The Cardiovascular System
Outcomes: By the end of this session the
student will be able to:
Discuss the cardiovascular system
Identify the normal changes that occur with
Explain the nurses role in the care of
residents with cardiovascular disease
The cardiovascular system comprises the
heart, the blood vessels and the blood.
* transport of oxygen, waste, hormones and
nutrients to and from various parts of the
The function of blood is to:
Carry oxygen (O²) from lungs to cells.
Carry carbon dioxide (CO²) from cells to the
Absorb nutrients (from food) from the
duodenum (in the digestive system) and
transports them to cells.
Carry waste products from the cells to the
kidneys to be eliminated as urine.
Carry hormones from the endocrine system
to receptors in various cells.
Red cells (erythrocytes) which contain
*Haemoglobin carries the oxygen (O²) in the
White cells (leukocytes) which fight infection
by destroying bacteria/virus/etc and help to
Plasma, which is the liquid portion of blood
and contains protein and salts.
Platelets (thrombocytes) which are important
Consist of arteries, arterioles (which
carry oxygen rich blood to cells), veins,
venules (which carry blood rich in CO²
away from cells) and capillaries.
Blood pressure is the pressure of the
blood against the walls of an artery as
the heart contracts (called systole) and;
relaxes between contractions (called
diastole); specifically, the period when
the two ventricles are dilated by the
blood flowing into them.
Dilation and contraction of the blood vessels
helps the body regulate temperature.
Blood vessels reach every organ of the body,
including the heart itself.
The heart is a hollow organ about the size of
a fist and is composed of special muscle
tissue. (cardiac muscle).
It lies under the breast bone (sternum) in the
centre of the cardiothoracic cavity.
The heart has of 3 layers –
pericardium (outer layer),
myocardium (the muscle layer)
endocardium (the inside layer).
There are four chambers within the heart:
Two atria above
Two ventricles below.
The septum divides the right atria and the
right ventricle from the left atria and the left
Valves, control the blood flow between the
chambers of the heart
There are four valves within the heart:
Mitral (Bicuspid) Valve
The heart is supplied by its own arteries
The “conduction system” of the heart is a
system of nerve cells and fibres that
determine its beat, which averages at 72
beats per minute.
Increase in size of heart.
Impaired response to exercise.
Decrease in cardiac output due to loss of
heart muscle elasticity.
Decrease in blood flow to organs.
Increase in blood pressure.
Artery walls thicken.
Changes occur in veins and valves.
The interior of vessels roughens.
Cardiovascular adjustments to changes in
Arteriosclerotic changes to the vessels occur,
CCF is the inability of the heart to
maintain circulation sufficient to meet
the bodies needs.
Signs & Symptoms:
abnormal retention of water and sodium
leading to oedema (fluid retention) with
congestion of the lungs or the peripheral
circulation or both
Care is concerned with alleviating the presenting
Fluid balance chart- fluid restriction
Oxygen therapy as required - very important
for the nursing assistant NOT to initiate oxygen
Special diet - low sodium
Report any consistent, hacking cough
Observe for cool, pale skin
Observe for oedema, dyspnoea
Assist with activities of daily living as
A conduction disorder is an abnormal
electrical conduction of the heart
resulting in an abnormal rate or rhythm
of the heart.
These depend upon the location in the heart of
the disorder but generally there is :
An irregular pulse.
A feeling of general malaise.
Report any symptoms or change in resident
to registered nurse.
Assist with ADL’s.
Oxygen therapy as required (NOT initiated
by nursing assistant).
Angina is chest pain due to inadequate
oxygen supply to cardiac muscle.
Chest pain, often bought about by
exercise or stress.
“Tightness” in chest.
Report any episodes of angina to
Discuss with resident lifestyle choices,
which impact on the disease i.e.
Smoking, diet, and obesity.
A myocardial infarction or “heart attack”
is an area of necrotic myocardium due to
a lack of oxygenated blood
Acute, crushing retro-sternal chest pain,
radiating down left arm and into the jaw
Shortness of breath.
Desire to open bowels.
Do not ignore ℅ pain in chest, jaw or (L) arm
Assist resident to a comfortable position
Do not leave the resident
Notify the RN
Be prepared to assist with whatever is required.
Know where all emergency equipment is stored.
Hypertension is defined as sustained,
elevated BP i.e. >140/90
(65yrs+ = >160/95)
Headache, tinnitus, blurred vision.
Successive raised blood pressure.
Also depends on underlying cause i.e.
vascular problems, renal disease.
Encourage resident in lifestyle related
decisions that affect hypertension: diet
(low sodium, low caffeine), exercise, no
Report any acute change in condition of
resident that reflects above symptoms.
Postural hypotension is low blood
pressure associated with change in
the residents position.
Nausea, dizziness, fainting.
Instruct and assist resident to sit up
Do not leave resident during episode.
A cerebral vascular accident is a
disruption of blood supply to the brain
resulting in loss of brain function.
PLAQUE BUILDUP IN AN ARTERY
The presenting problems of a CVA reflect the
location and severity of the CVA in the brain
Dizziness, headache, poor concentration,
“pins and needles”.
Noticeable droop on one side of the face.
Change in level of consciousness, weakness.
Speech, sensory, motor deficits.
Changes in behaviour and/or personality.
Personal care and assistance with
activities of daily living.
Work with other members of the health
care team - Physiotherapist,
Therapist, Dietitian, and Speech
Encourage as much independence as
possible to promote dignity and selfesteem.
Unfortunately, many people adopt
changes to their lifestyle after they
develop the symptoms of heart disease.
Lifestyle changes are vital in the ongoing
management and prevention of heart
Eating – low fat, low sodium, low animal
products and high carbohydrate.
A reduction of caffeine and alcohol
Stress management and relaxation
Education about risk factors, eg smoking.
Nepean Hospital Outpatient Program – Healthy Heart.
As a person ages they experience changes
In circulation, as their heart cannot
function as it once did. These changes
Cold hands and feet
Ulceration, especially on the feet and
Cyanosis – especially the extremities
Anderson et al 1996