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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
Which class of heart failure includes patients with cardiac disease who experience symptoms with activity that would limit those without disease?
Class I
26
Which class of heart failure includes patients with cardiac disease who experience symptoms with ordinary activity?
Class II
27
Which class of heart failure includes patients with cardiac disease who experience symptoms with less than ordinary activity?
Class III
28
Which class of heart failure includes patients with cardiac disease who experience symptoms at rest?
Class IV
29
What are the two categories of HF?
HF with reduced EF less than or equal to 40% and HF with preserved EF greater than or equal to 50%
30
What are the cardiovascular disorders that are risk factors for HF?
Hypertension, CAD, Valvular heart disease, and peripheral vascular disease
31
What are the lifestyle choices that are risk factors for HF?
illicit drug use and alcohol abuse
32
Which infectious disease is a risk factor for HF?
rheumatic fever
33
Which medications can lead to HF?
cardiotoxic agents (such as some chemotherapies)
34
Which metabolic disorder is a risk factor for HF?
Diabetes
35
Ischemic cardiomyopathy, the most common cause of HF, is a type of failure that occurs secondary to ________ and _______.
CAD and HTN
36
3 types of cardiomyopathies
dilated, hypertrophic, and restrictive
37
If the RCA is occluded, what will happen?
inferior MI
38
What is the most common cause of Right sided HF?
RV infarct
39
If the RCA is occluded, what will happen?
RV infarct
40
If the RCA is occluded, what will happen?
an inferior MI
41
If the LAD, CX arteries are occluded, what will happen?
high lateral MI or an Antero-septal MI
42
Which valves are open during systole?
semilunar
43
Which valve is open during diastole?
AV valves
44
5 causes of HF
CAD, Valvular Dysfunction, Infection, Cardiomyopathy, Uncontrolled HTN
45
2 types of left sided ventricle failure
diastolic and systolic
46
What kind of manifestations are seen with left ventriculatory failure?
respiratory
47
3 common causes of RVF
LVF, PE, or RV infarct
48
What is the most common cause of RVF?
LVF
49
What are the most common types of s/s seen with RVF?
systemic congestion (JVD, Ascites, peripheral edema, weight gain, etc.)
50
What is the most common cause of ventricular remodeling?
systolic heart failure
51
What causes systolic heart failure?
CAD and non-ischemic cardiomyopathy
52
Which side of the heart fails when systolic heart failure occurs?
both
53
Which blood test is most diagnostic of HF?
BNP
54
How does the body compensate during HF?
1. SNS 2. the RAAS 3. Ventricular hypertrophy if HTN is present
55
Which gland secretes ADH?
pituitary gland
56
What happens when angiotensin II stimulates the pituitary gland?
ADH is secreted and it signals the kidneys to retain water, and this increases vascular volume
57
Which medications are used to halt/reduce the progression of HF remodeling?
ACEI or ARB, Aldactone, Beta Blocker
58
What is cardiomyopathy?
a disease of the heart muscle affecting its ability to contract and adequately perfuse the body's vital organs
59
Is cardiomyopathy curable?
no
60
What is the best way to diagnose cardiomyopathy?
A TEE (Transesophageal Echo)
61
Why are most patients with cardiomyopathy on anticoagulants?
blood pools in the heart, and they are more at risk for emboli
62
What is the treatment regimen for dilated cardiomyopathy?
diuretics, Na restriction, ACE inhibitors, Beta Blockers, Blood Thinners, Antidysrhythmics, Vasodilator (nitroglycerin), Inotropic Agents, pacemakers, AICDS, LVADS, heart tx
63
What is the most common reason that someone may have a pacemaker?
cardiomyopathy
64
If a patient begins to go into V-Tach, what will the AICDCS do?
will shock the patient with a higher energy level
65
What happens in hypertrophic cardiomyopathy?
thickening of the inter ventricular septum
66
Who is most affected by hypertrophic cardiomyopathy?
young adults
67
What kind of monitor is given to patients with hypertrophic cardiomyopathy?
Halter monitor
68
What medications need to be avoided in patients with hypertrophy cardiomyopathy?
inotropes and preload reduction meds
69
What is the goal of HOCM treatment?
reduce contractility and relieve left ventricular outflow obstruction
70
Which meds are given for HOCM treatment?
beta blockers, ca channel blockers, Coumadin if in Afib, Antidysrhythmic, prophylactic antibiotics to prevent infective endocarditis
71
What are some non-pharm interventions that are done to treat HOCM?
AICDs, permanent pacemaker, and mitral valve replacement
72
How do calcium channel blockers affect after load?
reduces afterload
73
Which cardiomyopathy is the least common?
restrictive cardiomyopathy
74
What is the purpose of an LVAD?
bridge to transplant that takes over or assists the pumping role of the left ventricle
75
What does aortic valve disease commonly lead to?
Pulmonary HTN
76
Most common cause of mitral valve regurgitation
mitral valve prolapse
77
How is mitral valve regurgitation treated? (for meds)
ACE inhibitors, Nitrates, Digitalis for chronic patients, diuretics
78
What is the main goal for HF?
promote oxygenation
79
What is the benefit of a porcine or bovine valve compared to a mechanical valve?
no anticoagulation therapy
80
Why aren't tissue valves better for long term than mechanical valves?
they do not last as long and there is a 30% failure rate in the first 10 years
81
What is the 4th most common cause of life-threating infectious syndromes?
infective endocarditis
82
What is the first area of the heart that is affected by infective endocarditis?
tricuspid valve
83
With a porcine valve replacement, which medications are necessary to take daily?
beta blockers and ACE inhibitors

NURS 470 (33 decks)

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