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Circulatory(Cardiovascular System) Unit 40

Adonis K. Lomibao, R.N.12/15/11

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Objectives

Define & spell key terms Review location & function of circulatory

organs Describe PCT actions regarding

PVD,Atherosclerosis,Hypt., Angina, MI, CHF Pacemaker care measures

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Introduction

Transportation:

-Takes nourishment to the cells

-Carries away waste products Diseases affect overall body function Long-standing disease will affect pulmonary

system

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Structure & Function

Heart-central pumping station Blood vessels:

-Arteries-carry blood away from the heart

-Veins-carry blood towards the heart

-Capillaries-tubes that connect arteries and veins

Lymphatic vessels-tubes that carry lymph or tissue fluid to the bloodstream

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Arteries

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Veins

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The Blood

Composed of plasma & cellular elements Body contains 4-6 liters Plasma:make up 55%...watery solution

containing antibodies, nutrients, gases, & waste products.

Blood cells produced in bone marrow & lymphatic tissues.

Bone marrow, liver, & spleen destroy worn-out cells

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Blood Cells

Red Blood Cells-erythrocytes-carry oxygen & small amount of carbon dioxide

White Blood Cells-leukocytes-fight infection Thrombocytes-platelets-seal small leaks in the

walls of vessels & initiate blood clotting.

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The Heart

Hollow muscular organ divided into L & R side and 4 chambers

Three layers:

-Endocardium-lines heart chambers

-Myocardium-muscle layer

-Pericardium- membranous outer covering.

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The Four Chambers

The Right Atrium-receives deoxygenated blood from the body

The Right Ventricle-receives blood from right atrium and sends it to the lungs through pulmonary artery to pick up oxygen & rid carbon dioxide

The Left Atrium-receives oxygenated blood & sends it to L ventricle

The Left Ventricle- receives blood from LA & sends to Aorta & rest of body.

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Circulatory Flow

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Common Circulatory Disorders

Disorders can affect blood vessels, the heart, & blood dyscrasias(abnormalities).

Observations to report:

-Color change

-Cool or hot to touch

-Changes in rate or rhythmn

-B/P changes

-Edema

-Disorientation

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Peripheral Vascular Disease

Vessels serving outer body parts like hand & feet Affect arteries & diminish flow to the extremities.

Tissue may not get nourishment needed. Affects the arms, legs, & brain. S&S include;

-burning pain during exercise

-dusky red skin, or cyanotic, brownish skin.

-difficulty with ambulation

-Pg. 688

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PVD

Treatment aims to increase local circulation:

-Positioning & exercises to promote arterial flow & venous return

-Oscillating (rocking) bed to improve circulatory flow

-Prevent injuries that may heal poorly

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PCT Care

Protect the feet-pts. At risk of ulceration, gangrene, & eventual amputation.

-check feet & legs daily & report abnormalities

-proper fitting footwear

-do not cut toenails-licenced HCP only

-make sure bed linen isn't too tight

-support feet during transport

-p. 690

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Atheroslerosis

Atheromas-growths that develop over fatty materials and form on inner walls of arteries, narrowing the vessels.

Often affects vessels of heart, brain, and those to legs

Grow larger till blood flow is blocked Clots break off and travel as emboli

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Atherosclerosis

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Stent Placement

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Atherosclerosis

Narrowing of vessels can lead to complications such as:

-formation of blood clots

-angina pectoris

-myocardial infarction

-strokes

-gangrene

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Atherosclerosis

Risk factors:

-Hypertension

-Diabetes

-Overweight

-Heredity

-Smoking

-Stress

-lack of exercise

-p.691

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Varicose Veins Form when the valves in the veins in the legs

become weakened.

-blood does not flow as it should

-veins become distended & visible

-may become inflamed (phlebitis)

-blood clot may form in vein PCT Care:

-report pain or aches in legs

-signs of inflammation (warmth, redness)

-never massage or rub area

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Varicose Veins

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Transient Ischemic Attack

Temporary interruption of blood flow to part of the brain.

Pt. may experience:

-weakness or paralysis of extremity or face

-vision problems

-speech difficulty

-difficulty swallowing S&S may last minutes to 24hrs & are

temporary.

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Hypertension

High blood pressure-follows illnesses involving the blood vessels, kidneys, & liver.

-promotes atherosclerosis

-increases stress on the heart

-damages blood vessel walls

-limits blood flow to organs & body Treatment:

-drugs, low sodium diet, exercise, etc. p.692

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PCT Care Hypt.

Report:

-flushed face

-dizziness

-nosebleeds

-headaches

-changes in speech patterns

-blurred vision

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Angina Pectoris

Cardiac pain effort Angina attack- vessels unable to carry enough

blood to meet the heart's demand for oxygen Can develop over time as atheromas develop

or suddenly as vessels constrict Precipitated by exertion, heavy eating, stress S&S include pain under stress, pale or flushed

face,perspiration

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Treatment

Treatment:

-Treadmill stress test to diagnose hidden causes

-teach pt. To avoid stress & sudden exertion

-drugs that relax the coronary arteries

-coronary artery bypass surgery

-angioplasty- surgical procedure to open vessels

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PCT Care

Help in avoiding unnecessary emotional or physical stress

Encourage pt. Not to smoke Report S&S of attack to nurse

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Myocardial Infarction

Coronary Heart Attack-period in which the heart cannot function properly

Occurs when the coronary arteries nourishing the heart are blocked.

Ischemia causes cells to die. (Infarction) Coronary occlusion-coronary artery blockage Coronary thrombosis-thrombus (stationary

clot) formation Coronary embolism-moving clot (embolus)

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Signs & Symptoms Crushing chest pain N & V Irregular pulse & respiration Perspiration (diaphoresis) Feelings of anxiety & weakness Drop in b/p & pallor SOB Syncope(fainting) Restlessness Cyanosis or grey color

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MI-PCT Care

Watch for bleeding & report Assist with ADL's Monitor vital signs Explain risk factors to avoid

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Congestive Heart Failure

The heart enlarges(hypertrophy) and compensates for additional workload. Eventually, heart can no longer compensate & heart failure occurs

Also called cardiac decompensation Heart cannot pump efficiently and causes

congestion of the lungs

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S&S of CSF

Hemoptysis(spitting up blood) Cough Dyspnea Orthopnea Ascites Neck vein swelling Fatiguing easily p.696

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CSF Treatments Drugs to help heart beat regularly & strongly Procedures to open the arteries (stent) Low-sodium diet Fluid restriction Orthopneic positioning TED hoses Assist with ADL's I&O's and Vital signs p.696-697

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Heart Block

Develops due to interference in the electrical current through the heart

Pacemaker is implanted to signal the heart muscle to contract.

Demand pacemaker sends messages when normal messages are delayed.

Others send regular signals to keep the heart contracting at a preset rate.

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Pacemaker

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Implanted

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PCT Care

Count, record pulse-rate, & report abnormalities

Report discoloration over implant site Keep pt. Away from microwave ovens and

cellular phones p.697

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Anemia

Results in the decrease in the quanity or quality of red blood cells.

Pernicious-inability to absorb B12 Sickle Cell-inability to form normal hemoglobin Deficiency-inadequate intake, absorbtion, or

loss of iron Dietary-inadequate intake or iron or vitamins

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Anemia S&S and Treatment

Little energy Dyspnea Rapid pulse Increased respiratory rate p. 698 Treatment:

-Iron supplements, eliminating cause, blood transfusions, Nutrition

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Leukemia

'Cancer” of the blood White blood cell number increase, but of poor

quality Erythrocytes & platelets decrease. Highly susceptible to infection Prone to bleeding

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Leukemia Treatment

Patient comfort Maintain normal blood vessels- may need

blood transfusions Antibiotics Chemotherapy/radiation

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Special Care for Cancer & Anemia

Vital signs Encourage rest & handle pt. Gently Good nutrition & fluid intake Report signs of bleeding Prevent falls p. 698

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Diagnostic Tests

Blood chemistry tests-electrolyte panels CBC EKG Cardiac cath & angiogram Ultrasound