. - Note the rate, rhythm, amplitude, and symmetry of the carotid pulses. Compare this rate to the apical pulse.