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XIO > Cardio - valves, infection, surgery > Flashcards

Cardio - valves, infection, surgery Flashcards

1
Q

myocarditis - also called - AND are men or women most at risk? (mei likes men)

A

Inflammatory cardiomyopathy, men most at risk.

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2
Q

myocarditis - what is the most frequent virus that causes it? (Mei has herpes) - what symptoms will you have?

A

most frequent virus. toxins also can cause it. if virus causes it, then you’ll have a fever.

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3
Q

most common cause of dilated cardiomyopathy/myocarditis (mei has covid)
(mei and brad appeared after Lupe had a transplant)

A

Lupus (SLE), hypersensitivity reactions, transplant rejection
COVID 19 and other viruses including influenza

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4
Q

S & S of cardiomyopathy/myocarditis (mei has symptoms in her PECCS)

A

Palpitations, SOB, chest pain, edema, CHF.

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5
Q

treatment of cardiomyopathy/myocarditis (Mei can sometimes solve her own problems)

A

Identify and treat cause, manage symptoms. sometimes resolves on its own. Can even do heart transplant if it’s bad.

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6
Q

nursing care cardiomyopathy - how to assess it, and assess for what? (monitor brad)

A

Cardiac monitor, assess for CHF

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7
Q

myocarditis patho (mei has direct damage, then secondary)

A

myocardium is damaged directly, then immune response causes secondary damage. usually entire myocaridum is affected.

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8
Q

myocarditis - what labs are used to diagnose it?

A

check inflammatory stuff - c-reactive protein, BNP, proteins, troponins

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9
Q

myocarditis complications (Mei is an athlete)

A

cardiomyopathy and dsyrrhymias that lead to death (usually the cause in young athletes)

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10
Q

myocarditis - should be on constant (my telemetry)

A

telemetry

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11
Q

myocarditis - lung assessement (the usual)

A

check for crackles and edema. jugular vein distention, weight gain, urine output. kidney function.

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12
Q

myocarditis - activities?

A

restrict activities

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13
Q

endocarditis

A

Inflammation/infection of the inside of the heart (inner most layer)

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14
Q

endocarditis - patho (Tjan has veggies and leaves)

A

Infection forms vegetations/thrombi inside the heart that break off from the valve leaflet; emboli disseminate

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15
Q

endocarditis - Destruction of valves, walls, chordae tendinae cause (Tjan loses his vents in Co)

A

loss of function and impaired ventricular filling (decreased CO)

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16
Q

endocarditis - Back up of blood causes

A

lung congestion

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17
Q

endocarditis - causes (think of the case study) (rheumy causes the end)

A

age,
Rheumatic heart disease, history of previous endocarditis
Prosthetic valve
IVDU
Contaminated invasive devices
Hemodialysis
Immunosuppression
Dental caries or gum disease

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18
Q

endocarditis - IV drug users usually have what side heart failure?

A

right-sided

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19
Q

endocarditis risk factors

A

hemodialysis, anyone with tons of IVs, biopsies

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20
Q

endocarditis patho (Tjan is turbulent)

A

turbulent blood flow usually affects heart valves, platelets and fibrin deposit on injury, the vegetations form and cause more damage.

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21
Q

endocarditis - clinical manifestions - what about a murmur? (think case study)

A

red pads of fingers and toes, painless spots on soles of feet (janyway) splinters under nails (blood clots) usually a new heart murmur, and HF, night sweats, weight loss. fever, confusion.

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22
Q

endocarditis - how to diagnose (tjan gets 2 blood tests and an ECG)

A

blood tests from 2 different sites. echo cardiogram, CBC

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23
Q

endocarditis treatment

A

IV antibiotics, usually 4 - 6 weeks or longer. repeat blood cultures until they test negative.

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24
Q

endocarditis - nursing care - monitor for what?

A

Monitor for organ failure, emboli (vegetatian breaks off 50% of the time), serial blood cultures, progressive exercise, education and rehabilitation

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25
Q

endocarditis - assessment (lungs, heart, etc) (tjan gets the same assessment)

A

check for crackles and edema. jugular vein distention, weight gain, urine output, decreased cap refill

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26
Q

pericarditis - acute or chronic?

A

can be acute or chronic.

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27
Q

causes of chronic pericarditis (C. Perry has uremia, TB, radiation, trauma and cancer)

A

TB, radiation exposure, trauma, uremia, metastatic cancer

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28
Q

causes of acute pericarditis (C. cute Perry also has TB, radiation, trauma and cancer)

A

trauma, viral infections (flu), uremia, post cardiac surgery, MI, raditation, neoplasms (tumors),

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29
Q

pericarditis - most common symptom (Peri is mostly causing me pain bc he rubs me the wrong way)

A

90% pleuritic chest pain. also will hear classic friction rub with pericarditis.

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30
Q

how to tell when pleuritic chest pain is an MI or pericarditis? (Peri feels better when he sits up)

A

with pericarditis, pain will be relieved with patient sits up (fowlers)

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31
Q

how to diagnose pericarditis (peri’s diagonosis is elevated) (the usual)

A

echo, ECG, chest xray, EKG - st elevation most common

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32
Q

pericarditis - lung exam? (Peri surprisingly has clear lungs) nothing is backing up in the lungs - think

A

lungs will be clear

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33
Q

pericarditisis treatment (peri’s treatment depends on the cause)

A

Depends on cause

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34
Q

pericarditisis complications (peri can be complicated and effusive)

A

effusion

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35
Q

pericarditis - monitor ECG for what?

A

Assess & monitor VS, RRED, WBC, cardiac rhythm & ST segment for elevation

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36
Q

pericarditis - heart sounds (peri is muffled)

A

muffled from fluid

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37
Q

cardiac tamponade (tampon for peri)

A

blood or fluid have leaked into pericardial sac.

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38
Q

causes of cardiac tamponade (micro peri is the cause of tampons)

A

MVA (microvascular angina?), RV biopsy, pericarditis

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39
Q

cardiac tamponade - cardiac output and what about pressure? (the tampons are low in Co, but the pressure has increased)

A

decreased CO, increased CVP (central venous pressure)

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40
Q

nursing considerations for cardiac tamponade - drainage? and check what? (check tampon for drainage with jugular)

A

monitor mediastinal CT drain (if chest was cracked open to remove fluid in peri). drainage should gradually get less. check JVD w/ normal lung sounds.

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41
Q

Obstructive Shock - what direction of blood flow is obstructed? (There’s an obstruction going forward)

A

Decreased outflow of blood from the heart or great vessels = low or no cardiac output
NO FORWARD FLOW OF BLOOD

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42
Q

Obstructive Shock treatment

A

relieve obstruction or pt will die

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43
Q

causes of obstructive shock (shocked by the TPP)

A

PE, tension pneumothorax, pericardial tamponade

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44
Q

Obstructive Shock - signs (I’m shocked you have no pulse)

A

decreased bp, pulsus paradoxus (bp decreases with inhalation), narrowing pulse pressure

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45
Q

cardiac surgery - invasive or no?

A

minimally invasive

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46
Q

complications of cardiac surgery - preload and afterload? Co?

A

ineffective CO, reduced preload, increased afterload, increased preload

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47
Q

complications of cardiac surgery - is angina normal? Peri? (surgery on gyna is not normal)

A

infection, pain management (sternotomy hurts), angina (this is a bad sign), neurological dysfunction, pericardial tamponade

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48
Q

nursing assessment - cardiac surgery - BP issues?

A

Hypotension
Hypertension
Bleeding

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49
Q

cardiac valve disease - more in men or women? (the valves have equal rights)

A

equal in men and women.

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50
Q

valve disease causes (val is caused by the CCIR cure)

A

infection, rheumatic fever caused by strep, congential, calcific atherosclerosis.

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51
Q

valve disease types

A

stenosis
prolapse

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52
Q

valve disease - most common (art is popular valve)

A

aortic stenosis. least is tricuspid and pulmonic valve (right side less pressure)

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53
Q

first sign of valve disease (val has a murmur)

A

murmur

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54
Q

valve disease s & s - breathing?

A

SOB, dyspnea, orthopnea

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55
Q

causes of cardiac valve dysfunction (valves can stop working inside, outside, or it’s mechanical)

A

inside - heart muscle valves
outside - pericardium
mechanical - faulty valves

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56
Q

valves most likely to be stenotic (2 of them)

A

aortic and mitral

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57
Q

valves most likely for regurgitation (just one)

A

mitral

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58
Q

cardiac valve - signs of right-sided HF - liver signs?

A

the tricuspid, and you’ll get signs of right sided heart failure. (Edema of abdomen, feet and ankles
Fatigue
Weakness
Decreased u/o
Jaundice
Ascites)

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59
Q

cardiac valve - if it’s the left side, it will be (and what about murmur)

A

pulmonic (signs and symptoms S & S
SOB, cyanosis
Poor weight gain in babies
Syncope
Murmur
Chest pain
Fatigue)

60
Q

cardiac valve - mitral symptoms (mite you be tachy and tired, you SOB) and esp what?

A

signs of left ventricular - SOB, especially orthopnea, dyspnea after exercise, coughing
CP, palpitations, tachycardia
Extreme fatigue

61
Q

cardiac valve - Regurgitation - will happen fast or slow?

A

will happen slowly

62
Q

mitral stenosis - causes (mite you be old with a fever)

A

aging, rheumatic fever, things get stiff

63
Q

regurgitation - who gets it and what is the main cause? (men regurgitate bs)

A

men 30 - 60

64
Q

stenosis main cause (calcium makes stan stiff)

A

calcification main cause

65
Q

Transcatheter Aortic Valve Replacement (TAVR) - invasive or not? (trans is minimal)

A

minimally invasive, highly successful.

66
Q

heart valve - non surgical - goals (goal for the valve is go to Co, stay steady, and take meds)

A

Maintain cardiac output
Treat arrhythmias
Prophylactic antibiotic therapy

67
Q

heart valve - surgical (balloon for my valve)

A

Repair
Balloon valvuloplasty
Commisurotomy
Reconstruction
Replace`
Synthetic
Biologic

68
Q

valve surgery - pre op care - (val is progressive)

A

Maintain cardiac output
Treat arrhythmias
FEN
Pulmonary function
Renal function*****
Pain anxiety management
Wound care
CT care
Monitored progressive activity
Self care education
SOB
daily weights

69
Q

cardiomyopathy (myo is large)

A

heart muscle is enlarged and thick.

70
Q

types of cardiomyopathy

A

Dilated:

Hypertrophic:

Restrictive:

71
Q

cardiomyopathy - causes (Brad door)

A

Idiopathic, HTN, viral infections, post MI, thyroid disease

72
Q

cardiomyopathy - cure?

A

none, just heart transplant, pacemaker

73
Q

endocarditis - what type of bacteria usually?

A

due to bacteria - usually strep and staph. if you get it once, you’re likely to get it again.

74
Q

chronic pericarditis causes what to happen? (C, peri is getting stiff in his old age)

A

The chronic (constrictive) inflammation causes pericardial thickening, leading to stiffness.

75
Q

acute pericarditis becomes what? (A cute peri becomes a tampon)

A

The acute condition leads to cardiac tamponade with pulseless electrical activity (PEA)

76
Q

chronic pericarditis - what age is common? And mortality? (c, peri is young and lives forever)

A

more in young and middle aged ppl. high reoccurance rate. mortality is really low, like 1%.

77
Q

acute pericarditis - causes - how long after surgery is the critical time? (a cute peri - 2 weeks was the morning)

A

10-14 days post op

78
Q

endocarditis may lead to (In the end, Tjan was SSHD)

A

May lead to TIA’s (transischemic heart attack), CVA (stroke), shock, death

79
Q

endocarditis - Rapid recognition and response (emergency tjan needs an ECG and o2)

A

VS, ECG monitor for dysrhythmias
Assess for symptoms of heart failure
Maintain gas exchange
Breath sounds, RRED, oxygen therapy to maintain saturation

80
Q

endocarditis monitor labs (tjan in the lab shifts left with the bun)

A

Monitor labs
WBC shift left, anemia
BUN/Cr (long term ABX)

81
Q

endocarditis - meds? (Tjan get meds in Hawaii for 4-6 weeks)

A

evaluate FEN status
Assess & maintain vascular access
CVC (central venous catheter)
ABX (antibiotics) 4-6 weeks on schedule with peak/trough

82
Q

endocarditis - symptom management (tjan door)

A

HA (headache?), fever, anorexia, nausea, position of comfort, modify activity

83
Q

endocarditis symptoms - feels like…(tjan and Jim hansen)

A

Vague flu like to heart failure with conduction defects

84
Q

endocarditis treatment

A

IV antiobotics

85
Q

percariditis patho (peri has white plates with fiber and fluid)

A

Collection of WBCs, platelets, fibrin and fluid (pericardial effusion) builds up in pericardial sac which restricts filling.
Fibrotic changes restrict filling and therefore decrease CO

86
Q

cardiomyopathy assessment findings - left side (brad is not on the pulse anymore, he’s 3rd or 4th)

A

Manifestations of decreased CO
Left sided HF symptoms – activity intolerance, weakness, narrow pulse pressure, decreased peripheral pulse strength, pre/syncope, angina, dyspnea, orthopnea, pulmonary congestion, dysrhythmias (PVCs, VT), murmurs, S3 & S4

87
Q

cardiomyopathy treatment (think, can thickness be fixed?)

A

No cure, treat underlying cause
Treatment palliative (symptom management) or surgical (heart transplant, muscle resection, valve replacement)
Manage heart failure
Maximize CO, maintain gas exchange, modify activity to tolerance
medications

88
Q

pericarditis - can cause tamponade? And what are the symptoms?

A

Observe for signs of pericardial tamponade (increase pressure, decreased filling, decreased CO)

89
Q

pericarditis - JVD? And what are the heart sounds? (Peri’s jugular)

A

Distant heart sounds, JVD

90
Q

pericarditis - patient position? (Peri in pain leans forward)

A

Assess and manage pain
Patient position (Fowler’s forward leaning or side lying
Analgesic, anti inflammatory

91
Q

valve disease - stenosis - (stenosis goes backwards)

A

chamber pressure increase causing backward effect

92
Q

valve disease - prolapse

A

falls in on itself

93
Q

symptoms of regurgitation - what is the big one? (men bathroom)

A

Palpitations, CP
Tachypnea, SOB, coughing
Fatigue is the big one

94
Q

mitral stenosis - breathing and edema? (mite you need help exercising with your edema)

A

Orthopnea or trouble breathing after exercise
Pulmonary edema
Exertional CP, palpitations
Peripheral edema

95
Q

stenosis s & s (stiff stan can’t exercise)

A

Exercise intolerance
Syncope
Angina

96
Q

cardiomyopathy - dilated (impairs what?)

A

Thick/enlarged ventricular walls
Dilation of chambers
Impairs systolic function (pumping)

97
Q

cardiomyopathy - hypertrophic - is filling or ejecting affected?

A

Hypertrophic:
Ventricles enlarge and ventricular cavities reduce in size therefore filling is decreased

98
Q

cardiomyopathy - restrictive (brad restricts amy after radiation)

A

d/t amyloidosis, XRT (radiation therapy)
Ventricles become rigid and fibrotic and filling is reduced

99
Q

cardiomyopathy - causes (can’t do cardio with brad if…)

A

diabetes, peripartum, alcoholism, anabolic steroid use

100
Q

cardiomyopathy - causes (Brad bald plant)

A

chemotherapy, XRTe (radiation), connective tissue disorders

101
Q

endocarditis - symptoms (Tjan has back pain)

A

back pain, and sometimes include symptoms from other organ systems depending on spread

102
Q

endocarditis - symptoms (Tjan on junk)

A

Anorexia, weight loss, fever, chills, night sweats

103
Q

endocarditis - murmur?

A

new murmur

104
Q

endocarditis can develop into (think case study - just 2 - worst case scenario)

A

HF development, systemic embolization

105
Q

endocarditis - late symptom (Oster is late to meet TJan)

A

Oster nodes (late)

106
Q

endocarditis - early symptom (Jane comes first)

A

Janeways lesions (early)

107
Q

endocarditis - spleen? (large spleen for 6 weeks)

A

> 6 weeks splenomegaly

108
Q

endocarditis - nails? (tjan clubs)

A

clubbing

109
Q

how to diagnose endocarditis?

A

Diagnosed with blood cultures, echocardiogram

110
Q

cardiomyopathy/myocarditis - (mei and brad are new)

A

new onset of arrhythmias or dysrthyrmias

111
Q

cardiomyopathy - right side - symptoms (Brad hall)

A

JVD, peripheral edema, atrial dysrhythmias (AF, PACs),

112
Q

medications for cardiomyopathy (Brad gets the same meds)

A

ACE inhibitors, afterload reducers, inotropes, calcium channel blockers, beta blockers, diuretics

113
Q

pericarditis - HR and pulse

A

increased HR with hypotension, decreased pulse amplitude/strength

114
Q

pericarditis - mental status? (Peri is out of it)

A

change in LOC and AMS (altered mental status)

115
Q

valve disease - insufficiency/regurgitation

A

cusps no longer close completely, chamber pressure and filling is impaired

116
Q

heart rhythm with regurgitation (Gab regurgitates)

A

aFib

117
Q

mitral stenosis - cough?

A

dry cough

118
Q

mitral stenosis (mite you have a hoarse, wet voice?)

A

Hoarse, wet sounding voice,
Fatigue

119
Q

cardiomyopathy - right side - symptoms (what organs)

A

hepatomegaly, splenomegaly, abdominal distension, anorexia, nausea

120
Q

cardiomyopathy - right side - bradycardia?

A

Bradycardia in restrictive due to heart blocks, conduction dysfunction

121
Q

cardiomyopathy - right side - symptoms (pee RIGHT away at night)

A

orthopnea, PND, nocturia

122
Q

devices for cardiomyopathy

A

Biventricular pacemaker
ICD

123
Q

cardiac tamponade - shock (tampons cause shock)

A

pressure in all 4 chambers will be the same and will end up in shock, narrowed pulse pressure.

124
Q

(3 lead) white on right

A

smoke over fire

125
Q

(5 lead) chocolate over my heart

A

green goes last

126
Q

pericarditis - blood tests (peri is tropin)

A

troponins, CBC (high white count) C-reactive

127
Q

obstructive shock - signs

A

tachycardia tachypnea, pale cool clammy skin, decreased SpO2.

128
Q

what tests to diagnose miocarditis? (only an echo can find mei)

A

ECG, usually always an echo to check the valves.

129
Q

cardiac surgery - assessment - is surgery cold?

A

FEN imbalances
Hypothermia

130
Q

cardiac surgery - assessment - what about kidneys? Wounds?

A

Renal dysfunction/ARF
Impaired wound healing

131
Q

cardiac surgery assessment - GI?

A

GI dysfunction
Stress ulcer
Paralytic ileus
N, V
Nutritional deficits

132
Q

cardiac tamponade - what happens with BP? (the tampon dropped my inspiration)

A

systolic will drop during inspiration

133
Q

cardiac tamponade - heart sounds? (the tampon muffled me)

A

heart sounds muffled, distented neck veins

134
Q

can cardiac surgery cause dysrhhthmias and pulmonary problems?

A

yes, dysrhtymia, pulmonary dysfuction

135
Q

peri treatment if tamponade occurs?

A

Pericardiocentesis if tamponade

136
Q

peri treatment if there is chronic fluid?

A

Surgical pericardectomy is indicated for chronic fluid accumulation (pericardial window)

137
Q

peri - pain treatment?

A

treat pain - NSAIDs, steroids, antibiotics

138
Q

valve disease - S & S - (Val at the door)

A

angina, syncope, weight gain

139
Q

valve disease - signs and symptoms (Val TV)

A

edema, pale cool extremities.

140
Q

cause of cardiac tamponade - (this surgery caused a tampon)

A

post operative hemmorhage in CABG (coronary artery bipass). post op.

141
Q

cause of cardiac tamponade (tampon trauma)

A

air bags. chest trauma.

142
Q

what is cardiac tamponade?

A

fluid builds up in the space between the heart muscle and the outer covering sac (pericardium) of the heart.

143
Q

cardiomyopathy - can you get up and walk around? And what meds? (Brad needs bedrest and DVT meds)

A

BR (bed rest), no straining, DVT prophylaxis, progressive recovery, education

144
Q

acute pericarditis - causes (a cute peri door)

A

MI, autoimmune (lupus, arthritis), rheumatic fever, hypothyrodism

145
Q

regurgitiation - main cause (The cause is always the same)

A

main cause is diastolic HTN

146
Q

endocarditis - lung symptoms (just cough basically)

A

pleuritic CP, cough

XIO (393 decks)

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