The external structures of the heart include the ventricles, atria, arteries,
and veins. Arteries carry blood away from the heart while veins carry blood into
the heart. The vessels colored blue indicate the transport of blood with relatively
low content of oxygen and high content of carbon dioxide. The vessels colored
red indicate the transport of blood with relatively high content of oxygen and
low content of carbon dioxide.
The right system receives blood from the veins of the whole body. This is
"used" blood, which is poor in oxygen and rich in carbon dioxide.
The left system receives blood from the lungs. This blood is now oxygen rich.
• The oxygen-rich blood returns through veins coming from the lungs
(pulmonary veins) to the heart.
• It is received from the lungs in the left atrium, the first chamber on the
left side.
• Here, it moves to the left ventricle, a powerful muscular chamber that
pumps the blood back out to the body.
• The left ventricle is the strongest of the heart's pumps. Its thicker muscles
need to perform contractions powerful enough to force the blood to all
parts of the body.
• This strong contraction produces systolic blood pressure (the first and
higher number in blood pressure measurement). The lower number
(diastolic blood pressure) is measured when the left ventricle relaxes to
refill with blood between beats.
• Blood leaves the heart through the ascending aorta, the major artery that
feeds blood to the entire body.
The Valves
Valves are muscular flaps that open and close so blood will flow in the right
direction. There are four valves in the heart:
• The tricuspid regulates blood flow between the right atrium and the right
ventricle.
• The pulmonary valve opens to allow blood to flow from the right ventricle
to the lungs.
• The mitral valve regulates blood flow between the left atrium and the left
ventricle.
• The aortic valve allows blood to flow from the left ventricle to the
ascending aorta.
Pathophysiology
Causes:
Reduced myocardial contractility
o Myocardial Infarction Increases cardiac workload
o Hypertension Decreased diastolic filling
o Aortic stenosis insufficiency Obstructions of left atrial
o Mitral stenosis insufficiency emptying
Pulmonary edema
Cellular hypoxia Vasoconstriction and
reabsorption of Na and water
ECF volume
Pathophysiology
Causes:
o LSCHF
o Pulmonary
Embolism Reduced myocardial Increases cardiac
o Right ventricular contractility workload
infarction
o Congenital septal
defects
Decreased diastolic
Obstruction of right Contraction of right sided filling
atrial emptying atrial filling
Increase right atrial Right sided CHF Blood drains back from
pressure RV to RA
Congestive heart failure (CHF), or heart failure, is a condition in which the heart
can't pump enough blood to the body's other organs.
• Infection
• Anemia
• Thyrotoxicosis
• Abnormal heart rhythms
• Rheumatic fever
• Infective Endocarditis
• Myocarditis
• Hypertension
• Heart attack
• Myocardial infarction
• Pulmonary embolism
• Overexercise
• Sudden increase in salt in the diet
• Excessive environmental heat or humidity
• Emotional crises
• Orthopnea
• Cough or wheezing
• Cerebral hypoxia
• Anxiety
• Irritability
• Restlessness
• Wheezing
• Dizziness
• Syncope
• Fatigue
• Weakness
• Anorexia
• Hypokalemia
• Polycythemia
• Confusion
• Impaired memory
• Insomnia Nocturia
• Oliguria
Right-Sided Heart Failure:
• Hepatomegaly
• Ascites
• Portal hypertension
• Splenomegaly
• Jaundice
• Hemolytic anemia
• Internal hemorrhoids
• Leg varicosities
• Weight gain
NURSING RESPONSIBILITIES
- Read doctor’s order
- Check IV label
- Check for patency of tubing
- Regulate as ordered
- Check IV infusion and amount
- Monitor Electrolyte
Name of drug/ Route/Adm General Action Indication or Purpose
generic inistration
name/brand Dosage
name and
frequency
of
administra
tion
Selective inhibitor of
beta1-adrenergic
receptors;
competitively blocks
beta1-receptors thus
lowering BP and
decreasing cardiac
output.
Nursing Responsibilities:
Captopril 25 mg SL
(Capoten) for BP > or ACE inhibitor It is used for treatment
equal to of hypertension.
140/90
Nursing Responsibilities:
NURSING RESPONSIBILITIES:
- Monitor vital signs, including central venous pressure and fluid intake
and output hourly. Report increasing oliguria.
- Monitor weight, renal function, fluid balance, serum, and urine sodium
and potassium levels daily.
- It can be used in measuring glomerular filtration rate.
Name of drug/ Route/Adm General Action Indication or Purpose
generic inistration
name/brand Dosage
name and
frequency
of
administra
tion
Nursing Responsibilities: