Cardiovascular System: Anatomy and Conditions

Terminology

• Hyperlipidemia means high cholesterol, which indicates high levels of fat and lipids in the blood
• PMM denotes past medical management
• PMH denotes past medical history

Roles of Organs and Structures

• The respiratory and cardiovascular systems supply oxygen and dispose of carbon dioxide
• The cardiovascular system transports blood, oxygen and nutrients to all the cells in the body
• Arteries transport oxygen-rich blood to the body
• Veins transport oxygen-poor blood back to the heart
• The aorta carries oxygen-rich blood from the heart to the body

Vital Signs

• Normal body temperature is 36-38 degrees
• A temperature greater than 38 degrees signifies hyperthermia
• A temperature less than 36 degrees signifies hypothermia
• Normal pulse is 60-100 bpm
• A pulse greater than 100 bpm signifies tachycardia
• A pulse less than 60 bpm signifies bradycardia
• Normal respiration rate is 12-20 bpm
• A respiration rate greater than 24 signifies tachypnea
• A respiration rate less than 10 signifies bradypnea
• Normal systolic blood pressure: 100-139 mmHg, normal diastolic blood pressure: 60-89 mmHg
• Blood pressure greater than 140/90 mmHg signifies hypertension
• Blood pressure less than 100/60 mmHg signifies hypotension
• Normal O2 saturation is 95-100%
• O2 saturation of 90-95% signifies mild hypoxia
• O2 saturation of less than 90% signifies severe hypoxia

Anemia

• Anemia involves a decrease in the number of quality red blood cells
• It leads to a lack of iron
• Signs and symptoms of anemia include pallor, sensitivity to cold, fatigue, dizziness, asthenia (weakness), tachycardia, dyspnea (shortness of breath), paresthesia (numbness and tingling), and decreased hemoglobin and hematocrit
• Interventions for tachycardia include consistent monitoring of heart rate and respiratory rate
• To help with shortness of breath, elevate the head of the bed
• Interventions for decreased Hb, pale skin, asthenia, dizziness, paresthesia: iron-rich diet and vitamin C rich diet
• You can prescribe antianemics, alternate activity with rest and ensure a safe environment

Angina

• Angina is characterized as chest pain
• Arteries increase blood supply
• Pain that will be relieved with nitro,temporary blockage
• Signs & Symptoms include Retrosternal pain, severe pain/ tightness in the chest that may radiate, nausea, pallor, diaphoresis, dyspnea and anxiety
• A key indicator is indigestion
• Immediate treatment for angina can include ceasing activity and sitting or lying down
• Stay with the patient to reduce axiety
• Check vital signs and O2 sat
• Administer nitro as prescribed
• For retrosternal pain: keep the patient at rest, assess PQRST, and administer nitroglycerin as prescribed (every 5 minutes, max 3 doses)
• To increase oxygen, administer oxygen as prescribed
• To facilitate breathing, place the patient in semi fowlers position

Myocardial Infarction

• Myocardial infarction involves a sudden blockage/obstruction of one or many coronary arteries
• Pain from myocardial infarction will continue, resulting in permanent blockage
• Signs and symptoms of a myocardial infarction: Sudden, sharp, crushing retrosternal chest pain, as well as pain or numbness that may radiate
• Nausea/ vomiting, feeling of doom, dyspnea, cold/clammy skin, irregular pulse can also be symptoms
• Additional symptoms include diaphoresis
• Nursing considerations for myocardial infarction: stool softeners and antiembolic stockings. Keep patient at rest, assess PQRST and administer nitroglycerin as prescribed
• Increase oxygenation of patient and provide ventilation as needed

Hypertension

• Hypertension is characterized as high blood pressure
• Signs and symptoms of hypertension include SOB, headaches, flushed face, dizziness, tinnitus and epistaxis
• Nursing considerations for hypertension: Administer analgesics and limit prolonged exertion
• Provide general care by monitoring BP regularly and administering antihypertensives as prescribed

Congestive Heart Failure

• Congestive heart failure involves the heart losing its pumping efficiency
• Signs & Symptoms include excessive fatigue and pitting edema
• Further symptoms of congestive heart failure include: Decreased urine output, dyspnea, JVD and persistent cough with thin whitish sputum
• Nursing considerations for congestive heart failure: Strict I/O, daily weights, O2, elevating legs, checking CTSM, monitoring edema and skin integrity as well as sputum
• Elevated HOB, pursed lip breathing and decreasing fluids and Na. A foley catheter may be needed

DVT

• Deep vein thrombosis is a clot that develops in a deep vein and affects normal blood flow
• Signs and symptoms include pain, redness, warmth, pitting edema, fever and a positive Homan's Sign
• Nursing considerations: Slightly elevate leg, check neurovascular signs, measure leg edema and have the patient on complete bed rest
• Provide anti-embolism stockings, immobilize affected area and tell the patient to avoid long periods of standing

Pneumonia

• Pneumonia involves an inflammation of the lung with air sacs filling with exudate
• Signs and symptoms of pneumonia: Severe sharp pain in chest and chills
• High fever, painful cough, green sputum, pain with breathing, rapid pulse, cyanosis, delirium and anxiety can be symptoms
• Nursing considerations for pneumonia: adequate fluid intake, elevate HOB to aid breathing, DB and C

COPD (chronic bronchitis)

• Chronic Bronchitis is an inflammation of the bronchial tubes, usually following a resp infection
• Signs & Symptoms: Productive hacking cough and constant SOB
• Other symptoms include: Hypoventilation, hypoxia and reddish/ blue colour
• Nursing Considerations: Raise HOB, promote hydration, pursed lip breathing, monitor O2, advise ceasing smoking
• Other considerations include coughing exercises, a higher fiber, and smaller frequent meals

COPD Emphysema

• Permanent enlargement of alveoli and alveolar ducts results in a lack of elasticity
• The first sign is difficulty breathing after exertion leading to persistent dyspnea
• Wheezing, cyanosis and paleness can be symptoms of COPD Emphysema
• Choking fear, use of accessory muscles, afraid to lie down and having a barrel chest can occur
• Nursing considerations: Raise HOB, promote hydration, pursed lip breathing, assist with coughing exercises, monitor O2.
• Other considerations include promoting a diet high in fiber, advising ceasing smoking and having smaller frequent meals

Asthma

• Asthma is a chronic lung disease with reversible airway obstruction and inflammation
• The airways will close down and create sections inside the lungs making it difficult to breathe
• Signs & Symptoms: Wheezing, SOB, cough (worse at night)
• Nursing Considerations: Raise HOB with arms on bedside table if needed, monitor O2 sat, pursed lip breathing, increased fluid intake. Allow patient to rest

Nursing Care

• Poor appetite can be helped by providing small frequent meals. A high protein and high calorie diet is also recommended
• Warmth can be assessed by monitoring NVS
• During sputum production monitor consistency, encourage coughing and give Ventolin if needed

Additional Symptoms

• During fever, monitor temp, provide antipyretic medications and increase fluids
• During SOB, provide oxygen, elevate HOB, assist with pursed-lip breathing and monitor O2 sat
• During edema, measure the leg, elevate slightly and provide anti-embolic stockings
• During redness, monitor temp, note change in colour and monitor PQRST
• During dizziness, ensure safety and have the patient maintain bed rest
• Help an anxious patient by creating a calm environment and remaining calm
• During a headache, monitor PQRST and medicate as needed

This lesson covers the function of arteries, heart rate terms, and blood flow. Furthermore, signs and symptoms of anemia, respiratory rate, and myocardial infarction are discussed. Additionally, hypertension and related emergencies are addressed.