CARDIO
A. Cardiovascular System
- Close system responsible for tissue perfusion
Blood - BV= 5 - 6 L
- Lower BV result to shock
- Lower perfusion leads to shock which leads to multiple problem
Heart
- Responsible to distributing / pumping blood in the body
- Dec. perfusion = cardiogenic shock
• Coronary causes
• Non coronary causes
In born
• Obstructive shock
No heart problem na spit lang si heart
Arteries
- Distribute oxygenated blood except pulmonary artery
Vessels/Veins
- Distribute deoxygenated blood except pulmonary vein
* Vascular tone disappears or damage can lead to Circulatory shock/
Distributive shock
• Causes:
- Infection - present of dilation of the vessel which can lead to
septic shock
- Allergies - in ammation which dilation vessel and can lead to
Anaphylactic shock
- Spinal cord injury - in ammation which lead to loss of SNS
hence, Neurogenic shock (Brady)
B. Blood Vessels
I. Arteries - resistance vessels ( Larger: Aorta)
Pulses
• Volume/ amplitude
+4 - strong bounding
+3 - full pulse
+2 - easy to palpate
+1 - week and threading
+0 - absent
II. Veins - Capacitance vessels (Larger: superior Vena Cava
III. Capillaries - exchange vessels / exchange gases (Largest surface area)
- 1 layer wall
Vascular disorder
1. Aneurism
a. Aortic aneurysm - Internal bleeding (HEMORRHAGIC SHOCK)
- Etio: Atherosclerosis = Atheromatous/Plaque hardening
, Risk factor
1. Age - the older the most risk in hardening the vessel
2. Family history
3. Sedentary lifestyle
4. Obesity
5. DM
6. HPN - Most risk
7. Smoking
8. Alcohol
9. Stress
10. Ca eine
• Ascending Aortic Aneurysm - Asymptomatic
• Thoracic AA- Asymptomatic
• Abdominal AA - pulsating mass in the abdomen (only reported symptom)
- De nitive test to all: Angiography
- Local Anes
- Check allergies to seafoods (+) provide histamine an evening before
- Invasive
- 2D ECHO
- Simple ultrasound
- Non invasive
- Dissecting aortic aneurysm - tearing
- Pian
Ascending - severe chest pain - Type A ( Type B - descending)
Type 1 - ascending & descending
Type 2 - ascending
Type 3 - descending only (TYPE B)
Thoracic - severe epigastric pain
Abdominal pain - severe low back pain
b. Congenital Aneurism - most fatal
BOARD QUESTIONS
You are admitting a patent with a type A aortic aneurysm where to place the
patient
- OR ( straight to OR)
Type B
- Monitor BP then transfer surgery
-
Post surgery health teaching
- live a healthy lifestyle
, 2. Peripheral vascular diseases
a. Vascular insu ciency. - Ischemia
1. Arterial insu ciency, - LE > UE
• Leg pain - claudication ( relieve by rest)
• Skin: Pain, thinning of hair (no blood ow), cool to touch
• Pulses: Maybe at normal ( no edema)
• Arterial ulcer - small but deep with circumscribed edges with no
granulation tissues (very painful).
- Independent N/R: Dependent (legs), reverse tende
Dx:
Acute pain
Risk for impaired skin integrity
Risk for infection
**Ine ective peripheral tissue perfusion**
2. Venous ins - inc. Venous pressure (congestion) - pataas
• Leg pain - Phlebitis
• Skin: cyanotic, dark, pigments
• Pulses: Di cult to palpate due to edema
• Venous ulcer - larger wounds with irregular borders with several
granulation tissues.
- Independent N/R: Elevate the legs
Dx:
Acute pain
Risk for impaired skin integrity
Risk for infection
**Ine ective venous circulation**
Dx tests:
Angiography
Utz - doppler duplex
b. Peripheral arterial d (PAD)
1. Arteriosclerosis obliterates (ASO) - lower extre
Etiology : Unknown
Risk factors
1. Age
2. Family history
3. Common Male
4. Smoking
5. HPN
6. Alchohol
7. Stress
Extremities - Lower Extre.
Septic Shock
Management:
1. Position - dependent
2. Pain medication- NSAID (COX 2)
3. Avoid trauma
4. Skin care
A. Cardiovascular System
- Close system responsible for tissue perfusion
Blood - BV= 5 - 6 L
- Lower BV result to shock
- Lower perfusion leads to shock which leads to multiple problem
Heart
- Responsible to distributing / pumping blood in the body
- Dec. perfusion = cardiogenic shock
• Coronary causes
• Non coronary causes
In born
• Obstructive shock
No heart problem na spit lang si heart
Arteries
- Distribute oxygenated blood except pulmonary artery
Vessels/Veins
- Distribute deoxygenated blood except pulmonary vein
* Vascular tone disappears or damage can lead to Circulatory shock/
Distributive shock
• Causes:
- Infection - present of dilation of the vessel which can lead to
septic shock
- Allergies - in ammation which dilation vessel and can lead to
Anaphylactic shock
- Spinal cord injury - in ammation which lead to loss of SNS
hence, Neurogenic shock (Brady)
B. Blood Vessels
I. Arteries - resistance vessels ( Larger: Aorta)
Pulses
• Volume/ amplitude
+4 - strong bounding
+3 - full pulse
+2 - easy to palpate
+1 - week and threading
+0 - absent
II. Veins - Capacitance vessels (Larger: superior Vena Cava
III. Capillaries - exchange vessels / exchange gases (Largest surface area)
- 1 layer wall
Vascular disorder
1. Aneurism
a. Aortic aneurysm - Internal bleeding (HEMORRHAGIC SHOCK)
- Etio: Atherosclerosis = Atheromatous/Plaque hardening
, Risk factor
1. Age - the older the most risk in hardening the vessel
2. Family history
3. Sedentary lifestyle
4. Obesity
5. DM
6. HPN - Most risk
7. Smoking
8. Alcohol
9. Stress
10. Ca eine
• Ascending Aortic Aneurysm - Asymptomatic
• Thoracic AA- Asymptomatic
• Abdominal AA - pulsating mass in the abdomen (only reported symptom)
- De nitive test to all: Angiography
- Local Anes
- Check allergies to seafoods (+) provide histamine an evening before
- Invasive
- 2D ECHO
- Simple ultrasound
- Non invasive
- Dissecting aortic aneurysm - tearing
- Pian
Ascending - severe chest pain - Type A ( Type B - descending)
Type 1 - ascending & descending
Type 2 - ascending
Type 3 - descending only (TYPE B)
Thoracic - severe epigastric pain
Abdominal pain - severe low back pain
b. Congenital Aneurism - most fatal
BOARD QUESTIONS
You are admitting a patent with a type A aortic aneurysm where to place the
patient
- OR ( straight to OR)
Type B
- Monitor BP then transfer surgery
-
Post surgery health teaching
- live a healthy lifestyle
, 2. Peripheral vascular diseases
a. Vascular insu ciency. - Ischemia
1. Arterial insu ciency, - LE > UE
• Leg pain - claudication ( relieve by rest)
• Skin: Pain, thinning of hair (no blood ow), cool to touch
• Pulses: Maybe at normal ( no edema)
• Arterial ulcer - small but deep with circumscribed edges with no
granulation tissues (very painful).
- Independent N/R: Dependent (legs), reverse tende
Dx:
Acute pain
Risk for impaired skin integrity
Risk for infection
**Ine ective peripheral tissue perfusion**
2. Venous ins - inc. Venous pressure (congestion) - pataas
• Leg pain - Phlebitis
• Skin: cyanotic, dark, pigments
• Pulses: Di cult to palpate due to edema
• Venous ulcer - larger wounds with irregular borders with several
granulation tissues.
- Independent N/R: Elevate the legs
Dx:
Acute pain
Risk for impaired skin integrity
Risk for infection
**Ine ective venous circulation**
Dx tests:
Angiography
Utz - doppler duplex
b. Peripheral arterial d (PAD)
1. Arteriosclerosis obliterates (ASO) - lower extre
Etiology : Unknown
Risk factors
1. Age
2. Family history
3. Common Male
4. Smoking
5. HPN
6. Alchohol
7. Stress
Extremities - Lower Extre.
Septic Shock
Management:
1. Position - dependent
2. Pain medication- NSAID (COX 2)
3. Avoid trauma
4. Skin care
