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NURS 470 > Alterations in Cardiac Function > Flashcards

Alterations in Cardiac Function Flashcards

1
Q

What are 3 risk factors for mitral valve stenosis?

A

rheumatic fever, age-related with degenerative valve changes, and being a woman

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2
Q

What are 4 risk factors for aortic valve stenosis?

A

cogenital, rheumatic fever, age-related with degenerative valve changes, and being a man

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3
Q

3 reasons that regurgitation may occur in the mitral valve

A

abnormalities of the leaflets, abnormalities of the annulus, and abnormalities of the chord tendinae or papillary musclces

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4
Q

What are risk factors for having abnormalities in the leaflets of the mitral valve?

A

rheumatic heart disease, infective endocarditis, collagen-vascular disease

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5
Q

What is a risk factor for having an abnormality in the annulus of the mitral valve?

A

cardiomyopathy

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6
Q

What are the risk factors for having abnormalities of the chord tendinae of the papillary muscle?

A

ischemic heart disease and mitral valve prolapse

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7
Q

What are risk factors for regurgitation in the aortic valve?

A

Congenital: born with valve malformation

Acquired: rheumatic heart disease

Age-related: degenerative valve changes

Calcification, infective endocarditis, trauma, Marfan syndrome

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8
Q

In the most serious of cases, what does mitral valve stenosis cause?

A

right sided heart failure

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9
Q

where will the heart hypertrophy in aortic stenosis?

A

left ventricle

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10
Q

What can develop in severe cases of mitral valve regurgitation?

A

LV enlargement and hypertrophy that leads to left-sided HF

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11
Q

What can acute aortic regurgitation lead to?

A

heart failure and pulmonary edema

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12
Q

What may occur with acute mitral valve prolapse?

A

elevated LH pressures that back up to the pulmonary vasculature and acute pulmonary edema

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13
Q

How does infective endocarditis begin?

A

injury to the endothelial lining of a valve

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14
Q

What are the fibrin encased growths of microorganisms that colonize on the heart valves called?

A

vegetations

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15
Q

2 most common bacterias to cause infective endocarditis

A

Streptococci (alpha-hemolytic or viridans) and Staphylococcus aureus

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16
Q

What most commonly occurs as a result of infective endocarditis?

A

aortic valve stenosis and mitral valve regurgitation

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17
Q

How long must antibiotics be taken for infective endocarditis?

A

minimum of 6 weeks

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18
Q

What is the therapeutic goal for patients with valvular dysfunction?

A

maintain normal sinus rhythm and avoid atrial fibrillation

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19
Q

What is an early sign of valve disease?

A

dyspnea on exertion

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20
Q

What lab parameter is assessed with heparin therapy?

A

PTT

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21
Q

If a patient is on warfarin, which lab value is assessed?

A

INR

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22
Q

Which pathology is associated with narrowing of the orifice of the mitral valve and obstructed blood flow during diastole?

A

Mitral stenosis

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23
Q

Which clients are most susceptible to infective endocarditis?

A

Clients who require hemodialysis

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24
Q

When a client has mitral regurgitation, which abnormal heart sound is detected?

A

Systolic murmur

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25
Q

Which class of heart failure includes patients with cardiac disease who experience symptoms with activity that would limit those without disease?

A

Class I

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26
Q

Which class of heart failure includes patients with cardiac disease who experience symptoms with ordinary activity?

A

Class II

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27
Q

Which class of heart failure includes patients with cardiac disease who experience symptoms with less than ordinary activity?

A

Class III

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28
Q

Which class of heart failure includes patients with cardiac disease who experience symptoms at rest?

A

Class IV

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29
Q

What are the two categories of HF?

A

HF with reduced EF less than or equal to 40% and HF with preserved EF greater than or equal to 50%

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30
Q

What are the cardiovascular disorders that are risk factors for HF?

A

Hypertension, CAD, Valvular heart disease, and peripheral vascular disease

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31
Q

What are the lifestyle choices that are risk factors for HF?

A

illicit drug use and alcohol abuse

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32
Q

Which infectious disease is a risk factor for HF?

A

rheumatic fever

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33
Q

Which medications can lead to HF?

A

cardiotoxic agents (such as some chemotherapies)

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34
Q

Which metabolic disorder is a risk factor for HF?

35
Q

Ischemic cardiomyopathy, the most common cause of HF, is a type of failure that occurs secondary to ________ and _______.

A

CAD and HTN

36
Q

3 types of cardiomyopathies

A

dilated, hypertrophic, and restrictive

37
Q

If the RCA is occluded, what will happen?

A

inferior MI

38
Q

What is the most common cause of Right sided HF?

A

RV infarct

39
Q

If the RCA is occluded, what will happen?

A

RV infarct

40
Q

If the RCA is occluded, what will happen?

A

an inferior MI

41
Q

If the LAD, CX arteries are occluded, what will happen?

A

high lateral MI or an Antero-septal MI

42
Q

Which valves are open during systole?

43
Q

Which valve is open during diastole?

44
Q

5 causes of HF

A

CAD, Valvular Dysfunction, Infection, Cardiomyopathy, Uncontrolled HTN

45
Q

2 types of left sided ventricle failure

A

diastolic and systolic

46
Q

What kind of manifestations are seen with left ventriculatory failure?

A

respiratory

47
Q

3 common causes of RVF

A

LVF, PE, or RV infarct

48
Q

What is the most common cause of RVF?

49
Q

What are the most common types of s/s seen with RVF?

A

systemic congestion (JVD, Ascites, peripheral edema, weight gain, etc.)

50
Q

What is the most common cause of ventricular remodeling?

A

systolic heart failure

51
Q

What causes systolic heart failure?

A

CAD and non-ischemic cardiomyopathy

52
Q

Which side of the heart fails when systolic heart failure occurs?

53
Q

Which blood test is most diagnostic of HF?

54
Q

How does the body compensate during HF?

A
  1. SNS 2. the RAAS 3. Ventricular hypertrophy if HTN is present
55
Q

Which gland secretes ADH?

A

pituitary gland

56
Q

What happens when angiotensin II stimulates the pituitary gland?

A

ADH is secreted and it signals the kidneys to retain water, and this increases vascular volume

57
Q

Which medications are used to halt/reduce the progression of HF remodeling?

A

ACEI or ARB, Aldactone, Beta Blocker

58
Q

What is cardiomyopathy?

A

a disease of the heart muscle affecting its ability to contract and adequately perfuse the body’s vital organs

59
Q

Is cardiomyopathy curable?

60
Q

What is the best way to diagnose cardiomyopathy?

A

A TEE (Transesophageal Echo)

61
Q

Why are most patients with cardiomyopathy on anticoagulants?

A

blood pools in the heart, and they are more at risk for emboli

62
Q

What is the treatment regimen for dilated cardiomyopathy?

A

diuretics, Na restriction, ACE inhibitors, Beta Blockers, Blood Thinners, Antidysrhythmics, Vasodilator (nitroglycerin), Inotropic Agents, pacemakers, AICDS, LVADS, heart tx

63
Q

What is the most common reason that someone may have a pacemaker?

A

cardiomyopathy

64
Q

If a patient begins to go into V-Tach, what will the AICDCS do?

A

will shock the patient with a higher energy level

65
Q

What happens in hypertrophic cardiomyopathy?

A

thickening of the inter ventricular septum

66
Q

Who is most affected by hypertrophic cardiomyopathy?

A

young adults

67
Q

What kind of monitor is given to patients with hypertrophic cardiomyopathy?

A

Halter monitor

68
Q

What medications need to be avoided in patients with hypertrophy cardiomyopathy?

A

inotropes and preload reduction meds

69
Q

What is the goal of HOCM treatment?

A

reduce contractility and relieve left ventricular outflow obstruction

70
Q

Which meds are given for HOCM treatment?

A

beta blockers, ca channel blockers, Coumadin if in Afib, Antidysrhythmic, prophylactic antibiotics to prevent infective endocarditis

71
Q

What are some non-pharm interventions that are done to treat HOCM?

A

AICDs, permanent pacemaker, and mitral valve replacement

72
Q

How do calcium channel blockers affect after load?

A

reduces afterload

73
Q

Which cardiomyopathy is the least common?

A

restrictive cardiomyopathy

74
Q

What is the purpose of an LVAD?

A

bridge to transplant that takes over or assists the pumping role of the left ventricle

75
Q

What does aortic valve disease commonly lead to?

A

Pulmonary HTN

76
Q

Most common cause of mitral valve regurgitation

A

mitral valve prolapse

77
Q

How is mitral valve regurgitation treated? (for meds)

A

ACE inhibitors, Nitrates, Digitalis for chronic patients, diuretics

78
Q

What is the main goal for HF?

A

promote oxygenation

79
Q

What is the benefit of a porcine or bovine valve compared to a mechanical valve?

A

no anticoagulation therapy

80
Q

Why aren’t tissue valves better for long term than mechanical valves?

A

they do not last as long and there is a 30% failure rate in the first 10 years

81
Q

What is the 4th most common cause of life-threating infectious syndromes?

A

infective endocarditis

82
Q

What is the first area of the heart that is affected by infective endocarditis?

A

tricuspid valve

83
Q

With a porcine valve replacement, which medications are necessary to take daily?

A

beta blockers and ACE inhibitors

NURS 470 (33 decks)

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