CV Alterations Flashcards

1
Q

What can cause Acute Rheumatic Fever?

A

throat infection with group A Streptococcal infection (Strept Throat)

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2
Q

When are Kawasaki epidemics most likely to happen?

A

Winter and Spring

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3
Q

S/S for Kawasaki’s disease?

A
–	High fever 100.4 – 105.8F (38-41C)
–	Conjuctival injection with photophobia
–	Oral changes
–	Polymorphous erythematous rash
–	Changes in hands and feet
–	Unilateral cervical lymphadenopathy
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4
Q

TX for Kawasaki’s?

A

– IV Immune globulin
– ASA therapy
– Coumadin

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5
Q

What should you monitor if you give IVIG?

A

Vitals. This is a blood product so if you see any adverse reaction you should discontinue and notify practitioner.

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6
Q

If a child presents with flu like symptoms or chicken pox while on asprin what should you do?

A

Discontinue Aspirin. You may change to another med like dipyridamole (Persantine)

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7
Q

What kinds of procedures can lead to Infective Endocarditis?

A

Invasive procedures. Examples:

•	Invasive procedures (Box 25-6)
–	Dental Work
–	Tonsillectomy or Adenoidectomy
–	Rigid bronchoscopy 
–	Surgical procedures involving respiratory mucosa
–	Esophageal stricture dilatation
–	Surgery involving biliary tract or intestinal mucosa
–	GU tract procedures
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8
Q

What are Olser Nodes?

A

Pea-sized nodules on the pads of fingers and toes. It is a late sign of Infective Endocarditis.

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9
Q

What are Janeway Lesions?

A

Small areas of hemorrhage on the soles and palms. This is also a late sign of Infective Endocarditis.

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10
Q

What are some clinical manifestations of Infective Endocarditis?

A
–	Most non-specific
–	New or changing murmur
–	Tachycardia
–	Heart Failure
*late signs can be Olser Nodes and/or Janeway Lesions.
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11
Q

When is prophylaxis against Infective Endocarditis recommended?

A
–	Prosthetic Cardiac valve
–	Previous Hx of IE
–	Complex Cyanotic Heart DZ
–	Surgically constructed arterial to pulmonary shunts
–	Acquired rheumatic valvular Dz 
–	Hypertrophic cardiomyopathy 
–	MVP with regurgitation
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12
Q

Nursing management for Infective Endocarditis?

A
–	Properly obtain blood cultures
–	Administering IV antibiotics
–	Possible PICC line
–	CHF
–	Teaching
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13
Q

Define Hypertension

A

Hypertension– systolic or diastolic blood pressure equal to or greater than the 95th percentile for age, sex and height on 3 separate occasions.

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14
Q

Define Pre-Hypertension?

A

if reading is between the 90th and 95th percentile

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15
Q

What are some things that can help diagnose secondary hypertension?

A
•	Any Dx testing is guided by the H&P
–	Renal Ultrasound
–	Labs: CBC, CMP, U/A, Lipid panel, renin levels
–	Echocardiogram
–	B/P in legs
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16
Q

What are some treatments for Primary Hypertension?

A
  • Wt loss
  • Low Salt diet
  • Exercise
  • Medications
17
Q

Who should get screened for hyperlipidemia?

A

– Children > 2 years of age in the following groups
• Parents or Grandparent with HX of CAD or PAD prior to age 55.
• Parent with Total Cholesterol > 200
• Children and adolescents with several risk factors for future CAD.

18
Q

Treatment for hyperlipidemia?

A

– Lifestyle changes
• Diet
• Weight Loss
• Exercise

19
Q

What types of meds are given for hyperlipidemia?

A

• Statins

20
Q

In achute rheumatic fever what do you look for primarily?

A

A murmur

21
Q

What is the leading cause of rheumatic fever?

A

Strep throat

22
Q

How many times do you have to screen a person before you can call them Hypertensive?

A

3

23
Q

What is the preferred method of having a BP taken for a pediatric patient?

A

Through Auscultation

24
Q

What is the most important teaching for those with Acute Rheumatic Fever?

A

Teach them to complete their meds!

25
Q

What kills off the organism that causes Acute Rheumatic Fever?

A

Penicillin

26
Q

What is the biggest anti-inflammatory used in Acute Rheumatic Fever?

A

Aspirin.

27
Q

When is a person given best rest during Acute Rheumatic Fever?

A

If they also have Heart Failure

28
Q

What group is most likely to have Kawasaki’s Disease?

A

Under age 2, boys, Asian

29
Q

A new murmur could be an indicator of…

A

Infective Endocarditis

30
Q

Nursing Care for Kawasaki’s includes:

A

Tepid Bath
Lip Balm
Soft Diet
Quiet Environment

31
Q

If a person has abnormally bronze skin they probably have…

A

Thallasemia

32
Q

TX for Thallasemia?

A
No Cure
–
Goal: normalize Hb & Hct, minimize effects of anemia
Blood transfusions >> Splenectomy
Hemosiderosis “excess iron”
-chelating agent
Bone marrow & stem cell transplants
33
Q

Tetralogy of Fallot

A
  • VSD
  • Pulmonary Stenosis
  • RV Hypertrophy
  • Overriding Aorta

…These are all signs of Congenital Heart Disease.

34
Q

What position might you put a person with congenital heart disease?

A

Knee-Chest

35
Q

What drug might you give a person with Congenital Heart Disease?

A

Morphine

36
Q

The main cause of CHF in infants is..

A

congenital heart disease

37
Q

The main cause of CHF in children and adolescents is…

A

ACQUIRED heart disease