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Acquired Cardiac Flashcards

1
Q

what is bacterial endocarditis

A

an inflammatory process resulting from infection of the valves and the inner lining of the heart

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2
Q

describe the pathophysiology of bacterial endocarditis

A

organisms enter bloodstream from an area of localized infection and grow on the endocardium -> vegetations, fibrin deposits, and platelet thrombi form -> lesions may invade adjacent tissues or break off and embolize

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3
Q

what are CM of bacterial endocarditis

A

Low grade intermittent fever
Anorexia
Malaise
Weight loss
Joint pain
Positive blood culture
New heart murmur or change in existing murmur
Petechiae of mucous membranes
Janeway spots
Osler nodes
splinter hemorrhages under nail

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4
Q

what are janeway spots

A

painless hemorrhaging spots on hands and feet

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5
Q

what are osler nodes

A

painful red intradermal nodes with white centers on fingers and toes

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6
Q

what is the typical therapeutic management of bacterial endocarditis

A

IV antibiotics for up to 2-8 weeks
surgical removal of significant emboli and / or valve replacement

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7
Q

how can bacterial endocarditis be prevented in the hospital

A

prophylactic antibiotic 1 hour before a risky procedure

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8
Q

what are some high risk patients for bacterial endocarditis

A

artificial heart valve, CHD, repaired defects, heart transplant

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9
Q

what is rheumatic fever

A

a systemic inflammatory disease that follows a group A beta hemolytic streptococcus infection - autoimmune reaction to step antibodies

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10
Q

the primary concern with rheumatic fever is that it may develop into what

A

rheumatic heart disease which causes damage to the mitral valve = weakened valve that allows a back flow of blood

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11
Q

what age group is most likely to develop rheumatic fever

A

school age

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12
Q

what may be present 2-6 weeks prior to symptoms developing for rheumatic fever

A

upper respiratory infection

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13
Q

are males or females more at risk of developing rheumatic fever

A

males

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14
Q

what are the 5 major CM of rheumatic fever

A

polyarthritis
carditis
chorea (involuntary, sudden facial movements)
erythema marginatum (rash)
subcutaneous nodules

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15
Q

what are the 4 minor CM of rheumatic fever

A

arthralgia
low grade fever
elevated ASO titer
abdominal pain

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16
Q

how to prevent cardiac damage and relieve symptoms of rheumatic fever

A

salicylate therapy - 2 weeks for inflammation
steroids to decrease inflammation
bed rest

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17
Q

how to prevent recurrence of rheumatic fever and endocarditis

A

prophylactic antibiotics

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18
Q

is Kawasaki disease contagious

A

no

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19
Q

what are the acute symptoms of kawasaki disease

A

bacterial conjunctivitis without exudate
oral mucosa changes
enlarged lymph nodes
patchy rash
fever that doesn’t respond to tylenol or ibuprofen
dry, red, cracked lips
strawberry tongue
erythema and swelling of palms and soles

20
Q

how long is the acute phase of kawasaki disease

21
Q

when is the subacute phase of kawasaki disease

A

10-35 days

22
Q

what are the CM of the subacute phase of kawasaki disease

A

vasculitis
desquamation of toes, feet, fingers, and palms
thrombocytosis
arthritis

23
Q

how long can the convalescent period be for kawasaki disease

A

up to 10 weeks

24
Q

what is the most dangerous phase of kawasaki disease and why

A

recovery / convalescent phase because there is an increased amount of platelets in the blood and that can contribute to the development of a heart attacj

25
what are the s/s you may see for a patient you suspect to be having an MI due to the convalescent phase of kawasaki disease
abdominal pain vomiting restlessness inconsolable crying pallor shock
26
in the case of kawasaki disease what needs to be given within 10 days of fever to assist in avoiding the long lasting cardiac problems
high dose IV gamma globulin
27
high dose aspirin is started on children with kawasaki diseased until when
they are afebrile for 48-72 hours
28
why does a child need aspirin long term if they are diagnosed with kawasaki disease
for the anti-platelet effects
29
what nursing considerations are important when administering gamma globulin to a child with kawasaki disease
know that this is a blood product - need to stay with patient and do a ton of monitoring monitor for pulmonary congestion, respiratory distress, or fluid volume overload
30
after a child has kawasaki disease they should be instructed to not get any live vaccines for how long
11 months
31
what is the initial use and long term use of aspirin in children that have kawasaki disease
initial is anti-inflammatory and long term is for anti-platelet
32
what can cause hypertension in only the upper extremities of children
coarctation of the aorta
33
a total cholesterol under what is considered acceptable for children
< 170
34
should fat intake be controlled between birth - 2 years
nope
35
what is supraventricular tachycardia
rapid, regular heart rate 200-300 bpm
36
what are the 2 potential treatments of SVT
vagal maneuvers, valsalva maneuver
37
what does adenosine
impairs AV conduction = converts dysrhythmia to normal rhythm
38
what two common things can send patients into SVT
psuedophed and caffeine
39
a sinus arrthymia is noted in a school age child what should you do
know this is normal, have them hold their breath and see if it fixes after that
40
what is cardiomyopathy
myocardial abnormalities which impair the cardiac muscles ability to contract
41
what are the 3 types of cardiomyopathy
dilated hypertrophic restrictive
42
what is dilated cardiomyopathy
ventricular dilation with greatly decreased contractility leading to CHF
43
what is hypertrophic cardiomyopathy
increase in heart muscle mass without an increase in cavity size
44
what is restrictive cardiomyopathy
restriction to ventricular filling
45
what are the 4 CM of cardiomyopathy
CHF dysrhythmia syncope sudden death
46
what is digoxin for
to increase the contractility of the heart but not speed it up

Peds (12 decks)

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