CARDIOVASCULAR

SYSTEM
CARDIOVASCULAR SYSTEM
 CARDIOVASCULAR SYSTEM
(cardio = related to the heart, vascular = related to blood vessels)

 COMPOSITION:
a. Heart
b. Blood vessels
c. Blood - the cells and plasma
 MAIN FUNCTION:
Maintains the circulation
of life giving blood to all
parts of our body which is
necessary for delivery of
nutrients, removal of wastes
and exchange of oxygen
and carbon dioxide.
 A. THE HEART
 Composition: Muscular organ
 Parts: It has four chambers –
1. ATRIA - 2 upper chambers known as atria
(receives blood) and
2. VENTRICLES - 2 lower ones known as
ventricles (pumps blood to the various parts of
our body and the lungs).
 Location: Chest between the two lungs,
slightly to the left’ protected by the rib cage.
 Function: It pumps blood to the various parts of
our body by repeated rhythmic contractions. It
beats 72 times in a minute.
 Cardiac Cycle:
Two parts:
a. SYSTOLE –
contraction phase
(ejection of blood
from atria and then
both ventricles)
initiated by SA Node

b. DIASTOLE
– resting,
relaxation phase
both atria and
ventricles
Cardiac Output:
Stroke Volume x Heart Rate

STROKE VOLUME – amount of blood ejected with each heartbeat by SA Node

HEART RATE – Number of beats per minute
 B. BLOOD VESSELS
--the tubes that carry the blood.

They are of 3 types:

 Arteries - carry blood from the heart
to different parts of our body
 Veins - carry blood from the different
parts of our body back to our heart
 Capillaries - small, thin walled
vessels that form a network between
the arteries and veins in the tissues
and function in the exchange of
nutrients and gases.
 C. BLOOD
 DEFINITION:
DEFINITION:AAspecialized
specializedbody
bodyfluid
fluidthat
thatflows
flows
through
throughthe theblood
bloodvessels.
vessels.
 COMPOSITION:
COMPOSITION:ItItisiscomposed composedof ofthe
thefluid
fluidpart
part
known
knownas asplasma
plasmaandandblood
bloodcells.
cells.
a.a. Plasma
Plasmaisismostly
mostlymade
madeup upofofwater
waterand andalso
also
contains
containsproteins,
proteins,salts
saltsand
andother
othersubstances.
substances.
b. Blood
b. Bloodcells:
cells: are
areof
of33types:
types:
1.1. Red
Redblood
bloodcells
cells(responsible
(responsiblefor forthe
the
transport
transportofofrespiratory
respiratorygases)
gases)––due duetoto
hemoglobin
hemoglobinpigment
pigment
2.2. White
Whiteblood
bloodcells
cells(responsible
(responsiblefor forimmunity
immunity
against
againstdiseases)
diseases)
3.3. Platelets
Platelets(responsible
(responsiblefor forblood
bloodclotting.)
clotting.)
 DIVISIONS OF THE
CARDIOVASCULAR SYSTEM

2. PULMONARY
Circulation

1. SYSTEMIC
Circulation
1. DIVISION: Systemic Circulation

 FUNCTION: Delivery of oxygenated blood

to the various parts of our body.
 FLOW: Blood from the left ventricle is
pumped to the various parts of the body
through the aorta.
2. DIVISION: Pulmonary circulation

 FUNCTION: The oxygenation of blood in

the lungs.
 FLOW: Blood from the right ventricle is
pumped to the lungs via the pulmonary
artery where it gets oxygenated and it
reaches the left atrium via the four
pulmonary veins.
BLOOD PRESSURE
1. BLOOD PRESSURE
 Refers to the
measurement of
force exerted by
circulating blood
the walls of blood
vessels, and
constitutes one of the
principal vital signs
2. BLOOD PRESSURE
 Refers to arterial
pressure, i.e., the
pressure in the
larger arteries, the
blood vessels that
take blood away
from the heart
Terms to Know:

 Hypertension: Abnormally high blood pressure over 140 mm Hg

systolic and or about 90mm Hg diastolic for at least two
consecutive readings
ARTERIAL PRESSURE
 The pressure of blood as a result of
the contraction of the ventricles
(100-140mm Hg)

 The pressure when the ventricles

are at rest (60-90mm Hg)

PULSE PRESSURE:
DIFFERENCE BETWEEN THE
SYSTOLIC & DIASTOLIC
PRESSURE (Normal: 30-40mmHg)
 Hypotension: Abnormally low blood
pressure, systolic pressure below
100/60 mm Hg
 Orthostatic hypertension: A blood
pressure that falls when the client sits
or stands
Factors affecting Blood pressure
1. Age. Decreased elasticity of blood vessels
increases BP.
2. Exercise. Increases cardiac output
3. Stress. SNS stimulation causes increase in
BP.
4. Obesity. BP is elevated among overweight
and obese people.
5. Sex. Males before age 65 have higher BP;
females have higher BP after 65
6. Disease process. DM, Renal failures,
Hyperthyroidism.
NORMAL BP: ADULT
Low 90 / 50

Normal 120 / 80

Prehypertension 130–140

Hypertension
Stage 1 Mild 140–160
Stage 2 Moderate 160–180
Stage 3 Severe 180 / 110
NORMAL VITAL SIGNS
AGE NORMAL BLOOD PRESSURE
Newborn 60/40 mm Hg
1-4 years old 90/60 mm Hg
5-12 years old 100 /60 mm Hg
Adult 120/80 mm Hg
Factors affecting BP: Disease, anxiety, cardiac
output, arterial elasticity, age, weight exercise,
drugs
 Korotkoff sound-are sound
heard during measurement of
blood pressure
 Phase 1 SHARP TAPPING SOUND
 Phase 2 SWISHING/SWOOSHING SOUND
 Phase 3 THUMP SOFTER THAN THE
TAPPING IN PHASE 1
 Phase 4 A SOFTER BLOWING MUFFLED
SOUND THAT FADES
 Phase 5 SILENCE (last sound is the beginning of phase 5)
METHODS
OF
TAKING BP
Methods of Taking Blood Pressure

A. DIRECT METHOD
•Requires the use of
sphygmomanometer and
stethoscope for auscultation
and palpation as needed
•Most common site: client’s
arm over brachial artery
•Other sites: Leg site over
popliteal artery (behind the
knee)
Methods of Taking Blood Pressure

 B. INDIRECT METHOD
 An invasive procedure
 An intravenous catheter with an
electronic sensor is inserted into an
artery and the artery-transmitted
pressure on an electronic display
unit is read
PURPOSES
 To have a baseline blood pressure
measurement
 To evaluate client’s condition after
treatment, therapies and medications
 To evaluate the cardio-vascular states of
the client
EQUIPMENTS NEEDED:
 Sphygmomanometer
 Stethoscope
 Cottonballs with alcohol
 Watch or clock with second hand
EQUIPMENT
1. SPHYGMOMANOMETER

An instrument for
measuring arterial
pressure
 3 Types of Blood Pressure
Apparatus (Sphygmomanometer)
1. MERCURY
GRAVITY
MANOMETER
/ MERCURIAL
– has a mercury
filled cylinder
or tube
calibrated in
millimeter
2. ANEROID
MANOMETER/
ANEROIDAL
– has a cuff that is
attached to a round
calibrated dial with
a pointer that
indicates pressure
3. ELECTRONIC
BLOOD
PRESSURE
MEASUREMENT/
DIGITAL –
electrically
operated/battery
operated
Parts: a. Mercury Gauge /
Aneroid / Digital
(Pressure Gauge)
b. Pressure cuff (velcro or
hook) w/ rubber bladder.
Note: Inside the cuff in
an elastic cloth covering
- Airtight, flat and
inflatable
c. Pressure source
 Pressure control bulb
 Pump bulb
 Rubber bulb
 Hand bulb
d. Handle
e. Rubber Tubing (2)
f. Release valve (screw)
 2. STETHOSCOPE
 Used to auscultate the
sound heard directly over
the artery as the pressure in
the cuff is released
 Parts:

a. Ear tips / Ear pieces

b. Metal tubing - Neck / Binaurals (Metal)
c. Rubber tube
d. Chest pieces / Stems – diaphragm; bell
IMPLEMENTATION
OF PROCEDURE
 ASSEMBLE
THE
EQUIPMENTS
A. Preparation
Assess the client.
Signs and symptoms of To accurately assess BP and
hypertension, hypotension significance of pressure changes

Factors affecting blood Can cause false elevations in BP

pressure: exercise and smoking
(wait for 15 minutes before
taking BP measurements)
Allergy to latex cuff
To avoid injuring the client; helps
Condition of client (injury)
to determine type of BP apparatus
to be used and site of BP
application
Assemble equipment.
Gather, assemble, and prepare
equipment or articles needed.
Select a cuff appropriate for the Be sure that the cuff is
client. Measure with a tape, the circumference an appropriate size for
of the bare upper arm at the midpoint between the the client to ensure
shoulder (acromonion) and the elbow (olecranon). accuracy
It should cover 2/3rds of the upper arm.
Check the equipment and supplies. Accurate measurements
Make sure they work. depend on functional
equipment.
B. Procedure
Identify yourself and
verify client’s identity.
Explain to the client what
you are going to do, why it
is necessary, and how the
client can cooperate. Have
the client rest at least 5
minutes (PHN 2007) before
measurement.
Establishes rapport
and trust
Encourages client’s
participation and reduces
client’s anxiety
Readings taken at
different times can be
objectively compared when
all are assessed with client
at rest
Perform hand hygiene, Reduces transmission of
and observe other microorganisms.
appropriate infection
control procedures.

Provide for client Minimizes or avoids

privacy. embarrassment on the
client.
Position the client comfortably and appropriately.
a. The adult client should be
sitting unless otherwise
specified. Both feet
should be flat on the floor.
b. The elbow should be
slightly flexed and the
forearm supported (while
client is sitting or lying) at
heart level.
c. Loosen and fold the
client’s sleeve. Expose the
upper arm.
Helpsin the accurate
measurement of BP
Ifthe arm is above the
level of the heart, the BP
reading will be erroneously
low; while if the arm is
below the level of heart,
the BP reading will be
erroneously high.
Ensures proper cuff
application
Wrap the deflated cuff around the upper arm.
Locate the brachial artery. Apply the center of the
bladder directly over the artery.
Adjust the cuff so that Proper placement
the lower border is ensures accuracy of
approximately 2.5cm result
(1inch) above the
antecubital space.
Proper BP apparatus
would occupy 2/3rds of
the upper arm.
If this is the client’s initial assessment, perform
a preliminary palpatory determination of
systolic pressure.
a. Palpate the brachial (or radial) artery with Identifies
approximate
the fingertips at one hand. systolic
pressure and
b. Close the valve on the bulb. determines
maximum
c. Pump up the cuff until you no longer feel inflation point
the brachial pulse. Note the pressure on the for accurate
reading.
sphygmomanometer at which the pulse is Prevents
no longer felt and add 30mmHg pressure auscultatory
gap
above point which pulse disappears.
d. Release the pressure completely in the Prevents
venous
cuff, and wait 1-2mins (other books:30mins) congestion and
before taking further measurements false high
readings
Position the stethoscope appropriately.
a. Cleanse the earpieces with Avoids transfer
antiseptic wipe. of microorganisms
b. Insert the ear attachments of the
Proper placement
stethoscope in your ears so that
ensures accuracy of
they tilt slightly forward. result
c. Ensure that the stethoscope hangs
freely from the ears to the
diaphragm.
d. Place the bell of the amplifier of the
stethoscope over the brachial
pulse. Place stethoscope directly
on skin, not on clothing over the
site. Hold the diaphragm with the
thumb and index fingers.
Auscultate the client’s blood pressure.
 Ensures accurate measurement of systolic pressure.
Too rapid or slow a decline in mercury level can cause inaccurate
readings.

1. Pump up the cuff until the sphygmomanometer is

30mmHg above the point where the brachial pulse
disappeared.
2. Release the valve on the cuff carefully so that the
pressure decreases at a rate of 2-3mmHg per second.
3. As the pressure falls, identify the manometer
reading at Korotkoff phases I, IV and V.
Note the first clear sound heard. This indicates
systolic pressure (K I).
Note the point at which the sound changes to a
muffled sound (K IV) the last sound before
silence (K V) is diastolic pressure.
4. Deflate the cuff rapidly and completely.
5. Wait 1-2 minutes before making further
determinations. (Manual: 20 to 30 minutes – to allow
venous circulation in the arm to stabilize.
6. Repeat the above steps once or twice as
necessary to confirm the accuracy of
reading.
Remove the cuff. Wipe .Prevents
the cuff with an transmission of
appropriate microorganism
disinfectant.
.

Assist client in returning Restores

to comfortable position
and cover upper arm if comfort.
previously clothed.
 Promotes participation
in care and
Inform client of reading. understanding of
health status.

Wash hands. Prevents transmission

of microorganisms.

Document and report

pertinent assessment Vital signs should
be recorded
data according to immediately to
agency policy. ensure accuracy.
PREPARED BY:
Helen S. Lubiano, MAN