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Karch’s Focus on Nursing Pharmacology, 9th Ed., Tucker
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Chapter 42: Introduction to the Cardiovascular System

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Karch’s Focus on Nursing Pharmacology, 9th Ed., Tucker | Registered Nurse (RN) School Study Aid

Chapter 42: Introduction to the Cardiovascular System
16 Picmonics to Learn | 30 mins
Coronary Artery Bypass Grafting (CABG)
Indications
ST-Segment Elevation Myocardial Infarction (STEMI)
Cardiovascular Disease (CAD)
Uncontrolled Angina
Considerations
Internal Mammary Artery
Saphenous (Leg) Vein
Transient Limb Edema
Closely Monitor Patients
Venous Thromboembolism (VTE) Prophylaxis
Incentive Spirometer
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2 mins
Types of Heart Failure
Left Sided
Pulmonary Congestion
Right Sided
Peripheral Edema
High Output
Unable to Meet Metabolic Needs
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1 min
Heart Failure Interventions
Diagnostic Tests
Echocardiogram
Invasive Hemodynamic Monitoring
Improve Gas Exchange
High Fowler's Position
Oxygen
Advanced Airway
Drugs and Devices
Diuretics
Beta Blockers
Angiotensin II Receptor Blockers (ARBs)
ACE Inhibitors
Digoxin (Lanoxin)
Pacemaker
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2 mins
Right Heart Failure Assessment
Jugular Venous Distention (JVD)
Peripheral Edema
Hepatosplenomegaly
Nocturia
Weight Gain
Ascites
Fatigue
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1 min
Left Heart Failure Assessment
Pulmonary Assessment
Pulmonary Congestion
Pink Frothy Sputum
Wheezing or Crackles
Dyspnea with Exertion
Cough
Systemic Assessment
Fatigue
Tachycardia
Weak Peripheral Pulse
S3, S4 Heart Sounds
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1 min
Cardiac Catheterization
Considerations
Fluttering Sensation
Contrast Media
NPO 6-12 Hours
After Procedure
Bed Rest
Assess Circulation
Assess for Bleeding
Monitor Vital Signs
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2 mins
Evolution of Myocardial Infarction and Complications
Hours to Days
Arrhythmia
Before 7 Days
Fibrinous Pericarditis
Papillary Muscle Rupture
Interventricular Septum Rupture
Before 14 Days
Ventricular Pseudoaneurysm
Ventricular Free Wall Rupture
After 14 Days
True Ventricular Aneurysm
Dressler Syndrome
Other
Left Ventricular Failure
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2 mins
Low Blood Pressure Response
Characteristics
Posterior Pituitary Releases Vasopressin
Vasoconstriction
Adrenal Cortex Releases Aldosterone
Increased Na+ and H2O Reabsorption
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1 min
High Blood Pressure Response
Characteristics
Atria Release Atrial Natriuretic Peptide
Vasodilation
Antagonizes Aldosterone
Na+ and Water Excreted
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1 min
Blood Pressure Classification (JNC 7)
Classifications
Normal
Systolic (<120)
Diastolic (< 80)
Prehypertension
Systolic +20 (120-139)
Diastolic +10 (80-89)
Stage 1 Hypertension
Systolic +20 (140-159)
Diastolic +10 (90-99)
Stage 2 Hypertension
Systolic + > 20 (160)
Diastolic + > 10 (100)
Hypertensive Crisis
Systolic > 180
Diastolic > 110
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4 mins
Myocardial Infarction Assessment
Assessment
Substernal Chest Pain
Crushing or Dull Sensation
Arm, Jaw, and Neck
> 20 Minutes
Unrelieved by Nitro
Palpitations
Diaphoresis
Fear of Impending Doom
Nausea and Vomiting
Shortness of Breath
Considerations
Monitor for Arrhythmias
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2 mins
Myocardial Infarction Interventions
MONA
Morphine
Oxygen
Nitrates
Aspirin
Thrombolytics (tPA)
Invasive Procedures
Cardiac Catheterization
Stent Placement
Angioplasty
Coronary Artery Bypass Grafting (CABG)
Considerations
Decrease Modifiable Risk Factors
Resuming Activity (Physical, Sexual)
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2 mins
Myocardial Infarction Diagnosis
Diagnosis
12 Lead ECG
ST Elevation
Q Wave
T Wave Inversion
Troponin T and I
CK-MB
Considerations
Early ECG
Cardiac Stress Test
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2 mins
Troponin Lab Values
Troponin T (cTnT)
< 0.1 ng/mL Normal
Troponin I (cTnI)
< 0.5 ng/mL Normal
> 2.3 ng/mL Myocardial Injury
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2 mins
Hypoxia (Late Symptoms)
Cyanosis
Cool, Clammy Skin
Use of Accessory Muscles
Retractions
Hypotension
Arrhythmias
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2 mins
Hypoxia (Early Symptoms)
Diaphoresis
Restlessness
Tachypnea
Dyspnea on Exertion
Tachycardia
Hypertension
Arrhythmias
Decreased Urine Output
Unexplained Fatigue
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1 min

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