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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
Infective carditis risk factors
- Immunocompromised - Artificial heart valve - Congential/valvular heart dz - IV drug use - GIngival disease
26
Infective carditis prevention
- Oral/dental care | - Prophylactic antibiotics per criteria
27
Infective carditis S&S
- Fever - Murmur - Petechiae (classic) - Janeway lesions - Osler's nodes
28
Infective carditis complications
- Vegetative emboli - Heart valve stenosis/regurgitation - HF
29
Infective carditis diagnostic tests
- Blood cultures | - Echo
30
Infective carditis medical/NIs
- 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
Pericarditis (what is it?)
Inflammation of the pericardium
32
Pericarditis pathophysiology
Ventricular filling reduces (decreased cardiac output and BP)
33
Pericarditis etiology
- Infections, Lyme disease - Drug reactions - Connective tissue disorders - Neoplastic disease - Postmyocardial infarction - Dressler’s syndrome - Renal disease or uremia - Trauma
34
Pericarditis S&S
- Chest pain: substernal, radiates, grating (Increases with deep inspiration)(Relieved by sitting up/forward) - Pericardial friction rub - Dyspnea - Low grade fever - Cough
35
Pericarditis diagnostic tests
- ECG - Echo - WBC - Pericardial fluid - CT - MRI
36
Pericarditis therapeutic interventions
- Pericardiocentesis | - Treat cause (antibiotics, hemodialysis, percaridal window, pericardiectomy)
37
Pericarditis Medical/NIs
- VS - Bed rest - Cardiac function/tamponade S&S
38
Cardiac tamponade
Medical emergency Too much fluid around pericardium Goes into shock quickly Surgery needed
39
Pericarditis pain relief
- NSAIDs/corticosteroids | - Position of comfort
40
Myocarditis (what is it?)
Inflammation of myocardium - Rare - Often follows virus
41
Myocarditis S&S
- None - Possible viral infection S&S - CP - Tachycardia
42
Myocarditis diagnostic tests
- Endomyocardial biopsy - MRI - Echo - ECG
43
Myocarditis therapeutic interventions
- Reduce heart's workload - O2 - Treat cause (antimicrobial) - Treat HF
44
Myocarditis medical/NIs
- Bed rest - VS/Cardiac status - Diversional activities - Energy conservation - Education
45
Cardiomyopathy
- Enlagement of heart muscle | - No cure
46
Dilated cardiomyopathy
- Ventricular cavity enlarges - Contractility decreases - Stasis of blood - Most common
47
Dilated cardiomyopathy S&S
- Exertional dyspnea - Orthopnea - Fatigue
48
Dilated cardiomyopathy medical/NIs
- ACE inhibitors, beta blockers, diuretics, digoxin - Biventricular pacing - Implantable defibrillators - Heart transplant
49
Hypertrophic cardiopyopathy
Left ventricle muscle wall enlargement - Decreases ventricular filling - Can cause sudden death in athletes
50
Hypertrophic cardiopyopathy S&S
Exertional dyspnea | Angina at rest
51
Hypertrophic cardiopyopathy medical/NIs
- Beta blockers - Calcium channel blockers - Myectomy - Septal ablation
52
Restrictive cardiomyopathy
- Cardiac muscle stiffness - Impairs ventricular stretch - Limits ventricular filling - Systolc emptying of ventricle normal - Rarest form
53
Restrictive cardiomyopathy S&S
- Exertional dyspnea - Syncope - Arrhythmias
54
Restrictive cardiomyopathy medical/NIs
- Vasodilators | - Heart transplant
55
Diagnostic tests for cardiomyopathy
-Cardiac workup
56
Therapeutic interventions for cardiomyopathy
- No cure - Palliative care - HF treatment - Anticoagulants
57
Nursing management for cardiomyopathy
- 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
Pulmonary edema
Accuulation of fluid in lung tissues and alveoli | -Complication of CHF
59
Pulmonary edema S&S
- Restlessness - Agitation - Disorientation - Diaphoresis - Dyspnea - Tachypnea - Tachycardia - Pallor - Cyanosis - Cough- large amounts of blood-tinged, frothy sputum - Wheezing, crackles - Cold extremities
60
Pulmonary edema medical/NI's
- 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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