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Medical-Surgical Nursing, 10th Ed., Ignatavicius & Workman, 2020 | Nursing (RN) School Study Aid


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30 - Assessment of the Cardiovascular System
21 Picmonics to Learn | 37 mins

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Coronary Arteries
Aortic Root
Right Coronary Artery (RCA)
Right (Acute) Marginal Artery
Posterior Descending Artery (PDA)
Left Coronary Artery (LCA)
Left Anterior Descending (LAD) Artery
Circumflex Artery
Left Marginal Artery
1 min
Cardiac Cycle - Diastole
Characteristics
Aortic Valve Closes
Pulmonary Valve Closes
Ventricles Relax
Mitral Valve Opens
Tricuspid Valve Opens
Ventricles Fill
Sinoatrial (SA) Node Fires
Atrial Contraction
3 mins
Cardiac Cycle - Systole
Characteristics
AV Node
AV Node Conducts Signal to Bundle of His
Bundle of His Signals Purkinje Fibers to Contract Ventricles
Tricuspid Valve Closes
Pulmonary Valve Opens
Mitral Valve Closes
Aortic Valve Opens
2 mins
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
4 mins
Autonomic Nervous System
Characteristics
Sympathetic Nervous System
Fight or Flight
All Preganglionic Neurons Release Acetylcholine
Sympathetic Postganglionic Neurons Release Norepinephrine
Antagonistic Effects of Sympathetic and Parasympathetic Nervous Systems
Parasympathetic Nervous System
Rest and Digest
Parasympathetic Postganglionic Neurons Release Acetylcholine
2 mins
Acute Pericarditis Assessment
Pericardial Sac Inflammation
Assessment
Sharp Chest Pain
Increased with Inspiration
Pain Decreased by Leaning Forward
Pericardial Friction Rub
Diffuse ST-Elevation
T Wave Inversion
Fever
Considerations
May Be Asymptomatic
Cardiac Tamponade
2 mins
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
1 min
Lymphatics
Characteristics
Recycles 10% of Interstitial Fluid
Transport Large Lipids from Lacteals
Unidirectional Valves
Lymph Nodes Filter Lymph
WBCs Monitor Lymph for Pathogens
Merge with Veins
2 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
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
2 mins
Cardiac Enzyme Evaluation: Troponin
Measures
Cardiac Muscle Injury
Time Ranges
Onset: 1 Hour
Peak: 10 - 24 Hours
Return to Normal: 5 - 14 Days
Considerations
Most Specific for Cardiac Muscle
Treated Aggressively
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
2 mins
Cardiac Enzyme Evaluation: Creatine Kinase CK-MB
Measures
Skeletal or Cardiac Muscle Injury
Time Ranges
Onset: 4-8 Hours
Peak: 12-24 Hours
Return to Normal: 2-3 Days
1 min
Cardiac Enzyme Evaluation: Myoglobin
Measures
Skeletal or Cardiac Muscle Injury
Time Ranges
Onset: 1 - 4 Hours
Peak: 12 Hours
Return to Normal: 24 Hours
Considerations
Elevation After 24 Hours: Reinfarction
2 mins
Cholesterol Lab Values
LDL (Low Density Cholesterol)
< 100 mg/dL
HDL (High Density Cholesterol)
> 40 mg/dL Males
> 50 mg/dL Females
Total Cholesterol
< 200 mg/dL
1 min
Triglycerides Lab Value
< 150 mg/dL
50 secs
PT/PTT Lab Values
Prothrombin Time (PT)
10-14 seconds
Activated Partial Thromboplastin Time (PTT or aPTT)
25-35 seconds
1 min
INR Lab Value
0.8-1.2 Normal Range
Warfarin
2.0-3.0
1 min
Hypocalcemia
Assessment
< 8.5 mg/dL Ca2+
Decreased Bone Density
Muscle Spasms
Tetany
Chvostek's Sign
Trousseau's Sign
Increased DTR
ECG Changes
QT Prolongation
Considerations
Oral and IV Replacement of Ca2+
Seizure Precautions
2 mins
Cardiac Catheterization
Considerations
Fluttering Sensation
Contrast Media
NPO 6-12 Hours
After Procedure
Bed Rest
Assess Circulation
Assess for Bleeding
Monitor Vital Signs
2 mins
Magnetic Resonance Imaging (MRI)
Procedure
Internal Body Images
Detects Variations of Soft Tissues
Considerations
No Metal Objects
No Pacemakers
Contrast is Non-Iodine
Safe During Pregnancy
Long Procedure
Antianxiety Medications
2 mins

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