Handout Cardiovascular System
I.
The heart
a. Location:
i. _________________ cavity
ii. Behind ________________ between ______________
b. Protection
i. __________________________ (protective sac)
ii. Layers of tissue: epicardium, myocardium, endocardium
c. Function:
i. Double ______________
ii. Right
1. Receives blood from the ____________ and pumps it to the ____
iii. Left
1. Received blood from the ___________ and pumps it to the ______
II.
Blood flow
a. (blood enters the heart through) Inferior & Superior _________ ___________ 
b. ___________ atrium (___________________ valve) 
c. ___________ ventricle (_____________________ valve) 
d. Pulmonary __________________
i. Pulm. _______________  Pulm. ____________  Pulm. ________ 
e. Pulmonary __________________ 
f.
Left _________________ (__________________ / mitral valve) 
g. Left _____________________ 
h. _________________________ (aortic valve) 
i.
III.
Body Arteries  Capillaries  veins  back to the Heart
Heart beats (lub-dub)
a. First sound: ________
i. Caused by ________ valves closing (tricuspid & Bicuspid)
b. Second sound: ___________
i. Caused by ____________________ valves closing (aortic & pulmonary)
c. Conduction system
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i. Cardiac _________________ does not need the _____________ system to generate an
electrical impulse. Heart beat is controlled by special cells in the __________________
called the “_____________________________ system”
1. Sinoatrial (______) node (AKA: ____________________) 
2. Internodal ___________________________ 
3. Atrioventricular (______) node 
4. Bundle of ________________ 
5. _____________________ fibers
ii. Measured via: ___________________________________________ (EKG)
d. Cardiac Cycle
i. ____________________ & relaxation of the heart = _________ heart beat
ii. Diastole: ______________________ relax (and fill)
iii. Systole: ventricles ____________________
e. Heart Rate
i. Normal: ________________________
ii. > ____________ cardia
iii. < ____________ cardia
f.
Stroke Volume
i. Amount of __________ pushed from the heart with _________ heart beat
g. Cardiac Output
i. Amt. of blood pumped in _____________________
IV.
Peripheral Vascular system
a. _______________ of blood _____________ that carry blood to the peripheral ____________
and then return it to the ___________________
i. Arteries: Carry blood __________________________________
ii. Capillaries: Where oxygen & nutrients are _____________________
iii. Veins: Carry blood ____________________________________
b. Blood flow
i. Aorta  ______________________  _____________________  CAPILLARIES 
_____________________  ____________________  superior & inferior vena cava
c. Blood vessel Structure:
i. Inner layer: __________________ surface
ii. Middle layer: Smooth ________________
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1. Constrict: _______________________________
2. Dilate: _____________________________
iii. Outer layer: __________________________
iv. Veins vs. Arteries: Veins have _________________________
d. Blood Pressure: _________________ extended by blood against the wall of the ___________
i. Systolic: Pressure exerted when the heart ____________________
ii. Diastolic: Pressure exerted when the heart ____________________
iii. Optimal Blood Pressure: ________________________
e. Blood:
i. ________________________ blood that is carrying oxygen ______
ii. ________________________ blood that is NOT carrying oxygen (carrying _________)
V.
Small Group Questions
a. Fill in the diagram. Identify where the blood would be oxygenated and deoxygenated.
b. How is the heart protected?
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c. What is the function of the right side of the heart?
d. What is the function of the left side of the heart?
e. Describe the sounds of a heart beat and explain what makes the different “sounds”
f.
Define cardiac output, stroke volume and cardiac cycle
g. What is blood pressure?
h. What do veins have that arteries do not? What is good and bad about these structures?
VI.
Cardiac Assessment
a. History
i. ____________ pain
ii. _____________________ problems: ___________________________
iii. Change in ___________________ level
iv. ________________________
v. Life style
1. _________________ intake
2. ______________________
3. ______________________
4. Illicit __________________
b. Skin color:
i. _____________ pale
ii. _____________ blue
c. _______________________
d. _______________________ pulses
e. _______________________ refill
f.
___________________________?
g. ___________________________ the heart
VII.
Cardiac diagnostic tests
a. Lipid profile
i. Choleterol, triglycerides, high-density lipoproteins (HDL’s) low-density lipoproteins
(LDL’s)
b. Serum Cardiac markers
i. Creatine phosphokinage; CK-MB; cTnT, cTn1
ii. Dead or damaged heart muscles  __________________
iii. ________ levels = heart damage
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c. Electrocardiogram (__________): ________________________________
i. _____ wave: ____________ depolarization (____________________________)
ii. __________ complex: ____________________ depolarization ( _____________
iii. _____ wave: ____________ repolarization ( ____________________________)
iv. ___________ interval: time period from ________node  _________ node
d. CT scan (Computerized Tomography): ____________________________
e. MRI scan (_______________________ resonance imaging)
i. No _________________________ in the room with the machine
ii. Assess for ______________________ or _______________________
f.
Angiography
i. ___________________________ insertion into an ______________
1. _________________ + fluoroscopy
ii. Risks
1. ________________________ & blood clots
iii. Assess: ______________ site & pedal _________________
VIII.
Small Group Questions:
a. Describe a cardiovascular assessment. What does it include?
b. What does a lipid panel/profile indicate?
c. What do the cardiac enzymes lab values tell you? What causes them to increase or decrease?
d. A patient is going in for an EKG. What nursing teaching do you give them?
e. Describe the different parts of an ECG? What do each wave represent?
f.
A patient is going to have a CT scan of their heart. What do you teach your patient?
g. A patient is going to have an MRI. What questions do you ask them before entering the MRI
room?
h. A patient had an angiography 1 hour ago. What do you include in your assessment?
IX.
Coronary Heart Disease
a. __________________ of the arteries that supply blood to the _________ muscle
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b. Arteriosclerosis: __________________________________________________
c. Atherosclerosis: ___________________________________________________
d. Risk factors
Changeable
Non-changable
e. Atherosclerosis  __________________ arteries  _______ blood flow 
_________________________  _________________________
f.
S&S of Atherosclerosis: ____________________________________
g. IDT interventions
i. Quit ________________________
ii. Diet
iii. ______________________
iv. Control _______________________ & _________________
h. Atherosclerosis Medications
i. Cholesterol-Lowering Drugs
ii. Nrs implications: Monitor _____________________ & ______________
X.
Angina Pectoris: _______________ due to ________ blood/oxygen to the _________
a. Locations
i. __________________
ii. ___________________ to: neck, shoulder, arm, jaw
b. Characteristics: ______________ squeezing ________________
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c. Other symptoms: _____________________________
d. Medications
i. Nitrates
1. Action: ___________ blood vessels  ____ blood flow to the heart
2. Nitroglycerin:
3. Route: Sub-lingual, patches, ointment
ii. Beta Blockers
1. ________ workload of the heart: _______ pulse ________ BP
2. Nrs. Implications: Take ________ & pulse – if pulse < _______ hold
iii. Calcium Channel blockers
1. Purpose: Treat _______________ & ______________
2. Nrs. Implications: Take ________ & pulse – if pulse < _______ hold
XI.
Myocardial Infarction (_____) AKA: _________________________
a. ________ blood/oxygen to the ___________ muscle  ischemia  __________________/
________________  _____ cardiac output  death
b. S&S
i. Chest ______________
ii. ___________ cardia
iii. SOB: __________________________
iv. Skin: _________________________________ & ___________________
v. Anxiety, N&V
c. IDT treatment
i. IV, Oxygen, bed rest
d. Medications
i. Asprin
1. _____________ blood
ii. Pain reliever: Nitroglycerin, Morphine sulfate  ___________ muscles around the
blood vessels  vaso___________________  ____ blood flow
iii. Fibrinolytic agents: Drugs that ______________________ clots
XII.
Heart Failure: Inability of the heart to ______________ as a _____________ to meet the needs of
the body
a. Left-side heart failure
i. Results in
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1. ______ cardiac output
2. ______ pulmonary pressure
ii. S&S
1. ___________________ intolerance
2. SOB ____________________________
3. Orthopnea
4. __________________________ & _____________________
b. Right-side heart failure
i. Results in __________ venous pressure  ___________
ii. S&S
1. _________________________ intolerance
2. _______________________
3. _________________ vein distention
c. Medications:
i. Diuretics: Furosemide / Lasix
1. Action: _________ urine output
ii. Positive Inotropic Agents: Digoxin / Lanoxin
1. ___________ contractility (heart contraction strength)
XIII.
Hypertension: AKA ___________________________________
a. Normal Values: __________________ - ______________
b. Risk Factors
Changeable
Non-changeable
Diet
Wt:
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d. S&S
i. Any S&S are due to _____________________________
e. Tx
i. Monitor ____________________
ii. NO ______________________ & NO _____________________
iii. Lifestyle changes: _______________________________________________
f.
Medications: Anti-hypertensives
i. ACE inhibitors (angiotensin-converting enzyme)
1. ________________ formation of angiotensin II  vaso__________
2. ________________ aldosterone  ___________ fluid volume
ii. Beta-Blockers
1. __________ heart rate
__________ cardiac output
2. __________ contractility
iii. Calcium Channel blockers
1. Blocks Ca+ in ____________ smooth muscles ______________
iv. Diuretics:
1. ________ urine output
2. ________ fluid volume
XIV.
Venous Thrombosis/thrombophlebitis
a. Thombi =____________________ -osis =___________________
b. _______________________________
c. Phlebo = _____________________ -itis = ___________________
d. _______________________________
e. 3 factors to developing venous thrombosis
i. Venous ______________________________
ii. __________ blood coagulation
iii. Vessel wall ____________________
f.
When a clot develops blood returns to the heart via _________________________
g. Emboli = __________________________
h. Common location: #1 ___________________
i.
S&S
i. Calf _________________
ii. ______________ tenderness
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iii. __________________ calf
iv. ________ temperature
j.
Complication of DVT
i. Pulmonary ____________________: Clot travels to the ________ and blocks the
pulmonary ________________
k. Diagnostic test
i. Doppler untrasonography
l.
Medications
i. NSAID’s: ______________________________
ii. Anticoagulants (heparin or Warfarin/Coumadin)
1. Prevent blood _____________________
2. S/E: _____________________________
iii. Fibroinolytic drugs
1. ____________________ clots
2. S/E: _____________________________
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Directed Reading
Chapter 15: The Cardiovascular system & assessment
1.
The right atrium receives what type of blood? The left atrium receive what type of blood?
2. The right side of the heart pumps blood to what part of the body? The left side of the heart pumps
blood to what part of the body?
3. What 3 factors determine peripheral vascular resistance?
4. What affect does an increase in renin/angiotensin (released by the kidneys) have on blood
pressure?
5. What affect does and increase in antidiuretic hormone released by the pituitary have on blood
pressure?
6. As a person ages, what changes occur with their heart rate (especially when they exercise)?
7. On an 12-lead ECG, how much time is a small box? 1 large box? How many large boxes make 1
second?
8. Label the parts of an ECG (P wave, QRS complex, T wave, P-R interval)
9. What are the 3 main risks of angiography?
10. What do you need to tell a patient for whom the doctor has ordered a lipid profile to be done?
Chapter 16
1.
What is the leading risk factor for CHD?
2. Which lipoproteins are good and which are bod?
3. What is the primary cause of CHD?
4. What is angina Pectoris? What is the primary cause?
5. What is the drug of choice to treat a angina attack?
6. What long term angina medication is contraindicated in a patient with asthma or COPD?
7. What medication is frequently prescribed to patients with angina to decrease the risk of clot
formation?
8. Why is giving oxygen part of the nursing interventions for a patient with a nursing diagnosis of
decreased cardiac tissue perfusion?
9. What procedures would the nurse perform before a client had an angiography or angioplasty
procedure?
10. What procedures would the nurse perform after a client had an angiography or angioplasty
procedure?
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