Cardiac Cycle - Diastole
- Aortic Valve Closes
- Pulmonary Valve Closes
- Ventricles Relax
- Mitral Valve Opens
- Tricuspid Valve Opens
- Ventricles Fill
- Sinoatrial (SA) Node Fires
- Atrial Contraction
Cardiac Cycle - Systole
- 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
High Blood Pressure Response
- Atria Release Atrial Natriuretic Peptide
- Vasodilation
- Antagonizes Aldosterone
- Na+ and Water Excreted
Primary Hypertension Risk Factors
- Excessive Alcohol Consumption
- High Sodium Diet
- Dyslipidemia
- Obesity
- People of African Descent
- Advanced Age
- Vitamin D Deficiency
- Reduced Nephron Number
- Diabetes
- Lack of Physical Activity
Hypertension Assessment
- Essential Hypertension
- Secondary Hypertension
- Headache
- Vision Changes
- Nosebleed (Epistaxis)
- Chest Pain
- Syncope (Fainting)
- Average 2 Sets, 2 Minutes Apart
- After 2 or More Visits (within 1-4 weeks)
- Take BP Both Arms
- Common in African Americans
Varicose Veins Assessment
- Increased Venous Pressure
- Incompetent Valves
- Telangiectasias
- Small Reticular Veins
- Dilated and Tortuous Veins
Superficial Thrombophlebitis
- IV Catheter Irritation
- Erythema
- Cord-like Vein
- Edema
- Remove IV Catheter
- Elevate
- Warm Compress
- Rotate Sites Q3 Days
- Aseptic Technique
Venous Thromboembolism (DVT) Assessment
- Venous Wall Inflammation caused by Thrombus
- Tenderness
- Edema
- Warmth
- Asymmetry
- Could be Asymptomatic
- Monitor for Pulmonary Embolism
Venous Thromboembolism (DVT) Interventions
- Anticoagulants
- Prevention Education
- Frequent Ambulation
- Leg Exercises
- Compression Stockings or SCD's
- Avoid Nicotine and Oral Contraceptives
- Surgery
Deep Vein Thrombosis (DVT) Characteristics
- Virchow's Triad
- Venous Stasis
- Endothelial Damage
- Hypercoagulability
- Tenderness
- Homan's Sign
- Warmth
- Redness
- Swelling
- Asymptomatic
Pulmonary Embolism Causes
- FAT BAT Mnemonic
- Fat
- Air
- Deep Vein Thrombosis (DVT)
- Bacteria
- Amniotic Fluid
- Tumor
- Hypercoagulable
- Central Venous Lines
- Immobilized
Pulmonary Embolism Presentation and Diagnosis
- Sudden onset Shortness of Breath (S.O.B.)
- Tachypnea
- Pleuritic Chest Pain
- Hemoptysis
- Hypoxemia
- Sudden Death
- Gold Standard: CT Pulmonary Angiography
- X-Ray
- D-Dimer
- V/Q Scan
Pulmonary Embolism Assessment
- Shortness of Breath (SOB)
- Pleuritic Chest Pain
- Tachypnea
- Hemoptysis
- Hypoxemia
- Sudden Death
Abdominal Aortic Aneurysm
- Screen Males 65-75 Who've Ever Smoked
- Ultrasound
- Observation
- Asymptomatic and < 5 cm in Size
- Surgical Repair
- > 5.5 cm in Abdomen
- Emergent Surgery
- Ruptured or Symptomatic
Abdominal Aortic Aneurysm (AAA) Assessment
- Atherosclerosis
- Bruit
- Pulsation in Abdomen
- Abdominal or Lower Back Pain
- Tearing Pain
- Ultrasound
- Rupture
- Shock
- Surgical Repair
Hypercholesterolemia Disease
- Diabetes
- Smoking
- Family History
- Hypertension
- HDL < 40
- Men Older than 45 Years of Age
- Women Older than 55 Years of Age
- Atheromas
- Plaques in Blood Vessel Walls
- Tissue Ischemia
- Xanthomas
- Lipemia Retinalis
Stable Angina
- Chest Pain with Exertion
- Relieved within 15 Minutes
- ST Depression
- Nitroglycerin
- Up to 3 Doses q 5 Minutes
- Rest
- Antiplatelet Medication
- CABG
- Angioplasty
Unstable Angina
- Chest Pain with Rest or Exertion
- Limits ADLs
- > 15 Minutes
- Less Likely Relieved by Nitroglycerin
- ST Depression
- Fatigue
- Acute Coronary Syndrome (ACS) Treatment
- Emergency Treatment
Myocardial Infarction 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
- Monitor for Arrhythmias
Left Heart Failure Assessment
- Pulmonary Congestion
- Pink Frothy Sputum
- Wheezing or Crackles
- Dyspnea with Exertion
- Cough
- Fatigue
- Tachycardia
- Weak Peripheral Pulse
- S3, S4 Heart Sounds
Right Heart Failure Assessment
- Jugular Venous Distention (JVD)
- Peripheral Edema
- Hepatosplenomegaly
- Nocturia
- Weight Gain
- Ascites
- Fatigue
Myocardial Infarction Diagnosis
- 12 Lead ECG
- ST Elevation
- Q Wave
- T Wave Inversion
- Troponin T and I
- CK-MB
- Early ECG
- Cardiac Stress Test
Myocardial Infarction Interventions
- Morphine
- Oxygen
- Nitrates
- Aspirin
- Thrombolytics (tPA)
- Cardiac Catheterization
- Stent Placement
- Angioplasty
- Coronary Artery Bypass Grafting (CABG)
- Decrease Modifiable Risk Factors
- Resuming Activity (Physical, Sexual)
Cardiac Catheterization
- Fluttering Sensation
- Contrast Media
- NPO 6-12 Hours
- Bed Rest
- Assess Circulation
- Assess for Bleeding
- Monitor Vital Signs
Coronary Artery Bypass Grafting (CABG)
- ST-Segment Elevation Myocardial Infarction (STEMI)
- Cardiovascular Disease (CAD)
- Uncontrolled Angina
- Internal Mammary Artery
- Saphenous (Leg) Vein
- Transient Limb Edema
- Closely Monitor Patients
- Venous Thromboembolism (VTE) Prophylaxis
- Incentive Spirometer
Heart Failure Interventions
- Echocardiogram
- Invasive Hemodynamic Monitoring
- High Fowler's Position
- Oxygen
- Advanced Airway
- Diuretics
- Beta Blockers
- Angiotensin II Receptor Blockers (ARBs)
- ACE Inhibitors
- Digoxin (Lanoxin)
- Pacemaker
Acute Pericarditis Assessment
- Pericardial Sac Inflammation
- Sharp Chest Pain
- Increased with Inspiration
- Pain Decreased by Leaning Forward
- Pericardial Friction Rub
- Diffuse ST-Elevation
- T Wave Inversion
- Fever
- May Be Asymptomatic
- Cardiac Tamponade
Acute Pericarditis Causes
- Idiopathic
- Infection
- Trauma
- Cardiac
- Myocardial Infarction
- Autoimmune Diseases
- Uremia
- Tumor
- Radiation
Acute Pericarditis Interventions
- Treat Underlying Disorder
- Antibiotics
- Colchicine + NSAIDs
- Corticosteroids
- Place Patient Upright with Head of Bed at 45°
- Pericardiocentesis
- Pericardial Window
Cardiac Tamponade
- Fluid in the Pericardial Sac
- Pericarditis
- Decreased Cardiac Output
- Beck's Triad
- Hypotension
- Jugular Venous Distention (JVD)
- Distant Heart Sounds
- Pulsus Paradoxus
- Electrical Alternans
- Pericardiocentesis
Hypertrophic Cardiomyopathy Signs, Symptoms and Treatment
- Sudden Death Of Young Athlete
- Heart Failure
- Angina
- Arrhythmias
- Syncope
- Harsh Systolic Ejection Murmur
- S4 Heart Sound
- Beta Blocker
- Non-dihydropyridine Calcium Channel Blocker
Dilated Cardiomyopathy
- Chronic Alcohol Abuse
- Doxorubicin Toxicity
- Cocaine Use
- Wet Beriberi
- Hemochromatosis
- Coxsackie B
- Chagas Disease
- Peripartum
- S3
- Eccentric Hypertrophy
Pregnant Cardiac Patient Assessment
- Cardiac Decompensation
- Frequent Cough
- Dyspnea
- Palpitations
- Excessive Fatigue
- Pulse > 100 bpm
- Crackles
Hyperkalemia
- > 5.0 mEq/L K+
- Abdominal Cramps
- Muscle Weakness
- Diarrhea
- Arrhythmia
- Tall, Peaked T Waves
- IV Calcium
- Infusion of Glucose and Insulin
- Loop or Thiazide Diuretics
- Kayexalate
- Dialysis
- Prevention Education
Hypokalemia
- < 3.5 mEq/L
- Muscle Weakness
- Arrhythmia
- U Wave
- Ileus
- Hyporeflexia
- IV K+ Infusion at 5-10 mEq/hr
- Give Orally with Food
- Monitor Respiratory Status
Hypernatremia
- > 145 mEq/L Na+
- Change in LOC
- Extreme Thirst
- Orthostatic Hypotension
- Dry Flushed Skin
- Muscle Twitching
- Seizures
- Treat and Prevent Dehydration
- Hypotonic Solutions (0.225% or 0.45% NaCl)
- Sodium Restriction
- Diuretics
Hypermagnesemia
- Flushing
- Lethargy
- Muscle Weakness
- Decreased Deep Tendon Reflexes (DTRs)
- Decreased Respirations
- Bradycardia
- Hypotension
- Dialysis
- IV Calcium Gluconate
- Diuretics
- Avoid Antacids and Laxatives containing Mg2+
Phases of Cardiac Rehabilitation
- MET Levels
- Acute Phase
- Assessment
- Education
- Discharge
- Goals
- Outpatient Phase
- Reinforcing Phase 1
- Ergonomic Approach
- Community Based
- Acute Care
- Long-Term Acute Care
- Skilled Nursing Facilities (SNF)
- Independent Living