Cardiovascular System

CNA 2 OSBN Curriculum

This project was funded $3,000,000 (100% of its total cost) from a grant awarded under the Trade Adjustment Assistance Community College and Career Training Grants, as implemented by the U.S. Department of Labor’s Employment and Training Administration. Rogue Community College is an equal opportunity employer/program. Auxiliary aids and services, alternate form and language services are available to individuals with disabilities and limited English proficiency free of cost upon request.

This work is licensed under a Creative Commons Attribution 4.0 International License.

Heart

Blood Vessels

Blood

Lymphatic System

Overview Anatomy & Physiology

Hollow Organ Four Chambers

◦R & L atriums◦R&L ventricles

Heart

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Arteries Veins Arterioles Capillaries

Blood Vessels

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Finding Pulses of Lower Extremityhttp://www.youtube.com/watch?v=0qZ5-C13Ccs

Liquid: Plasma Solid:

◦Erythrocytes RBC’s

◦Leukocytes WBC’s

◦Thrombocytes Platelets

Blood

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One Way System Asst w/ Fluid Balance Fights Infection Lymph Nodes Empty into Lg. veins

LymphaticSystem

http://www.medcomrn.com/dev/flash/flvplayer/movie.php?movie=http://ss1.medcomrn.com/flv/78715r_sec06_300k.flv&title=&detectflash=false&detectflash=false

Coronary Artery Disease (CAD)

◦Acute Coronary syndrome (ACS) Angina

Myocardial Infarction (MI)

Cardiac Terminology:

Cardiovascular System Conclusion:Takes food and oxygen in, takes away waste. It seems so simple, but as we've seen, it's really a complex task that takes four body parts - the heart, blood vessels, blood, and lymph vessels - all working together to do this "simple" job, that keeps us alive.

Hearts blood supply Arteries may narrow Could eventually occlude Risk Factors Treatment:

◦ Stent◦ CABG

CAD

Angina (Pectoris)

Tightness/Pressure/Discomfort/radiation Dyspnea Nausea Pale Diaphoresis Weakness

Observation & Reporting

AKA: Heart Attack

Myocardial Infarction (MI)

Angina: more intense, longer SOB Anxiety/ feeling of “doom” Irregular heartbeat Changes in BP

Observation & Reporting

Report c/o of angina to RN STAT VS STAT or as directed Stay w/patient & call for help Calm patient Stop/Limit physical activity

CNA 2 Actions

Cardiac Catheterization

Diagnostic Treatment

◦Stent Femoral dressing

◦CABG Sternal Precautions

Post-care◦Care of the Surgical Patient”

Stent & CABG

Heart FailureAKA:

◦HF◦Congestive Heart Failure◦CHF

Inability of the heart to pump enough blood for the bodies needs Right-sided vs. Left-sided

Venous Back-up◦ Feet, ankle, legs are swollen◦ Urinary frequency esp at noc

Right-Sided Failure

Lungs Backed-up◦ Congestion◦ Coughing◦ SOB

Left-Sided Failure

Observation & Reporting SOB w/activity Fatigue w/exertion Cyanosis Sudden Wt. gain Edema Vertigo Diaphoresis Confusion and memory lapses

Report to nurse Accurate I&O Daily weights as ordered Low sodium diet restrictions Fluid restrictions as ordered Prevent fatigue

CNA 2 Actions

Abnormal Heart beat Electrical Condition May be life-threatening Treatment depends on type EKG/ECG:

◦Electrical activityof the heart

Dysrhythmia

Sinus Rhythm: 60-100 per min. “normal”

Bradycardia: <60◦slow

Tachycardia: >100◦fast

Common Dysrhythmias

Atrial Fibrillation◦Atria quivers◦At risk for block clots

Heart Block: ◦Stimulus can’t get through◦Sx’s depend on level of block

Common Dysrhythmias

Ventricular Tachycardia◦vents too fast◦Can’t fill all the way

Ventricular Fibrillation: ◦vents quiver

Asystole: ◦NO HEART BEAT◦Start CPR

Lethal Dysrhythmias

Palpitations c/o pounding chest Dizziness Light-headedness Fainting/weakness SOB Chest discomfort Slow pulse

Observation & Reporting

Report S/S to nurse NOW If S/S severe call RRT or CODE and stay with patient.

CNA 2 Actions

Bedside Tele: http://www.medcomrn.com/dev/flash/flvplayer/movie.php

?movie=http://ss1.medcomrn.com/flv/m109_sec09_300k.flv&title=&detectflash=false&detectflash=false

 

12 Lead video: http://www.medcomrn.com/dev/flash/flvplayer/movie.php

?movie=http://ss1.medcomrn.com/flv/m109_sec07_300k.flv&title=&detectflash=false

 

EKG Education video: http://www.youtube.com/watch?v=MSc0Trc_d88  

EKG lead placement video  http://www.youtube.com/watch?v=1n5f0qtQOp8

CARDIAC LAB

Thrombus in veins Blood pools Clot forms Blocks circulation

OR Embolus

◦Can be fatal

Deep Vein Thrombosis (DVT)

Swelling in Leg May be Warm to Touch Pain or tenderness Report STAT:

◦Chest Pain◦SOB◦Dyspnea

Observation & Reporting

Prevention:TEDSSCDSROMAmbulationPresentAll activity directed by nurseElevate extremity if directed

Do not massage leg

CNA 2 Actions

Classification

SBP mmHg

DBP mmHg

Normal <120 or <80

Prehypertension

120-139 or 80-89

Stage 1HTN

140-159 or 90-99

Stage 2HTN

> 160 or > 100

Hypertension (HTN)

Confirm reading White Coat HTN Silent Killer Can lead to:

◦CVA◦MI◦Kidney Failure◦Blindness

Hypertension (HTN)

Obesity Atherosclerosis Chronic Kidney Disease (CKD) Drug Related Inactivity Smoking ETOH Abuse Other

Common Causes

Observation & Reporting HTN checked x2 in both R & L Headache Blurred Vision Dizzy Chest Pain Nosebleeds

Check BP x2 in both arms◦Manual

Report to nurse ASAP Low sodium diet

CNA 2 Actions

Consistently:◦SBP< 90 mmHg ◦DBP< 60 mmHg

Causes:◦Low bld vol.◦Irreg. HR◦Medications

Orthostatic Hypotension

Hypotension

Low BP Rapid HR Rapid/shallow breathing C/O

◦Vertigo◦Syncope◦Blurred vision◦Nausea◦Diaphoresis

Observation & Reporting

Check BP x2 in both arms: Manual Report to nurse STAT Lie down/elevate feet

CNA 2 Actions

Discontinue saline lock (Does not have fluids running)https://www.youtube.com/watch?v=73tYvGurGE4

Technical Skills

This project was funded $3,000,000 (100% of its total cost) from a grant awarded under the Trade Adjustment Assistance Community College and Career Training Grants, as implemented by the U.S. Department of Labor’s Employment and Training Administration. Rogue Community College is an equal opportunity employer/program. Auxiliary aids and services, alternate form and language services are available to individuals with disabilities and limited English proficiency free of cost upon request.

This work is licensed under a Creative Commons Attribution 4.0 International License.