cardiac


Introduction to Cardiovascular Nursing

  • Nursing Responsibilities

    • Key tasks related to drugs and patient monitoring.

  • Pharmacology and Med Dosage

    • Importance of understanding medications in cardiac care.

CPR Steps

  1. Check Airway

  2. Start Chest Compressions

  3. Give Rescue Breaths

Section 1: Perfusion & Shock Objectives

  • Evaluate cardiovascular assessment data (adult and pediatric).

  • Manage diagnostic tests/procedures in cardiac disorders.

  • Analyze pathophysiology and formulate evidence-based nursing care.

  • Assess preoperative and postoperative care in cardiac procedures.

Section 2: Heart Anatomy

Blood Flow Pathway

  1. Deoxygenated Blood from the body enters via veins.

  2. Right Atrium → Tricuspid Valve → Right Ventricle.

  3. Pulmonary Valve → Lungs for gas exchange.

  4. Oxygenated Blood from lungs via pulmonary veins to:

  5. Left Atrium → Mitral Valve → Left Ventricle.

  6. Pumps blood to body through Aorta.

Components of the Heart

  • Chambers: Right atrium, right ventricle, left atrium, left ventricle.

  • Valves: Tricuspid (R), Mitral/Bicuspid (L), Pulmonic (R), Aortic (L).

  • Layers: Epicardium, myocardium, endocardium.

Section 3: Cardiac Assessment

Health History Collection

  • Collect data on patient’s chief complaint, present illness, and medications.

  • Identify risk factors and comorbidities.

Physical Assessment

  1. Inspect: Jugular venous distention, cyanosis.

  2. Palpate: Peripheral pulses, thrills.

  3. Auscultate: Heart sounds, murmurs.

Nursing Responsibilities

  • Identify abnormal lung & heart sounds, monitor EKG data.

  • Differentiate normal vs. pathological findings.

Subjective & Objective Data

  • Gather comprehensive health history including lifestyle factors.

Section 4: Cardiac Output and Hemodynamics

  • Cardiac Output (CO): 💡 Normal = 4-8 L/min.

  • Stroke Volume (SV): 💡 Normal = 60-100 mL/beat.

  • Ejection Fraction (EF): 💡 Normal = 55-70%.

Key Formulas

  1. CO = HR x SV

  2. Preload: Amount of blood in ventricles at diastole end.

  3. Afterload: Pressure ventricles must overcome to eject blood.

Section 5: Types of Shock

Hypovolemic Shock

  • Definition: Loss of blood volume → inadequate perfusion.

  • Manifestations: Tachycardia, hypotension, cool clammy skin.

  • Management: IV fluids, blood transfusions, monitor vitals.

Cardiogenic Shock

  • Definition: Heart fails to pump effectively.

  • Manifestations: Pulmonary edema, cyanosis.

  • Management: Oxygen, medication, IV fluids, possible mechanical support.

Septic Shock

  • Definition: Severe infection leads to systemic vasodilation.

  • Manifestations: Fever, hypotension, increased heart rate.

  • Management: IV fluids + antibiotics, monitor lactate levels.

Neurogenic Shock

  • Definition: Loss of sympathetic tone leads to vasodilation.

  • Management: Positioning, intravenous fluids, medications.

Anaphylactic Shock

  • Definition: Severe allergic reaction causing vasodilation.

  • Management: Epinephrine, IV fluids.

Section 6: Common Cardiovascular Medications

Anticoagulants

  • Use: Prevent thromboembolic events.

  • Monitoring: aPTT for heparin, INR for warfarin.

Antiplatelet Agents

  • Use: Prevent clot formation in CAD.

Thrombolytics

  • Use: Break down clots in ST-elevation myocardial infarction (STEMI).

Inotropes

  • Examples: Dobutamine, epinephrine – improve myocardial contractility.

Vasoactive Medications

  • Use: Treatment of shock, maintain blood pressure.

Section 7: ECG Interpretation

Normal Sinus Rhythm

  • Rate: 60-100 bpm, Regular rhythm, P waves present.

Arrhythmias

  • Atrial Fibrillation: Irregular rate; risk of thrombus.

  • Ventricular Tachycardia: Wide QRS; may progress to cardiac arrest.

  • Ventricular Fibrillation: Completely chaotic; immediate CPR needed.

Summary and Nursing Considerations

  • Patient Safety: Continuous monitoring required for vital signs and rhythms.

  • Education on Lifestyle: Healthy diet, exercise, adherence to medications.

  • Vigilance in Recognition: Early identification of shock states vital for patient outcomes.