Medical-Surgical Nursing, 9th Ed., Ignatavicius & Workman, 2018 | Registered Nurse (RN) School Study Aid
Coronary Arteries
- Aortic Root
- Right Coronary Artery (RCA)
- Right (Acute) Marginal Artery
- Posterior Descending Artery (PDA)
- Left Coronary Artery (LCA)
- Left Anterior Descending (LAD) Artery
- Circumflex Artery
- Left Marginal Artery
Cardiac Cycle - Diastole
- Aortic Valve Closes
- Pulmonary Valve Closes
- Ventricles Relax
- Mitral Valve Opens
- Tricuspid Valve Opens
- Ventricles Fill
- Sinoatrial (SA) Node Fires
- Atrial Contraction
Cardiac Cycle - Systole
- AV Node
- AV Node Conducts Signal to Bundle of His
- Bundle of His Signals Purkinje Fibers to Contract Ventricles
- Tricuspid Valve Closes
- Pulmonary Valve Opens
- Mitral Valve Closes
- Aortic Valve Opens
Blood Pressure Classification (JNC 7)
- Normal
- Systolic (<120)
- Diastolic (< 80)
- Prehypertension
- Systolic +20 (120-139)
- Diastolic +10 (80-89)
- Stage 1 Hypertension
- Systolic +20 (140-159)
- Diastolic +10 (90-99)
- Stage 2 Hypertension
- Systolic + > 20 (160)
- Diastolic + > 10 (100)
- Hypertensive Crisis
- Systolic > 180
- Diastolic > 110
Autonomic Nervous System
- Sympathetic Nervous System
- Fight or Flight
- All Preganglionic Neurons Release Acetylcholine
- Sympathetic Postganglionic Neurons Release Norepinephrine
- Antagonistic Effects of Sympathetic and Parasympathetic Nervous Systems
- Parasympathetic Nervous System
- Rest and Digest
- Parasympathetic Postganglionic Neurons Release Acetylcholine
Acute Pericarditis Assessment
- Pericardial Sac Inflammation
- Sharp Chest Pain
- Increased with Inspiration
- Pain Decreased by Leaning Forward
- Pericardial Friction Rub
- Diffuse ST-Elevation
- T Wave Inversion
- Fever
- May Be Asymptomatic
- Cardiac Tamponade
Left Heart Failure Assessment
- Pulmonary Congestion
- Pink Frothy Sputum
- Wheezing or Crackles
- Dyspnea with Exertion
- Cough
- Fatigue
- Tachycardia
- Weak Peripheral Pulse
- S3, S4 Heart Sounds
Lymphatics
- Recycles 10% of Interstitial Fluid
- Transport Large Lipids from Lacteals
- Unidirectional Valves
- Lymph Nodes Filter Lymph
- WBCs Monitor Lymph for Pathogens
- Merge with Veins
Myocardial Infarction Assessment
- Substernal Chest Pain
- Crushing or Dull Sensation
- Arm, Jaw, and Neck
- > 20 Minutes
- Unrelieved by Nitro
- Palpitations
- Diaphoresis
- Fear of Impending Doom
- Nausea and Vomiting
- Shortness of Breath
- Monitor for Arrhythmias
Myocardial Infarction Diagnosis
- 12 Lead ECG
- ST Elevation
- Q Wave
- T Wave Inversion
- Troponin T and I
- CK-MB
- Early ECG
- Cardiac Stress Test
Cardiac Enzyme Evaluation: Troponin
- Cardiac Muscle Injury
- Detection in Blood: 4 Hours
- Peak: 24 - 36 Hours
- Return to Normal: 5 - 14 Days
- Most Specific for Cardiac Muscle
- Treat Aggressively
Troponin Lab Values
- Troponin T (cTnT)
- < 0.1 ng/mL Normal
- Troponin I (cTnI)
- < 0.5 ng/mL Normal
- > 2.3 ng/mL Myocardial Injury
Cardiac Enzyme Evaluation: Creatine Kinase CK-MB
- Skeletal or Cardiac Muscle Injury
- Onset: 4-8 Hours
- Peak: 12-24 Hours
- Return to Normal: 2-3 Days
Cardiac Enzyme Evaluation: Myoglobin
- Skeletal or Cardiac Muscle Injury
- Onset: 1 - 4 Hours
- Peak: 12 Hours
- Return to Normal: 24 Hours
- Elevation After 24 Hours: Reinfarction
Cholesterol Lab Values
- LDL (Low Density Cholesterol)
- < 100 mg/dL
- HDL (High Density Cholesterol)
- > 40 mg/dL Males
- > 50 mg/dL Females
- Total Cholesterol
- < 200 mg/dL
PT/PTT Lab Values
- Prothrombin Time (PT)
- 10-14 seconds
- Activated Partial Thromboplastin Time (PTT or aPTT)
- 25-35 seconds
INR Lab Value
- 0.8-1.2 Normal Range
- Warfarin
- 2.0-3.0
Hypocalcemia
- Muscle Spasms
- < 8.5 mg/dL Ca2+
- Decreased Bone Density
- Tetany
- Chvostek's Sign
- Trousseau's Sign
- Increased DTR
- ECG Changes
- QT Prolongation
- Oral and IV Replacement of Ca2+
- Seizure Precautions
Cardiac Catheterization
- Fluttering Sensation
- Contrast Media
- NPO 6-12 Hours
- Bed Rest
- Assess Circulation
- Assess for Bleeding
- Monitor Vital Signs
Magnetic Resonance Imaging (MRI)
- Internal Body Images
- Detects Variations of Soft Tissues
- No Metal Objects
- No Pacemakers
- Contrast is Non-Iodine
- Safe During Pregnancy
- Long Procedure
- Antianxiety Medications