NUR 220- Heart & Neck Vessels

CV system consists of:

heart & blood vessels

what is the precordium?

an area (not an actual structure)

* heart and great vessels
* Apical impulse- ==**IMPORTANT**==
* point of maximal impulse

What is the Mediastinum?

place where the heart is located

where is the base of the heart?

top

Where is the apex of the heart?

the bottom

what are the layers of the heart wall?

pericardium, myocardium, and endocardium

what are the 4 chambers of the heart?

right atrium, right ventricle, left atrium, left ventricle

How many heart valves are there?

4

what are the 3 AV valves?

tricuspid (right AV valve) & bicuspid/mitral (left AV valve)

what are the 2 semilunar valves (SL)?

Pulmonic (right SL valve) & Aortic (left SL valve)

direction of blood flow

1. vena cava
2. RA
3. tricuspid valve
4. RV
5. pulmonary valve
6. pulmonary arteries
7. lungs
8. pulmonary veins
9. LA
10. mitral/bicuspid valve
11. LV
12. aortic valve
13. aorta
14. body

ventricles are ____ during diastole

relaxed

During diastole, AV valves are __ & SL valves are __

open, closed

Ventricles ____ during systole

contract

during systole, AV valve __ & SL valve _

closes, opens

infant considerations

* fetal heart begins to beat after 3 weeks of gestation
* inflation and aeration of lungs at birth produces circulatory changes

pregnancy considerations

* blood volume increases 30-40%
* BP drops to lowest point during second trimester
* BP varies with person’s position
* heart enlarges- ==**MAY DEVELOP A SYSTOLIC MURMUR**==

aging adult considerations

* increase in systolic BP due to thickening and stiffening of arteries
* LV wall becomes thicker but the overall size of the heart does not change

cultural considerations

* African Americans have the world’s highest rates of HTN
* HTN develops earlier in life and is more severe than other ethnic groups
* Hispanic males have the highest LDL cholesterol worldwide followed by white women

Risk factors for CVD

* genetic, environmental, and lifestyle
* HTN
* smoking
* obesity
* high cholesterol
* diabetes

subjective data for CVD

* chest pain
* dyspnea
* fatigue
* cyanosis or pallor
* edema
* past cardiac history
* family cardiac history
* patient-centered care

objective data for CVD is collected by using what equipment?

stethoscope & alcohol wipes

CV assessmet

* pulse and BP
* neck vessels
* precordium
* auscultation of heart sounds

is there percussion in CV assessment?

NO

What do you listen for a bruit with?

BELL

S1

* lub
* closing of AV valves
* loudest at apex, beginning of systole

S2

* Dub
* closing of SL valves
* loudest at the base, end of systole

S3

* sounds like distant Kentucky thunder
* occurs immediately after S2
* beginning of diastole

S4

* soft and low pitch Tennessee
* occurs just before S1
* end of diastole