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cardiac > Chapter 37 & 40 > Flashcards

Chapter 37 & 40 Flashcards

1
Q

Sensitivity response that develops after an upper respiratory tract infection with group A beta-hemolytic streptococci

A

Rheumatic Carditis (Rheumatic Endocarditis)

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2
Q

Occurs when chronic pericardial inflammation causes a fibrous thickening of the pericardium

A

Chronic Constrictive Pericarditis

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3
Q

Inflammation or alteration of the pericardium (the membranes sac that encloses the heart)

A

Acute Pericarditis

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4
Q
  • Microbial infection of the endocardium
  • Most common infective organism (Streptococcus viridans and Staphylococcus aureus)
  • Port of entry (oral cavity, skin rashes lesions abcesses, infection and surgery or invasive procedures
A

Infective Endocarditis

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5
Q

Fluid accumulation in the pericardial sac

  • hypotension
  • jugular venous distention, muffled heart sounds, paradoxical pulse
A

Cardiac Tamponade

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6
Q

Chest pain caused by a temporary imbalance between the coronary arteries ability to supply oxygen and the cardiac muscles demand for oxygen

A

Angina Pectoris

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7
Q

may begin expectorating frothy, pink-tinged sputum

-sign of life threatening pulmonary edema

A

HF becomes very severe

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8
Q

changes in potassium levels

  • anorexia, fatigue, blurred vision, and changes in mental status
  • Nearly any dysrhythmia, but PVCs most common
  • Early signs bradycardia and loss of P wave
A

Digoxin toxicity

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9
Q

Benefits for patients with chronic HF with sinus rhythms and A Fib

  • increase contractility
  • Reduce HR
  • Slowing of conduction through the atrioventricular node
  • Inhibition of sympathetic activity while enhancing parasympathetic activity
A

Digoxin

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10
Q

the aortic valve, leaflets do not close properly during diastole and the annulus (the valve ring that attaches to the leaflets) may be dilated, loose, or deformed
-Asymptomatic for many years
Symptoms
-exertional dyspnea, orthopnea, and paroxysmal nocturnal dyspnea

A

Aortic Regurgitation

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11
Q

Patients develop murmur

  • HF most common complication, Arterial embolization
  • abdominal assessment; rebound tenderness on palpation
  • petechiae (pinpoint red spots)
  • Positive blood culture is prime diagnostic test
A

Infective Endocarditis (bacterial endocarditis)

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12
Q

they require antibiotic administration before all invasive procedures and test

A

Valvular Heart Disease history remind health care providers

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13
Q

Prevent the mitral valve from closing completely during systole

  • left atrium and ventricle dilate and hypertrophy
  • Symptoms: fatigue ad chronic weakness as a result of reduced cardiac output
  • Report anxiety atypical chest pain, and palpitations
A

Mitral Regurgitation

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14
Q

Usually results from rheumatic carditis, which can cause valve thickening by fibrosis and calcification
-left atrial pressure increases
-left atrium dilates
-pulmonary artery pressure increases
-right ventricle hypertrophies
Pulmonary congestion and right side HF occur first

A

Mitral Stenosis

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15
Q

occurs because the valvular leaflets enlarge and prolaspe into the left atrium during systole

  • Most are asymptomatic.. Report chest pain, palpitations or exercise intolerance
  • shape pain localized to left side of heart
  • dizziness, syncope, and palpitation may be associated with atrial or ventricular dysrhythmias
A

Mitral Valve Prolapse (MVP)

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16
Q

Aortic valve orifice narrows and obstructs left ventricular outflow during systole.
-increase resistance to ejection or afterload resulting in ventricular hypertrophy

A

Aortic Stenosis

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17
Q

from fixed cardiac output: dyspnea, angina, and syncope on exertion

  • when CO falls: fatigue, debilitation, peripheral cyanosis
  • Narrow pulse pressure
  • diamond shaped systolic crescendo- decrescendo murmur noted on auscultation
A

Aortic Stenosis

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18
Q

Blackouts

A

Syncope

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19
Q

Occurs when the space between the parietal and visceral layers of the pericardium fills with fluid

A

Pericardial Effusion

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20
Q

Inability of the heart to work effectively as a pump

-sometimes referred to as pump failure

A

Heart Failure

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21
Q

Hypertension, coronary artery disease, valvular disease involving the mitral or aortic valve
-decrease tissue perfusion from poor cardiac output and pulmonary congestion from increasing pressure in the pulmonary vessels

A

Left sided Heart Failure (Ventricular)

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22
Q
  • When heart cannot contract forcefully enough during systole to eject adequate amounts of blood into the circulation
  • As ejection fraction decrease, tissue perfusion diminishes and blood accumulates in the pulmonary vessels
A

Systolic Heart Failure (Systolic Ventricular Dysfunction)

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23
Q

Symptoms: inadequate tissue perfusion or pulmonary and systemic congestion
-forward failure because CO is decreasing and fluid backs up into the pulmonary system

A

Systolic Heart Failure (Systolic Ventricular Dysfunction)

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24
Q

When the left ventricle cannot relax adequately during diastole
-inadequate relaxing or stiffening prevents the ventricles from filling with sufficient blood to ensure an adequate CO

A

Diastolic Heart Failure (HF with preserved Left Ventricular function)

25
Q

May be caused by left ventricular failure

  • cannot empty completely
  • increasing volume and pressure develop in the venous system and peripheral edema results
A

Right-sided Heart Failure (ventricular)

26
Q

when CO remains normal or above normal, unlike left and right sided HF

  • caused by increasing metabolic needs or hyperkinetic conditions
  • not as common
A

High-output Heart Failure

27
Q

result of pulmonary problems COPD or pulmonary hypertension

A

Right-sided HF in the absence of left-side HF is usually

28
Q

Weakness, fatigue, dizziness, acute confusion, pulmonary congestion, breathlessness, oliguria

  • pulse may be tachycardiac (may alternate in strength)
  • Respiratory rate typically exceeds 20 breaths/min
  • disoriented or confused when HF due to brain hypoxia
  • May auscultate crackles and wheezes in lungs
A

Symptoms of left-sided HF

29
Q

Increase systemic venous pressure and congestion

  • neck vein for distention and measure abdominal girth
  • hepatomegaly, hepatojugular reflux and ascites
  • dependent edema
  • ambulatory patients- ankles and legs
  • restricted to bedrest- sacrum
A

Symptoms of Right-Sided Heart Failure

30
Q

noninvase diagnostic procedure of choice to visualize the structure and movement of the heart

A

Echocardiography

31
Q

Produced and released by ventricles when the patient has fluid overload as a result of HF

A

B-type Natriuretic Peptide (BNP)

32
Q

Neurohormones that work to promote vasodilation and diuresis through sodium loss in the renal tubules

A

Natriuretic Peptides

33
Q

Enlargement of the myocardium with or without chamber dilation (slightly oxygen deprived)
-Cardiac muscle may hypertrophy more rapidly than collateral circulation can provide adequate blood supply to the muscles

A

Myocardial Hypertrophy

34
Q

Causes Na/water retention
Induces vasoconstriction
Increases preload/afterload
Aldosterone inhibitors (spironolactone)

A

Aldosterone

35
Q

Reduced blood flow to the kidneys, common in low-output states, results in activation of RAS
-Vasoconstriction becomes more pronounced and aldosterone secretion causes sodium and water retention

A

Renin-Angiotension System Activation

36
Q
  • increases catecholamines result of tissue hypoxia represents the most immediate compensatory mechanism
  • stimulation of the adrenergic receptors causes an increase in HR (beta adrenergic) and BP from vasoconstriction (alpha adrenergic)
  • increases HR results in an immediate increase in cardiac output
  • Results in arterial vasoconstriction maintaining blood pressure and improving tissue perfusion in low-output states
A

Stimulation of the sympathetic Nervous System

37
Q
  • observe patient for increased urinary output
  • monitor for decreased respiratory distress
  • Continue to monitor for improvement
  • Think about the possible causes of the patient’s heart failure
  • think about your response to the patient
  • develop a teaching plan for the patient prevent worsening or recurrent acute episodes of HF
A

What should you Reflect on Cardiac Problems

38
Q
  • taking VS
  • monitoring O2 sat by pulse ox
  • performing a complete cardiovascular assessment
  • performing a complete respiratory assessment (listen for crackles or wheezes)
  • Weighing patient
  • Assessing cognition
  • Assessing for pain or other symptoms
A

Should interpret and how to respond to patients experiencing inadequate oxygenation and tissue perfusion as a result of HF (perform/ interpret physical assessment including)

39
Q
  • Report SOB, especially on exertion
  • Report of dizziness
  • report of weight gain within days
  • syncope
  • dyspnea on exertion
  • report of palpitations
  • report of fatigue and weakness
  • disorientation or acute confusion (especially in older adults)
  • peripheral or abdominal ascites
A

Might notice if a patient is experiencing inadequate oxygenation and tissue perfusion as a result of HF

40
Q

subacute or chronic disease of cardiac muscle, and cause may be unknown

  • basis of abnormalities in structure and function
  • dilated cardiomyopathy
  • hypertrophic cardiomyopathy
  • restrictive cardiomyopathy
  • arrhythmogenic right ventricular cardiomyopathy
A

Cardiomyopathy

41
Q
  • seeing health care provider immediately or call 911 if patient is not in hospital setting
  • Notifying physician/ rapid response team
  • raising the head of the bed to a sitting position
  • giving O2
  • maintaining/ starting IV line
  • admin furasemide IV push
  • monitoring I and O
  • giving ACE inhibitors or ARBs IV or oral
A

Respond to patient experiencing inadequate oxygenation and tissue perfusion as a result of HF

42
Q

Observe patient for evidence of improved circulation and oxygenation

  • think about what may have caused it
  • think about how the nurse may have identified the problem sooner
A

what should you reflect from hypovolemic shock

43
Q

applying O2

  • assisting the patient to shock position (head and chest flat or elevated to no more than 30 legs elevated)
  • Notifying rapid response team
  • Ensuring placement of venous access
  • increase IV fluid infusion rate
A

Respond to hypovolemic shock

44
Q

-arterial blood gas values; pH lower than 7.35
-elevated serum lactate levels
-hemorrhage
decrease hct and hbg
decrease total RBC and platelets
-dehydration
increase RBC, hct, hbg
increase WBC count

A

Interpret lab values as a result of hypovolemic shock

45
Q
  • pulse rapid and thready
  • pulse pressure narrowed
  • respirations rapid and shallow
  • O2 sat by pulse ox decreases
  • skin cyanosis or pallor (in lighter-skinned patients)
  • skin cool and clammy
  • cyanosis or pallor of the lips and oral mucous membrane (in patients of any skin color)
  • patient is restless or anxious
  • Urine output that is less than expected compared with fluid intake
  • patient states he or she is thirsty
A

Might notice if the patient is experiencing inadequate oxygenation and tissue perfusion as a result of hypovolemic shock

46
Q

when the arteries that supply the myocardium are diseased, the heart cannot pump blood effectively to adequately perfuse vital organs and peripheral tissues

A

Coronary Artery Disease (CAD)

47
Q

chest pain caused by a temporary imbalance between the coronary arteries ability to supply oxygen and the cardiac muscles demand for oxygen

A

Angina Pectoris

48
Q

chest discomfort that occurs with moderate to prolonged exertion in a pattern that is familiar to the patient

  • only slight limitation of activity
  • usually associated with a fixed atherosclerotic plaque
  • relieved by nitroglycerin or rest
A

Chronic Stable Angina (CSA)

49
Q

describe patients who have either unstable angina or an acute myocardial infarction
-atherosclerotic plaque in the coronary artery ruptures resulting in platelet aggregation (“clumping”) thrombus (clot) formation, and vasoconstriction

A

Acute Coronary Syndrome (ACS)

50
Q

expandable metal mesh devices that are used to maintain the patient lumen created by angioplasty or atherectomy

A

Stents

51
Q

Scar tissue permanently changes the size and shape of the entire left ventricle

  • decrease function causing heart failure
  • scar tissue doesn’t contract or do conduct electricity causing chronic ventricular dysrhythmias surrounding the infarcted zone
A

Ventricular Remodeling

52
Q
  • observe patient for decrease report of pain and associated symptoms
  • continue to monitor O2
  • continue to monitor for dysrhythmias and VS
  • think about what could have precipitated this coronary events
  • think about how you respond
  • develop teaching plan for the patient to help prevent further episodes
A

What should reflect for coronary artery disease

53
Q
  • calling 911 if patient not at hospital
  • ensuring that patient rests
  • giving O2
  • giving nitroglycerin tablet
  • maintaining or starting IV line
  • admin morphine sulfate if MI suspected or diagnosed
A

Respond to a patient experiencing inadequate oxygenation and tissue perfusion as a result of Coronary Artery Disease

54
Q
  • take VS
  • monitoring O2 sat
  • taking 12-lead ECG
  • assessing level of consciousness and cognition
  • conducting complete pain assessment
  • drawing blood for lab assessment (troponins)
  • Ausculating breath sounds for crackles and wheezes
  • Auscultating heart for abnormal heart sounds (left sided heart failure)
  • assessing for peripheral edema (right sided heart failure)
A

Perform and interpret physical assessment to patient’s experiencing inadequate oxygenation and tissue perfusion as a result of Coronary Artery Disease

55
Q
  • report of pain (chest, shoulder, arm, jaw, back, abdomen)
  • report of persistent indigestion
  • dyspnea– diaphoresis
  • report of nausea
  • vomiting
  • anxious behavior
  • report of palpitations
  • report of fatigue
  • disorientation or acute confusion (especially in older adults)
A

Notice if the patient is experiencing inadequate oxygenation and tissue perfusion as a result of Coronary Artery Disease

56
Q

Infection of the mediastinum

  • fever continuing beyond the first 4 days after CABG
  • Instability (bagginess) of the sternum
  • Redness, induration, swelling, or drainage from suture sites
  • an increased WBC count
A

Mediastinitis by observing for

57
Q
  • sudden cessation of previously heavy mediastinal drainage
  • jugular venous distention but clear lung sounds
  • pulses paradoxus (BP more tham 10mmHg higher on expiration than on inspiration)
  • An equalizing of PAWP and right atrial pressure
  • Cardiovascular collapse
A

Assess for and report manifestations of Cardiac tamponade immediately, including

58
Q
  • fluid (blood) may accumulate around the heart

- fluid compress the atria and ventricles, preventing them from filling adequately and thus reducing cardiac output

A

Cardiac tamponade

cardiac (4 decks)

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