NCM 118 Nursing Care of Client with Life Threatening Conditions

Flashcards covering essential concepts of critical care nursing, cardiac anatomy, physiology, conduction, hemodynamics, and pulmonary artery catheter monitoring based on NCM 118 lecture notes.

Critical Care Nursing

A complex and challenging area of nursing practice where clinical expertise is developed over time by integrating critical care knowledge, clinical skill, and caring practices.

Endocardium

The innermost layer of the heart.

Myocardium

The middle, muscular layer of the heart responsible for pumping action.

Epicardium

The outermost layer of the heart.

Diastole

The relaxation phase of the cardiac cycle where all chambers relax, allowing the ventricles to fill with blood.

Systole

The contraction phase of the cardiac cycle, where the atria and then the ventricles contract to eject blood.

Atrioventricular (AV) Valves

Valves located between the atria and ventricles, consisting of the tricuspid valve (right side) and bicuspid/mitral valve (left side).

Semilunar Valves

Valves between the ventricles and the great arteries, including the pulmonic valve and the aortic valve.

Automaticity

The ability of the specialized cardiac conduction cells to initiate an electrical impulse.

Excitability

The ability of the cardiac cells to respond to an electrical impulse.

Conductivity

The ability of the cardiac cells to transmit an electrical impulse from one cell to another.

Sinoatrial (SA) node

Located at the junction of the SVC and RA, it is the primary pacemaker of the heart with an inherent rate of $60-100/min$.

Atrioventricular (AV) node

The secondary pacemaker located in the right atrial wall that relays impulses to the ventricles with a rate of $40-60/min$.

Bundle of His

The start of the ventricular pacemaker system which divides into right and left bundle branches with a rate of $30-40/min$.

Purkinje fibers

The terminal point of the cardiac conduction system that stimulates the ventricular myocardium.

Atrial Kick

The process where atrial contraction at the end of diastole augments ventricular filling by $15-20\%$.

Hemodynamics

The study of factors affecting myocardial function, regulating BP, and determining cardiac performance through principles of pressure, flow, and resistance.

Cardiac Output (CO)

The total amount of blood ejected by one of the ventricles in liters per minute; normal range is $4-8\,l/min$.

Cardiac Index (CI)

Cardiac output adjusted for body surface area (BSA); normal range is $2.5-4\,l/min/m^2$.

Stroke Volume (SV)

The amount of blood ejected from one of the ventricles per heartbeat; normal range is $50-100\,ml$.

Preload

The degree of stretch of the ventricular muscle at the end of diastole, determined by the volume of blood in the ventricle.

Frank-Starling Law

The principle stating that the greater the stretch (preload), the greater the volume ejected, until a physiologic limit is reached.

Afterload

The resistance to ejection of blood from the ventricle, often measured as Systemic Vascular Resistance (SVR) or Pulmonary Vascular Resistance (PVR).

Systemic Vascular Resistance (SVR)

The resistance of the systemic blood pressure to left ventricular ejection; normal range is $800-1200\,dynes/cm^3$.

Contractility

The force generated by the contracting myocardium, enhanced by catecholamines and suppressed by hypoxemia or acidosis.

Ejection Fraction (EF)

The percentage of end-diastolic blood volume ejected with each heartbeat; normal resting range is $55-65\%$.

Pulse Pressure

The difference between systolic and diastolic pressures; normal range is $40-60\,mmHg$.

Mean Arterial Pressure (MAP)

The pressure needed to perfuse vital organs; normal range is $70-105\,mmHg$; calculated as $\frac{\text{systole} + 2(\text{diastole})}{3}$.

Central Venous Pressure (CVP)

A measurement of right atrial pressure and right ventricular preload; normal range is $0-8\,mmHg$ via transducer or $3-8\,cmH_2O$ via manometer.

Pulmonary Artery Occlusion Pressure (PAOP)

Also known as wedge pressure, it is an indirect measurement of left atrial pressure and left ventricular preload; normal range is $6-12\,mmHg$.

Pulmonary Artery Pressure (PAP)

The pressure exerted by blood against the pulmonary arterial wall; normal systolic is $15-25\,mmHg$ and normal diastolic is $8-15\,mmHg$.

Mixed Venous Oxygen Saturation (ScvO2)

Measures the balance between oxygen delivery and consumption, reflecting oxygen "left over" after tissue extraction; normal range is $60-80\%$.