Care of Patients with Cardiac Problems Flashcards
Pulmonary edema
left ventricle fails to eject sufficient blood and pressure increases in the lungs. the increased pressure causes fluid to leak across the pulmonary capillaries and into the lung airways and tissues.
causes of pulmonary edema
severe HF
acute MI
mitral valve disease
dysrhythmias
symptoms of pulmonary edema
crackles, dyspnea, disorientation, confusion, tachycardia, HTN or hypotension, reduced UO, cough with frothy pink tinged sputum, PVC or other dysrhythmias, anxiety, restlessness, lethargy
pulmonary edema interventions
monitor VS, high fowlers if not hypotensive, high flow oxygen therapy, aggressive pulmonary therapy, nitroglycerin, rapid acting diuretics, IV morphine sulfate
types of valvular heart disease
mitral stenosis, mitral regurgitation, mitral valve prolapse, aortic stenosis, aortic regurgitation
mitral stenosis
narrowing of valve opening
causes pulmonary congestion and right HF
mitral regurgitation
valve does not completely close during systole
back flow of blood into the left atrium
mitral valve prolapse
valvular leaflets enlarge and prolapse into the left atrium
aortic stenosis
most common dysfunction
narrowing of valve opening
increased resistance to ejection and cardiac output is decreased and fixed
aortic regurgitation
valve does not close completely during diastole
back flow of blood into the left ventricle
key features of valvular disease
fatigue, dyspnea, angina, dysrhythmias, edema
diagnostic testing for valvular idease
echocardiogram
TEE
chest xray
ECG
non surgical management of valvular disease
medications
surgical management of valvular disease
replacement or repair
patients with defective or replaced valves are at risk for what
infective endocarditis, requires prophylactic antibiotic therapy before any invasive procedures
infective endocarditis
infection of the endocardium
streptococcus viridans or staphylococcus aures
causes of infective endocarditis
IV drug use
valve replacement
systemic infection
structural defects
portals of entry for infective endocarditis
oral cavity
skin rashes, lesions, abrasions
infections
surgery or invasive procedures, including IV placement
key features of infective endocarditis
fever associated with chills, night sweats, malaise, fatigue
anorexia and weight loss
cardiac murmur
petechiae
splinter hemorrhages
complications of infective endocarditis
HF and arterial embolization
diagnostic assessment of infective endocarditis
positive blood culture and echocardigram
interventions for infective endocarditis
IV antimicrobials for 4-6 weeks
rest
surgical management if antibiotic therapy is ineffective
acute pericarditis
inflammation or alteration of the pericardium (membranous sac that encloses the heart)
features of acute pericarditis
sternal precordial pain that radiates to the left side of the neck, shoulder, or back. pain is grating and oppressive and aggravated by breathing , coughing, and swallowing. pericardial friction rub. fever with elevated WBC
interventions for acute pericarditis
NSAIDS- pain
corticosteroids
IV antibiotics
may require pericardial drainage
avoid aspirins and anticoagulants
cardiomyopathy
subacute or chronic disease of cardiac muscle. heart muscles becomes enlarged, thick or rigid- may be replaced with scar tissue. high mortality rate for patients who develop heart failure. 4 types on the basis of abnormalities in structure and function
treatment for cardiomyopathy
varies with they type
medical treatment includes medications similar to those for heart failure and dysthymias
surgical interventions (heart transplant)
