NURS 315/501 Bootcamp

Lecture:Disorders of cardiac function

Perfusion of the HeartDescribe how is the myocardium supplied with oxygen. Discuss the factors that regulate blood flow to the myocardium.

Volume, pressure, resistance, and flow

Cardiac Conduction System

Describe the cardiac conduction system.

SA node, AV node, Bundle of His, bundle branches, Purkinje fibers

Coronary Perfusion and Electrical Activity

Describe the 3 phases of the action potential.

Resting membrane potentialDepolarizationRepolarization

Correlate the ECG events with the mechanical events of a cardiac cycle.

Phases of the Action Potential

Describe the 5 phases of a cardiac action potential.

Phase 4Phase 0Phase 1Phase 2Phase 3

Coronary Heart Disease

Describe the pathogenesis of CAD.Discuss how does atherosclerosis in coronary arteries can lead to ischemia, injury, and infarction.Compare and contrast ischemia, injury, and infarction. Describe the pathologic changes associated with MI.

Coronary Heart Disease

Schematically represent the 2 types of coronary heart disease.

Coronary Heart DiseaseAcute Coronary Syndrome:

Define unstable anginaDescribe changes in ECG and serum markers during a NSTEMI vs. STEMI.What does abnormal Q-waves in a 12-lead ECG mean?

Coronary Heart Disease

Chronic Ischemic Disease.

Compare and contrast stable angina, variant/vasospastic angina, and silent myocardial infarction.

Coronary Heart DiseaseIdentify the goals for the management of angina, CHD, and AMI. Describe the management strategies utilized to achieve management goals.

Anti-anginal drugsAnti-platelet therapyAnticoagulant therapy

Heart FailureDescribe the common causes of heart failure.Describe the cycle through which compensatory mechanisms lead to heart failure and how is the cycle perpetuated.Describe the compensatory mechanisms involved in the physiologic response to decreased cardiac output.

Heart FailureDistinguish between systolic and diastolic heart failure.Distinguish between right and left sided heart failure.Identify the goals of HF management.

Heart FailureDescribe the role of diuretics in the management of HFDescribe how ACE-I and ARB’s achieve the goals for HF management.Describe the function of beta-blockers in the management of HF.Describe the function of digoxin in the management of HF. What role does calcium channel blockers play in the management of HF?

Disorders of Valve Function

Compare and contrast the following disorders of valve function:

Mitral stenosisMitral regurgitation Aortic stenosisAortic regurgitation

Disorders of cardiac electrical conduction

Compare and contrast the following sinus dysrhythmias;

Normal sinus rhythmSinus bradycardiaSinus tachycardiaSinus dysrhythmia

Compare and contrast the following atrial dysrhythmias:

Premature atrial contractionAtrial flutterAtrial fibrillation

Disorders of cardiac electrical conduction

Compare and contrast the following ventricular dysrhythmias:

Premature ventricular contraction Ventricular tachycardiaVentricular fibrillation

Compare and contrast the following atrio-ventricular conduction dysrhythmias:

1st degree AV block2nd degree AV block3rd degree AV block

Disorders of cardiac electrical conduction

Outline in a table: The four classes of anti-dysrhythmic drugs, Agents classified under the class,Their mechanism of action,Indications,Adverse effects,Special considerations.

ShockDefine shockName an important serum marker used to assess cellular aerobic metabolism in tissues.Identify SNS compensatory mechanisms to ensure adequate tissue oxygenation.

Shock

Compare and contrast the 4 types of circulatory shock.Name common complications of shock on organ systems.

ShockWhat is the ultimate goal of therapy in management of shock?Identify mechanisms to ensure adequate oxygen delivery during shock.