Circulatory(Cardiovascular System) Unit 40

1. Adonis K. Lomibao, R.N. 12/15/11 Circulatory(Cardiovascular System) Unit 40

3. Objectives • Define & spell key terms • Review location & function of circulatory organs • Describe PCT actions regarding PVD,Atherosclerosis,Hypt., Angina, MI, CHF • Pacemaker care measures

4. Introduction • Transportation: -Takes nourishment to the cells -Carries away waste products • Diseases affect overall body function • Long-standing disease will affect pulmonary system

5. 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

6. Arteries

7. Veins

8. 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

10. 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.

11. 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.

13. 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.

14. Circulatory Flow

15. 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

17. 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

18. 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

19. 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

20. 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

21. Atherosclerosis

22. Stent Placement

23. Atherosclerosis • Narrowing of vessels can lead to complications such as: -formation of blood clots -angina pectoris -myocardial infarction -strokes -gangrene

24. Atherosclerosis • Risk factors: -Hypertension -Diabetes -Overweight -Heredity -Smoking -Stress -lack of exercise -p.691

26. 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

27. Varicose Veins

29. 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.

30. 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

31. PCT Care Hypt. • Report: -flushed face -dizziness -nosebleeds -headaches -changes in speech patterns -blurred vision

33. 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

34. 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

35. PCT Care • Help in avoiding unnecessary emotional or physical stress • Encourage pt. Not to smoke • Report S&S of attack to nurse

36. 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)

38. 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

39. MI-PCT Care • Watch for bleeding & report • Assist with ADL's • Monitor vital signs • Explain risk factors to avoid

40. 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

41. S&S of CSF • Hemoptysis(spitting up blood) • Cough • Dyspnea • Orthopnea • Ascites • Neck vein swelling • Fatiguing easily • p.696

42. 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

43. 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.

44. Pacemaker

45. Implanted

47. PCT Care • Count, record pulse-rate, & report abnormalities • Report discoloration over implant site • Keep pt. Away from microwave ovens and cellular phones • p.697

48. 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

49. Anemia S&S and Treatment • Little energy • Dyspnea • Rapid pulse • Increased respiratory rate • p. 698 • Treatment: -Iron supplements, eliminating cause, blood transfusions, Nutrition

50. Leukemia • 'Cancer” of the blood • White blood cell number increase, but of poor quality • Erythrocytes & platelets decrease. • Highly susceptible to infection • Prone to bleeding