Heart
What are the layers of the heart?
Endocardium- lining of heart and heart valves
Myocardium- muscle for pumping
Epicardium- serous layer (protects heart)
Pericardium (2)- sac surrounding heart
-visceral: covers heart surface
-parietal: lining of pericardial sac
What do arteries do?
Carry oxygenated blood away from the heart and to the rest of the body.
RBC level (male and female). Where is it made and what’s it do?
Male: 5-6 mill/mm3
female: 4-5 mill/mm3
its made in the bone marrow, it carry’s O2 to the rest of the cells.
Blood Pressure equation
Cardiac output (CO) X peripheral resistance (PR)
Diuretic agents
Thiazide and thiazide-like:
(hydrochlorothiazide, hydroflumethiazide, chlorthalidone)
-FIRST LINE FOR HTN
Potassium sparing diuretic:
(spironolactone, amiloride)
-monitor for hyperkalemia ESPECIALLY with ACE inhibitors
Loop diuretics:
(furosemide)
-monitor for hearing loss
What does the atria and ventricles do? What is the septum?
Atria- receives blood returning from body and lungs
ventricles- pumps blood to body and lungs
septum- separates right and left side of heart
What do veins do?
Carry DEoxygenated blood back to the heart
Hgb (hemoglobin) male and female. Where is it and what does it do?
Male: 15-17 gm/dL
Female: 12-15 gm/dL
Its on the RBC, it’s he part that carry’s O2.
What percent of hypertension is Essential/Primary and Secondary. And what do these mean?
Essential/Primary: 90-95%. Not caused by something else.
secondary: 5-10%. Caused by something else. (Ex. Renal failure, drug use, poorly controlled diabete, FVE)
Ace inhibitors
Block angiotensin converting enzyme in lungs preventing angiotensin l from becoming angiotensin ll in the lungs. Prevents vasoconstriction and aldosterone release. (Benazepril, Captopril)
What is perfusion? What are the requirements?
Process by which oxygenated blood passes through body tissues.
requirements: blood volume (ECF), Cardiac output, Vascular condition, Oxygen/ good ventilation.
What do capillaries do?
Connect arteries to veins, gas exchange happens here (RBC picks up O2 and drops CO2).
HCT lab value (male and female). What is it?
Male: 45-50%
Female: 36-45%
it’s the percent of blood that’s made up of RBC
Optimal blood pressure
< 120/80
Aldosterone receptor blockers (ARBSs)
Binds with anbiotensin ll receptors in the vascular smooth muscle and in the adrenal cortex to block vasoconstriction and the release of aldosteron.
-stops the renin-angiotensin-aldosterone cycle and lowers BP
(azilsartan, losartan, valsartan)
Parts of the right side of the heart
- SVC/IVC
-Right atrium
-tricuspid valve
-right ventricle
-pulmonary valve
-pulmonary artery
What is Preload?
Degree of stretching of the cardiac muscles at the end of diastole. Determined by the amount of blood left in the VENTRICLES at the end of diastole.
Platelet level. What do they do? What it mean is they are high and if they are low?
150,000-400,000/mm3
This is what clots. If they are high your blood is clotting and it puts you at risk for stroke, heart attack, etc. If they are low your blood is NOT clotting which means you could have excess bleeding.
Signs and symptoms of hypertension
-Potentially NONE
-dizziness
-headaches
-fainting
-visual disturbances
-facial flushing
-nose bleeds
Calcium channel blockers
Alters movement of calcium through cell membrane, resulting in vasodilation and decreased BP.
-decreases cardiac afterload
-CONTRADICTED IN AV node disease, severe heart failure, or severe hypotensio.
-monitor for hypotension, bradycardia, edema
(amlodipine, felodipine, nicradipine)
Parts of the left side of the heart
-pulmonary veins
-left atrium
-mitral valve
-left ventricle
-aortic valve
-aorta
What is afterload? What’s it impacted by?
The force the ventricles must overcome to empty the blood from the heart. It’s impacted by vascular resistance (resistance of blood to flow out of the ventricle).
Cardiac output equation?
what is cardiac output?
Strength volume (SV) X heart rate (HR)
this will tell you the amount of blood pumped in 1 minute
Complications of uncontrolled HTN. How much can double your chances?
-damaged vessels in the eyes and kidneys
-heart attack and stroke
-enlarged heart/CHF
-metabolic syndrome
-diabetes (type 2)
For every 10mm increase of mercury can double your chances.
Beta blockers
Blocks beta receptors in the heart causing decreased HR, decreased force of contractio, and decreased rate of AV conduction.
-S/E: bradycardia, lethargy, GI disturbances, CHF, decreased BP, and depression
- MUST count HR prior to administration
-may cause dyspnea in pts with asthma
(carvedilol, labetalol, metoprolo)