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Exam 3 (Spring) > Aeration/Circulation: Cardiac > Flashcards

Aeration/Circulation: Cardiac Flashcards

1
Q

Stenosis

A
  • Narrowed (valve doesn’t open completely)
  • Forward blow hindered
  • Decreased cardiac output
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2
Q

Regurgitation

A

Valve doesn’t close completely

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3
Q

Mitral Valve Prolapse- MVP

What is it?

A
  • During ventricular systole, mitral valve flaps normally close
  • In MVP, one/both flaps bulge into left atrium
  • If bulging flaps do not fit together, mitral regurgitation occurs
  • Unknown etiology
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4
Q

MVP S&S

A 
Often none
CP
Dyrythmias
Dyspnea
Fatigue
Palpitation
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5
Q

MVP complications

A

Dilation of L side of heart
HF
Infective endocarditis
Emboli

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6
Q

MVP NI’s

A 
None, unless symptoms are present
Healthy lifestyle
Avoid stimulants/caffeine
Stress management
Beta blockers for tachycardia
Valve surgery
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7
Q

Cardiac cvalvular surgery (2 types)

A

Minimally invasive:

  • endoscopy
  • Robotic

Traditional
-open cardiac surgery with cardiopulmonary bypass

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8
Q

Stenosed valve reapirs

A
  • Balloon valvotomy

- Commissurotomy

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9
Q

Insufficient valve repair

A

-Annuloplasty

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10
Q

Heart valve replacement: Mechanical

A
  • Durable
  • Creates turbulent blood flow (lifelong anticoagulation)
  • Used for younger adults usually
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11
Q

Complications of mechanical heart valve replacement

A

INR/PT montioring
Thrombus/Embolism formation
Anemia
Endocarditis

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12
Q

Heart valve replacement: Biological

A
  • Porcine (pig)
  • Bovine (cow)
  • Allografts (human)
  • Autograft
  • Not as durable as mechanical
  • Used for older adults usually
  • No lifelong anticoagulation needed
  • **Has cultural considerations
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13
Q

Biological heart valve replacement complications

A

Degenerative changes

Calcification

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14
Q

Cardiac surgery prep: Assesment

A
  • Circulatory status
  • Pain control needs
  • Diagnostic tests
  • Typing and cross-matching of blood needed
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15
Q

Cardiac surgery prep: Teaching

A
  • Pain management
  • IVF
  • Coughing/deep breathing
  • Foley
  • Endotracheal tube/ventilator
  • Communication
  • Chest tubes
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16
Q

Cardiac surgery prep: Other

A
  • Pre op meds
  • Antiseptic scrub showers
  • NPO
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17
Q

Pre-op vascular nursing diagnoses

A
  • Acute/Chronic pain
  • Anxiety
  • Knowledge deficit
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18
Q

Post-op vascular nursing diagnoses

A
  • Pain
  • Ineffective airway clearance
  • Impaired gas exchange
  • Decreased cardiac output
  • Risk for infection
  • Knowledge deficit
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19
Q

Post op nursing care

A
  • Pain relief
  • VC, ECG
  • ABGs
  • I&Os
  • Auscultate breath sounds
  • Check incision
  • Promote lung expansion
  • Prevent exposure (hand hygiene, cleanse stethescope, sterile technique, monitor temp)
  • Teaching (pain management, meds, activity, follow ups)
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20
Q

Rheumatic Heart Disease (what is it?)

A
  • Inflammatory disease which is a delayed childhood reaction to inadequately treated childhood upper respiratory tract infection of beta-hemolytic streptococci
  • Causes scar tissue in the heart
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21
Q

Rheumatic Heart Disease S&S

A
  • Elevated temperature
  • Elevated heart rate
  • Epistaxis
  • Anemia
  • Nodules on the joints
  • Heart murmur
  • Joint pain & stiffness
  • Polyarthritis
  • Abdominal pain
  • Lethargy
  • Fatigue
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22
Q

Rheumatic Heart Disease Medical Management/NIs

A
  • Prevention (treat infections rapidly and completely (antibiotics)
  • Bedrest
  • NSAIDs
  • Application of heat
  • Well-blaanced diet (supplement with vitamins B&C)
  • Encourage fluids
  • Commissurotomy or valve replacement
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23
Q

Infective carditis pathophysiology

A
  • Invading organism attaches to endocardium
  • Vegetative lesion forms
  • Damages valve leaflets
  • Emboli/HF possible
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24
Q

Infective carditis etiology

A

-Entry of organism into bloodstream

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25
Q

Infective carditis risk factors

A
  • Immunocompromised
  • Artificial heart valve
  • Congential/valvular heart dz
  • IV drug use
  • GIngival disease
26
Q

Infective carditis prevention

A
  • Oral/dental care

- Prophylactic antibiotics per criteria

27
Q

Infective carditis S&S

A
  • Fever
  • Murmur
  • Petechiae (classic)
  • Janeway lesions
  • Osler’s nodes
28
Q

Infective carditis complications

A
  • Vegetative emboli
  • Heart valve stenosis/regurgitation
  • HF
29
Q

Infective carditis diagnostic tests

A
  • Blood cultures

- Echo

30
Q

Infective carditis medical/NIs

A
  • IV antimicrobial drug 8 weeks
  • Bed rest
  • VS q4h
  • Adequate nutrition
  • Report HF/emboli S&S
  • Surgical valve replacement/repair
  • Teaching (good hygiene & oral care) (report: fever, chills, sweat, petechaie)
31
Q

Pericarditis (what is it?)

A

Inflammation of the pericardium

32
Q

Pericarditis pathophysiology

A

Ventricular filling reduces (decreased cardiac output and BP)

33
Q

Pericarditis etiology

A
  • Infections, Lyme disease
  • Drug reactions
  • Connective tissue disorders
  • Neoplastic disease
  • Postmyocardial infarction
  • Dressler’s syndrome
  • Renal disease or uremia
  • Trauma
34
Q

Pericarditis S&S

A
  • Chest pain: substernal, radiates, grating (Increases with deep inspiration)(Relieved by sitting up/forward)
  • Pericardial friction rub
  • Dyspnea
  • Low grade fever
  • Cough
35
Q

Pericarditis diagnostic tests

A
  • ECG
  • Echo
  • WBC
  • Pericardial fluid
  • CT
  • MRI
36
Q

Pericarditis therapeutic interventions

A
  • Pericardiocentesis

- Treat cause (antibiotics, hemodialysis, percaridal window, pericardiectomy)

37
Q

Pericarditis Medical/NIs

A
  • VS
  • Bed rest
  • Cardiac function/tamponade S&S
38
Q

Cardiac tamponade

A

Medical emergency
Too much fluid around pericardium
Goes into shock quickly
Surgery needed

39
Q

Pericarditis pain relief

A
  • NSAIDs/corticosteroids

- Position of comfort

40
Q

Myocarditis (what is it?)

A

Inflammation of myocardium

  • Rare
  • Often follows virus
41
Q

Myocarditis S&S

A
  • None
  • Possible viral infection S&S
  • CP
  • Tachycardia
42
Q

Myocarditis diagnostic tests

A
  • Endomyocardial biopsy
  • MRI
  • Echo
  • ECG
43
Q

Myocarditis therapeutic interventions

A
  • Reduce heart’s workload
  • O2
  • Treat cause (antimicrobial)
  • Treat HF
44
Q

Myocarditis medical/NIs

A
  • Bed rest
  • VS/Cardiac status
  • Diversional activities
  • Energy conservation
  • Education
45
Q

Cardiomyopathy

A
  • Enlagement of heart muscle

- No cure

46
Q

Dilated cardiomyopathy

A
  • Ventricular cavity enlarges
  • Contractility decreases
  • Stasis of blood
  • Most common
47
Q

Dilated cardiomyopathy S&S

A
  • Exertional dyspnea
  • Orthopnea
  • Fatigue
48
Q

Dilated cardiomyopathy medical/NIs

A
  • ACE inhibitors, beta blockers, diuretics, digoxin
  • Biventricular pacing
  • Implantable defibrillators
  • Heart transplant
49
Q

Hypertrophic cardiopyopathy

A

Left ventricle muscle wall enlargement

  • Decreases ventricular filling
  • Can cause sudden death in athletes
50
Q

Hypertrophic cardiopyopathy S&S

A

Exertional dyspnea

Angina at rest

51
Q

Hypertrophic cardiopyopathy medical/NIs

A
  • Beta blockers
  • Calcium channel blockers
  • Myectomy
  • Septal ablation
52
Q

Restrictive cardiomyopathy

A
  • Cardiac muscle stiffness
  • Impairs ventricular stretch
  • Limits ventricular filling
  • Systolc emptying of ventricle normal
  • Rarest form
53
Q

Restrictive cardiomyopathy S&S

A
  • Exertional dyspnea
  • Syncope
  • Arrhythmias
54
Q

Restrictive cardiomyopathy medical/NIs

A
  • Vasodilators

- Heart transplant

55
Q

Diagnostic tests for cardiomyopathy

A

-Cardiac workup

56
Q

Therapeutic interventions for cardiomyopathy

A
  • No cure
  • Palliative care
  • HF treatment
  • Anticoagulants
57
Q

Nursing management for cardiomyopathy

A
  • VS
  • HF/Emboli S&S
  • Signs of Digoxin toxicity
  • Activity tolerance/energy conservation
  • Emotional support
  • Patient & Family teaching (Medications, Emergency contacts, CPR, Home health care, Hospice)
58
Q

Pulmonary edema

A

Accuulation of fluid in lung tissues and alveoli

-Complication of CHF

59
Q

Pulmonary edema S&S

A
  • Restlessness
  • Agitation
  • Disorientation
  • Diaphoresis
  • Dyspnea
  • Tachypnea
  • Tachycardia
  • Pallor
  • Cyanosis
  • Cough- large amounts of blood-tinged, frothy sputum
  • Wheezing, crackles
  • Cold extremities
60
Q

Pulmonary edema medical/NI’s

A
  • High fowlers or orthopnic position
  • Morphine sulfate
  • O2
  • Nitroglycerin
  • Diuretic
  • Inotropic agents
  • Vasodilators
  • Assess lung sounds frequently

Exam 3 (Spring) (8 decks)

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