NUR 4120 Cardiovascular Exam 1.Assessment of cardiovascular function(2020/2021) Complete Solutions.

Assessment of cardiovascular function Cardiovascular Medication  Metoprolol  Warfarin - Coumudin  Diltiazem  Furosemide – Lasix Overview of Anatomy and Physiology  Three layers o Endocardium o Myocardium – muscle contraction and pump o Epicardium  Four chambers – know what is happening with s1 and s2  Heart valves o Know where the valves are and what they do o Atrioventricular valves o Semilunar valves  Vasculature Structure of the Heart: Coronary Circulation Cardiac Conduction System Terms - Cardiac Action Potential  Depolarization: electrical activation of cell caused by influx of sodium into cell while potassium exits cell  Repolarization: return of cell to resting state caused by re-entry of potassium into cell while sodium exits  Refractory periods o Effective refractory period: phase in which cells are incapable of depolarizing o Relative refractory period: phase in which cells require stronger-than-normal stimulus to depolarize Cardiac Action Potential Need to Know:  location of the vessels  Blood flow  Know your right from left side SA node starts the HB  60-100 beats AV nodes start at a later beat  First beat should not start here Focus on repolarization and depolarization  EKG strips  Electrolytes Phase 0 = Na comes into the actual cell (RAPID depolarization, SODIUM IN) Phase 1 = early cell repolarization – K+ coming out of the cell (POTASSIUM OUT) Phase 2 = plateau phase (rate of repolarization slows); Ca+ ENTER CELL Phase 3 = complete repolarization (return of cell to resting state) Phase 4 = resting phase before the next depolarization Great Vessel and Heart Chamber Pressures Cardiac Hemodynamics Hemodynamics Terms - Cardiac Output  Stroke volume: amount of blood ejected with each heartbeat  Cardiac output: amount of blood pumped by ventricle in liters per minute  Preload: degree of stretch of cardiac muscle fibers at end of diastole o Affected by volume, diarrhea, dehydration, vomiting  Contractility: ability of cardiac muscle to shorten in response to electrical impulse  Afterload: resistance to ejection of blood from ventricle  Ejection fraction: percent of end diastolic volume ejected with each heart beat o 55-60 normal o 40 lead to HF!!