# Nursing Study Guide/Care of Cardiovascular Needs
## Coagulopathy(clotting)

Coagulopathy is central to understanding cardiac pathophysiology. People maintain homeostasis of clotting in their body. Too little clotting or thin blood can lead to bleeding (haemophilia) and too much clotting can cause thrombosis or embolism in any of the major organ systems. Large clots can cut off the blood supply to lungs, heart, brain, kidney.

## Clinical assessment of Normal Heart Sounds

A heart pumping produces distinct noises that can be haerd at the bedside with a stethescope. There are three (3) different sounds heard, two of these are often described as the "lubb" and "dupp" sounds. These are the main beats of the heart. The "lubb" is the first heart sound, which is a low pitched noised caused by the atrioventricular valves and the surrounding fluid vibrating as the valves close at the start of the ventricular systole. The "dupp" is the second heart sound, which is a higher pitched sound caused from the aortic and pulmonary semilunar valves closing at the start of the ventricular diastole. A third faint sound can sometimes be heard, generally in young and thin people. It is caused by the blood flowing in a turbulent fashion into the ventricles.

## Heart Failure

The words 'Heart Failure' make it sounds like the heart has completely stopped working and there is nothing that can be done. It actually may mean that the heart isn't pumping as well as it should be. Heart failure is a condition where the heart can't pump enough blood to meet the bodily requirements. Another common case is when the heart can't pump enough blood to the entire body with enough force.

### Symptoms

+Swollen ankles/legs
* Angina; Chest or arm discomfort due to coronary artery blockage
* Weight gain/loss
* Shortness of breath
* Constant coughing/wheezing
* Fatigue
* Loss of appetite
* Confusion

### Nursing management

* Seek collaborative assistance
* screen for high blood pressure and report findings
* maintain healthy diet and exercise

## myocardial infarction
### chest pain

Cases of chest pain are a triage category one and must not be left alone. Sometimes the mere presence of a nurses will be reassuring to the client and allow an episode of stress to pass, but nurses may never assume that this will be the case. In case of chest pain, seek urgent collaborative assistance and consider transport to esclated care facility. Use the communication system for your facility to indicate a medical emergency code (eg. code blue). Clients with chest pain may need an oxygen order initiated by a physician, nurses at the scene should suggest the client take a few slow deep breaths allowing for more efficient ventilation and helping draw client focus from the crisis toward breath consciousness. Urgent ECG. Ask client about nitro-glycerine spray or other medications.

### signs of heart attack

Three main symptoms of having a heart attack include; Chest discomfort : Discomfort in the center of the chest that last for more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain. Uncomfortable in other areas of the body: Symptoms can also be pain, discomfort in one or both arms, the back, neck, jaw or stomach. Short of breath: With or without discomfort. Other signs can be breaking out in a cold sweat, nausea and dizziness. -Tahnee- Asessing The Heart- Assess the patients general appearance. Is he/she overly thin? obese? alert? anxious? Also inspect the patients precordium (the anterior region of the chest and thorax, including the epigastric area).

## authors

2012 enrolled nursing students Kate Kay, Ning Suangaram, Stevie Usher, Tahnee and Analyn Morrison