circulation

Here are the detailed notes on Circulation and Perfusion, compiled strictly from the provided slide deck:

1. Structure and Function of the Cardiovascular System

• The Heart & Cardiac Cycle:

  
  
  

  • Features the simultaneous contraction of the two atria, followed a fraction of a second later by the simultaneous contraction of the ventricles.

    
    

  • Driven by electrical conduction (electrical activity that initiates contraction of the myocardium).

    
    

• Cardiopulmonary Flow Sequence:

  
  
  

  • Body Tissues $\rightarrow$ Vena Cava $\rightarrow$ Right Atrium (via Tricuspid AV Valve) $\rightarrow$ Right Ventricle (via Pulmonary Semilunar Valve) $\rightarrow$ Pulmonary Arteries $\rightarrow$ Lungs.

    
    

  • Lungs $\rightarrow$ Pulmonary Veins $\rightarrow$ Left Atrium (via Bicuspid AV Valve) $\rightarrow$ Left Ventricle (via Aortic Semilunar Valve) $\rightarrow$ Aorta $\rightarrow$ Body Tissues.

    
    

• Blood Vessels & Components:

  
  
  

  • Arteries: Carry oxygenated blood away from the heart to tissues.

    
    

  • Arterioles, Capillaries, Venules, and Veins: Form systemic and pulmonary blood vessel networks.

    
    

  • Veins: Carry deoxygenated blood back to the heart and lungs; contain valves.

    
    

  • Red Blood Cells & Hemoglobin: Hemoglobin carries oxygen.

    
    

• Coronary Arteries:

  
  
  

  • Provide blood supply to the heart.

    
    

  • Fill during diastole. (Includes Left Coronary Artery, Anterior Interventricular Branch, Great Cardiac Vein, Right Coronary Artery and Vein).

    
    

• Regulation of Cardiovascular Function:

  
  
  

  • Autonomic Nervous System: Sympathetic and parasympathetic fibers regulate heart rate and contractility, while maintaining vascular tone in the vascular system.

    
    

  • Brainstem Centers: Regulate cardiac function and blood pressure.

    
    

  • Baroreceptors: Sensitive to pressure changes.

    
    

  • Vascular System: Sensitive to blood pH, oxygen levels, and carbon dioxide ($CO_2$).

    
    

2. Factors Influencing Cardiac Function

• Developmental Stage:

  
  
  

  • Infants: Transition to life outside the uterus, congenital heart factors.

    
    

  • Preschool/School-Age: Growth, diet, and obesity.

    
    

  • Adolescents: Substance use/abuse, diet, and obesity.

    
    

  • Adults: Lifestyle, stress, heredity, diet, exercise, obesity.

    
    

  • Older Adults: Thicker and more rigid valves, decreased myocardial strength, lower exercise tolerance, other health problems.

    
    

• Environment: Stress, allergic reactions, air quality, altitude, heat, and cold.

  
  

• Lifestyle: Pregnancy, nutrition, obesity, exercise, tobacco use, and substance abuse.

  
  

• Medications (Cardiovascular Depressants):

  
  
  

  • Used therapeutically to slow the heart rate or reduce the force of myocardial contraction, which may reduce cardiac output and impair tissue oxygenation.

    
    

  • Common examples: Beta-adrenergic blocking agents and Calcium channel blocking agents.

    
    

• Pathological Abnormalities:

  
  
  

  • Cardiovascular abnormalities: Heart failure, cardiomyopathy, cardiac ischemia, coronary artery disease, dysrhythmias, and heart valve abnormalities.

    
    

  • Peripheral vascular abnormalities.

    
    

  • Oxygen transport abnormalities: Anemia and carbon monoxide.

    
    

3. Laboratory, Diagnostic Testing, and Cardiac Monitoring

• Assessment & Recognizing Cues: Assess/recognize cues for risk factors, anxiety level, pain, fatigue, dyspnea, and peripheral circulation.

  
  

• Diagnostic Tests: Tests of blood oxygenation and lab testing.

  
  

• Cardiac Monitoring:

  
  
  

  • Evaluates rhythms including supraventricular, junctional, and ventricular rhythms.

    
    

  • Key waveform components: P wave, QRS complex, and T wave.

    
    

  • Standard lead placement reference points include landmarks like the Angle of Louis, chest placements, right/left arms, and right/left legs.

    
    

4. Common Cardiac Issues and Nursing Diagnoses

• Common Cardiac Issues: Heart failure, cardiomyopathy, cardiac ischemia, coronary artery disease (CAD), dysrhythmias, and heart valve abnormalities.

  
  

• Cardiovascular Nursing Diagnoses (Analyzing Cues):

  
  
  

  • Decreased Cardiac Output (defined as occurring when the heart is unable to pump adequate amounts of blood to meet the metabolic demands of the body; definitive interventions are collaborative).

    
    

  • Risk for Impaired Cardiac Tissue Perfusion.

    
    

  • Risk for Impaired Cerebral, Gastrointestinal, or Renal Tissue Perfusion.

    
    

  • Impaired Peripheral Tissue Perfusion.

    
    

  • Risk for Shock.

    
    

5. Promoting Peripheral Circulation and Nursing Actions

• Nursing Implementation and Taking Action:

  
  
  

  • Manage anxiety.

    
    

  • Promote circulation (both venous and arterial).

    
    

  • Prevent clot formation.

    
    

  • Administer medication.

    
    

  • Perform CPR.

    
    

• Specific Interventions to Prevent Clot Formation in the Legs:

  
  
  

  • Turn the patient frequently or encourage frequent position changes. (Note: Avoid keeping hips/knees flexed in bed or limiting oral hydration when aiming to promote circulation and prevent clots).