Chapter 32 Nursing Assessment Cardiovascular System Essay

An evaluation of Mrs Smith circulation was the next step carried out by the nurse, as in the breathing assessment Mrs Smith pallor was noted as being flushed and the patient appeared confused this could be associated with poor cardiac output. The nurse recorded the patient’s blood pressure using a dinamap it was measured at 88/50, it was then rechecked manually to ensure accuracy. The pulse was checked manually for rate and rhythm it was recorded as 98 beats per minute. Capillary refill was checked, was found to be normal.

Physical Examination: General: The patient is an alert, oriented male appearing his stated age. He appears to be in moderate distress. Vital signs: blood pressure 132/78 and pulse 68 and regular. Temperature is 38.56 oC (101.4 oF). HEENT:Normocephalic, atraumatic. Pupils were equal, round, and reactive to light. Ears are clear. Throat is normal. Neck: The neck is supple with no carotid bruits. Lungs: The lungs are clear to auscultation and percussion. Heart: Regular rate and rhythm. Abdomen:Bowel sounds are normal. There is rebound tenderness with maximal discomfort on palpation in the right lower quadrant. Extremities: No clubbing, cyanosis, or edema.

Composed of the heart, blood vessels, and blood, the cardiovascular system is the body system that carries out the tasks of pumping and transporting blood, oxygen, nutrients, and waste products, and other substances throughout the body.

1 Understand the requirements of legislation and agreed ways of working to protect the rights of individuals at the end of life.

| |Coronary circulation |that pushes blood to the organs, |Abnormal heart rhythms or arrhythmias |

With acute aortic insufficiency, pulse pressure widens as the valve deteriorates. Signs and symptoms may include a bounding pulse, atrial and ventricular gallops, chest pain, palpitations, pallor, crackles, dyspnea, and jugular vein distention, may also be present.

In transport, patient received O2 at 4 liters via nasal cannula, baseline EKG, Normal Saline IV started in left hand, 325 mg aspirin by mouth (po). Patient complained she was short of breath and experiencing severe pain between her shoulder blades. She stated that she has been feeling nasuseated for the past 3 hours. She states she has a history of stable angina and is currently taking medication as needed. She states she did not take the nitroglycerin because she was not experiencing chest pain, just back pain. She states that her last check-up with the Pulmonologist showed that her EKG did not show any changes since her last visit. She denies episodes of syncope. The patient does report that she tripped over something on the floor, which resulted in her falling and hitting her back on a large table. In addition, she states that her heart rate has been ranging from 130/ 90 to 140/92. Patient states her Primary care physician placed her on blood pressure medication 2 months ago due to the increase.

On arrival at the ED, the physician auscultates muffled heart tones, no breath sounds on the right, and faint sounds on the left. A.W. is

The heart, blood and blood vessels make up the basis of the cardiovascular system also known as the circulatory system. The average human body contains approximately 5 litres of blood which is carried around the body via a network of blood vessels split into three types; arteries, veins and capillaries. The arteries are the largest of the three vessels and carry blood away from the heart. Veins carry blood to the heart and are smaller than arteries, then finally the smallest vessels known as capillaries distribute the oxygen rich blood to organs whilst simultaneously picking up the waste carbon dioxide and water from the organs to transport back to the heart where it can be pumped into the lungs to be exhaled.

Lily was a 65 year old lady with stage 5 CKD, she had recently begun hemodialysis treatment three times a week as an inpatient and had been responding well to treatment. During dialysis treatment on the morning of the first day, Lily’s observations showed that she was: tachycardic, hypotensive, tachypnoeaic, had an oxygen saturation level of 88% and was becoming confused and drowsy. It became apparent that Lily had become hypovolaemic. The hypovolaemic shock seen in this patient was of a particular critical nature due to the fact that her dialysis treatment had moved her rapidly through the first two stages of shock with her compensatory mechanisms failing very quickly (Tait, 2012). It was also much harder to identify the early signs of

Cary T, Pearce J. Aortic Stenosis: pathophysiology, diagnosis, and medical management of nonsurgical patients. Critical Care Nurse. April 2013;33(2):58-72. http://web.a.ebscohost.com.ezproxy.gannon.edu/ehost/pdfviewer/pdfviewer?sid=e6ada210-f338-49e3-9017-25e89c7004d9%40sessionmgr4002&vid=11&hid=4206. Accessed July 4, 2015.

Ultrasonography can measure the aortic diameter to within 0.3-0.4 cm (Ferri, 2015, p. 3). The criteria for AAA diagnosis on the basis of measurement includes: the central widening of the abdominal aorta to greater than 3 cm and an increase in aortic diameter to 1.5 times greater the normal diameter (Revzin & Pellerito, 2014, p.732). Sonograms for AAA are preferably performed after 8 to 12 hours of fasting, thus reducing bowel gas which allows for better imaging (Revzin & Pellerito, 2014, p.726) Ultrasound examination of an AAA may be performed in a supine position or a right and left lateral decubitus, or right and left posterior oblique positions. Sonogram images are obtained in coronal and transverse planes from the level of the diaphragm to the level of the common iliac bifurcation, while viewing both common iliac arteries. Measurements of the aortic diameter should be recorded at the proximal, mid, and distal aorta, and at the proximal levels of both common iliac arteries (Revzin & Pellerito, 2014, p.726).

Follow a systematic palpate the sternoclavicular, aortic, pulmonic, tricuspid and epigastric areas using a systematic sequence. Using the ball of hand find the apical pulse then tips of finger over the precordium. Note abnormal finding such as heaves, thrills and fine vibration (purring cat). Palpate the other arterial pulses by pressing with the pads of your index and middle finger. Start at the temporal artery and work down to the dorsalis pedis pulse. Abnormal finding such week pulse could be due to cold weather or can indicate sever heart failure or peripheral vascular disease. Strong or bounding pulsations usually occur in a patient with a condition that causes increased cardiac output, such as hypertension, hypoxia, anemia, exercise, or anxiety. A thrill usually suggests a valvular dysfunction.

Patient is a 45 yo male; 5’7”, 221 lbs who entered the emergency room at 6:30 am on 9/7/14 with severe chest pain (onset at 6:00 am) radiating to his arm, L arm numbness and nausea and vomiting. Past medical history reported by wife includes peptic ulcer, tobacco use (1-2ppd for 27 years), elevated blood pressure (controlled by lopressor). Wife did not know of any family history but reports patient’s father is deceased, died at 42 in his sleep. Mother alive and with high blood pressure.

This allows your cardiovascular centres in your brain a little bit more latitude as far as controlling your heart rate. If you were to remove a beating heart from someone's body you would find that the heart is no longer being suppressed by the parasympathetic nervous system and it will accelerate to the same pace as the sinoatrial node. The SA node generates action potentials approximately 100 times per minute due to the physiology of the heart, its own permeability to sodium and calcium via its channels, and a host of other things. Anywhere between 80 to 100 beats per minute is normal for the SA node.