Blood Vessels that Carry Blood to and from Heart
- Arteries: oxygenated blood from heart–> body
* Veins: deoxygenated blood from body–> heart
Blood Flow Through Heart
Right Side (deoxygenated blood)
- Superior/Inferior Vena Cava
- Right Atrium
- Tricuspid Valve
- Right Ventricle
- Pulmonary Semilunar Valve
- Pulmonary Artery
Left Side (oxygenated blood)
- Pulmonary Vein
- Left Atrium
- Biscuspid/Mitral Valve
- Left Ventricle
- Aortic Semilunar Valve
- Aorta
Heart Valves
- Tricuspid and Mitral Valves: control blood flow from atriums–> ventricles
- Pulmonary and Aortic Valves: control blood flow out of ventricles
Arteries that Supply Oxygen and Nutrients to the Myocardial Tissue
• Left and Right Coronary Arteries ↑↓
Factors Influencing Cardiovascular Function: Developmental
- Young/Middle Adults: poor nutrition, sedentary lifestyle, lack of exercise, tobacco, family history or cardiovascular disease
- Older Adults: ↓ cardiac efficiency (heart muscle loses contracting strength, valves thicken/more rigid), heart response time to oxygen demands ↓, need more time recovering after exercise
Factors Influencing Cardiovascular Function: Environment
- Stress: catecholamines (↑ HR/contractility, vasoconstriction, blood clots)
- Allergic Reactions: Inflammatory (protease, histamine) cause blood vessels to dilate, local tissues damaged by protease, eosinophils/neutrophils, capillaries are more permeable, smooth muscle contracts
- Heat: vasodilation, ↑ cardiac output/oxygenation, ↑ metabolism
- Cold: vasoconstriction, ↓ metabolism, ↓ O2 demand, slows HR
Factors Influencing Cardiovascular Function: Lifestyle
- Pregnancy: ↑ oxygen demands
- Nutrition: saturated fat (atherosclerosis, CAD, hypertension) *ALL affect circulation/oxygenation
- Obesity: atherosclerosis, hypertension, ↑ workload of heart
- Exercise: + strengthens heart muscle, ↓ resting HR, improves blood circulation/oxygenation, ↑ metabolism; - reduces heart efficiency/capacity to ventilate
- Substance Abuse: alcohol (fatty infiltration, heart enlargement, dysrhythmias, thrombi); stimulants, hallucinogens, cannabinoids
Factors Influencing Cardiovascular Function: Smoking
•
Factors Influencing Cardiovascular Function: Medications
• Improve cardiac output/oxygenation: slow HR, ease workload, dilate blood vessels, ↓ BP, block abnormal heart rhythms, excrete excess fluids
Assessment of Cardiovascular/Perfusion: Interview Questions
- History of: cardiovascular/peripheral vascular systems, cardiac disease/prior cardiac problems, lifestyle, family
- Nutrition
- Demographics
Assessment of Cardiovascular/Perfusion: Physical Assessment: Palpation
- Cap refill
- Edema
- Pulses
- Skin temperature
Assessment of Cardiovascular/Perfusion: Physical Assessment: Percussion
• Areas of consolidation or air pockets
Assessment of Cardiovascular/Perfusion: Physical Assessment: Auscultation
• BP, heart/breath sounds, apical pulse, carotid arteries for bruits (swishing sound)
Assessment of Cardiovascular/Perfusion: Visual Inspection
- Breathing patterns
- Respiratory effort
- Chest structure/movement
- Mucous membrane color/edema
- Weight, height, BMI
- Chest pain
- Pallor or redness of skin
- Jugular Vein Distention
- Fatigue
- Clubbing of fingernails
- Cyanosis
- Hair distribution
Chest X-ray
- Anterior/posterior or lateral view of heart and lungs
* Shows tissue density (evaluates size, mass, fluid)
Cardiac Monitoring: ECG
- Electrocardiogram: reads electrical activity of heart
- Measures baseline, changes in baseline, dysrhythmias
- Also HR, size, rhythm
Holter Monitor
- Continuous ECG that correlates symptoms to cardiac activity
- 48 hours-7 days
Nursing Diagnosis: Decreased Cardiac Output
- Related to factors:
- Objective:
- Subjective:
- RN Interventions:
Nursing Diagnosis: Ineffective Tissue Perfusion
- Related to factors:
- Objective:
- Subjective:
- RN Interventions:
