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Overview of Cardiovascular Nursing

Aug 22, 2024

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Cardiovascular Nursing Lecture Notes

Introduction

  • Good evening and thanks to Team Nursing Notes Simplified and Coach Yacine for collaboration.
  • Focus on students preparing for PNLE and NCLEX.

Cardiovascular Nursing Overview

  • Cardiovascular nursing includes two main concepts:
    • Cardio: Refers to the heart.
    • Vascular: Refers to blood vessels.

Functions

  • Heart: Pumps blood throughout the body.
  • Blood Vessels: Circulation platform for blood flow.

Types of Blood Vessels

  • Arteries: Carry oxygenated blood away from the heart.
    • Remember: A = Arteries = Away from heart.
  • Veins: Carry deoxygenated blood towards the heart.
    • Remember: V = Veins = Towards heart.
  • Capillaries: Exchange fluids between blood and interstitial space.

Anatomy of the Heart

  • Heart is a muscle (myocardium) with three layers:
    1. Epicardium: Outermost layer.
    2. Myocardium: Middle layer (muscle layer).
    3. Endocardium: Innermost layer.
  • Pericardium: Double-walled sac protecting and lubricating the heart.
    • Contains pericardial fluid.
    • Pericarditis: Inflammation leads to chest pain.

Heart Chambers

  • Four chambers of the heart:
    1. Right atrium
    2. Left atrium
    3. Right ventricle
    4. Left ventricle
  • Atria: Receive blood from veins.
  • Ventricles: Pump blood to arteries.
  • Septum: Divides atria (interatrial septum) and ventricles (interventricular septum).

Heart Valves

  • Atrioventricular Valves:
    • Tricuspid valve (right side)
    • Bicuspid valve (mitral valve, left side)
  • Semilunar Valves:
    • Pulmonic valve (to pulmonary artery)
    • Aortic valve (to aorta)

Types of Circulation

  1. Pulmonary Circulation: Blood flow from heart to lungs and back for oxygenation.
  2. Systemic Circulation: Oxygenated blood flows to the rest of the body.

Cardiac Cycle

  • Cardiac cycle consists of two phases:
    1. Systole: Heart contracts (normal BP: 120).
    2. Diastole: Heart relaxes (normal BP: 80).

Control of the Heart

  • Controlled by autonomic nervous system:
    • Sympathetic Nerves: Increase heart rate and contraction strength.
    • Parasympathetic Nerves: Slow heart rate.

Hemodynamics

  • Preload: Amount of blood returning to the heart.
  • Afterload: Pressure against which the heart pumps.
  • Compliance: Heart muscle's ability to expand.
  • Contractility: Strength of heart muscle.

Ejection Fraction

  • Amount of blood ejected per heartbeat: normal is 55% or higher.

Stroke Volume

  • Volume of blood pumped from ventricles during each contraction.

Cardiac Pharmacology

Common Cardiac Medications

  1. ACE Inhibitors:
    • E.g., Captopril, Enalapril, Lisinopril
  2. Angiotensin II Receptor Blockers (ARBs):
    • E.g., Losartan, Valsartan
  3. Beta Blockers:
    • E.g., Metoprolol, Atenolol
  4. Calcium Channel Blockers:
    • E.g., Amlodipine, Nifedipine
  5. Direct Vasodilators:
    • E.g., Hydralazine, Nitroglycerin

Important Nursing Considerations

  • Monitor for side effects such as dry cough (ACE inhibitors), liver/kidney function (ARBs).
  • Avoid grapefruit with amlodipine.

Cardiovascular Disorders

Coronary Artery Disease (CAD)

  • Obstruction of coronary arteries.
    • Causes: clots, atherosclerotic plaque.
  • Management:
    • Diet therapy (low-fat, low-cholesterol)
    • Exercise program (15-30 minutes daily)
    • Surgical options: PTCA, CABG

Angina Pectoris

  • Chest pain due to myocardial ischemia.
  • Types:
    1. Stable Angina: Relieved by rest/nitroglycerin.
    2. Unstable Angina: Occurs at rest, can lead to MI.
    3. Prinzmetal Angina: Due to vasospasm.
  • Management:
    • Instruct on exercise, manage emotions, avoid heavy meals.
    • Medications: Nitroglycerin, coronary vasodilators.

Myocardial Infarction (MI)

  • Prolonged ischemia leading to heart muscle damage.
  • Symptoms: Severe chest pain, nausea, diaphoresis.
  • Management:
    • Bed rest, semi-fowlers position, cardiac monitoring.
    • Medications: Morphine, aspirin, thrombolytics.

Practice Questions

  1. Causes of Myocardial Infarction:
    • Deep vein thrombosis is a common cause.
  2. Management for Angina Pectoris:
    • Proper exercise, emotional management, and avoiding improper eating habits are key.

Conclusion

  • The lecture covered anatomy, physiology, pharmacology, and disorders of the cardiovascular system.
  • Encourage continued study and engagement with course material.

Note: These notes summarize the key points and discussions from the lecture for review purposes.

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