Exam 2 - Cardiomyopathies

Question 1

General pathophysiology for cardiomyopathies

Answer 1

Heart muscle disease that is not associated with cardiac dysfunction

Question 2

Most common cardiomyopathy

Answer 2

Dilated cardiomyopathy

Question 3

Significant dilation of ventricles WITHOUT hypertrophy and systolic dysfunction
Dilation of ventricles could cause valve dysfunction

Answer 3

Dilated cardiomyopathy

Question 4

Causes of dilated cardiomyopathy

Answer 4

alcoholism
beriberi
viral infections (i.e. Chagas disease)
chemotherapy
genetic
idiopathic

Question 5

Nursing considerations for patients with dilated cardiomyopathy on meds

Answer 5

They cannot take Verapamil!!

Question 6

Rare autosomal dominant condition that is often detected after puberty
Asymmetrical increase in size and mass of heart muscle, esp. along the septum
Hypertrophy leads to disorganized myocyte layer

Answer 6

Hypertrophic cardiomyopathy

Question 7

What kind of heart failure can hypertrophic cardiomyopathy lead to when it progresses enough?

Answer 7

Biventricular heart failure

Question 8

Characterized by diastolic dysfunction, which does not allow the heart to expand and contract correctly

Answer 8

Restrictive cardiomyopathy

Question 9

Associated with amyloidosis (abnormal protein buildup in muscle) and infiltrative diseases (scleroderma, lupus, heart cancer, chemo and radiation, excess of iron)

Answer 9

Restrictive cardiomyopathy

Question 10

Autosomal dominant condition where myocardium of the right ventricle progressively infiltrates and is replaced by fibrous scar and adipose tissue
Right ventricle dilates and has poor contractility
Manifests between ages of 15-40
May have ventricular tachycardia that originates in R ventricle

Answer 10

Arrhythmogenic right ventricular cardiomyopathy

Question 11

General manifestations of cardiomyopathy

Answer 11

Sx of heart failure: dyspnea, fluid volume overload, anorexia r/t fluid volume overload and GI system, hepatomegaly, splenomegaly
PND
Cough
Orthopnea
Palpitations
Chest pain
Dizziness
Syncope
Sudden cardiac death

Question 12

Nursing considerations for hypertrophic cardiomyopathy

Answer 12

Stay hydrated, BUT at risk for fluid overload
Teach them that if they are staying well hydrated, they should have the urge to pee q4h and it should be light yellow
NO DIURETICS
Digoxin may worsen obstruction

Question 13

Nursing considerations for restrictive cardiomyopathy

Answer 13

Avoid nifidipine (vasodilator)
Increased risks for digoxin toxicity (s/sx are nausea, vomiting, vision changes)

Question 14

Treatment options for severe cardiomyopathy

Answer 14

Identify underlying or precipitating causes
Correcting heart failure
- lifestyle changes
- beta blockers, ACE inhibitors, diuretics, inotropics, restricting sodium and fluids
Controlling dysrhythmias
Surgery

Question 15

Which cardiomyopathies can have an ICD?

Answer 15

Hypertrophic cardiomyopathy and restrictive cardiomyopathy

Question 16

What other surgeries can hypertrophic cardiomyopathy have?

Answer 16

Alcohol septal ablation and left ventricular outflow tract

Question 17

What surgeries can pts with dilated cardiomyopathy have?

Answer 17

Restrict physical activity

Pacemaker

Question 18

What other surgeries can be used for cardiomyopathies?

Answer 18

Latissimus dorsi muscle wrap
Heart transplant
Mechanical assist devices

Question 19

Treatments for complications with cardiomyopathy - cardiac output

Answer 19

Rest
Assess need for O2 administration
Administer meds: beta blockers, ACE inhibitors, diuretics, inotropics
Restrict sodium and fluids

Question 20

Treatments for complications with cardiomyopathy - activity intolerance

Answer 20

energy conservation - teach s/sx of exacerbation and when they should rest

Question 21

What can pts with restrictive cardiomyopathy and hypertrophic cardiomyopathy NOT do?

Answer 21

Isometric/high intensity exercise - sets them up for severe ventricular arrhythmias and could die

Question 22

Treatments for complications with cardiomyopathy - anxiety

Answer 22

Help alleviate stressors
Provide education and how to manage cardiomyopathy
Make environment open and therapeutic
Give them respect to discuss death
Make sure they are aware of unlikelihood of getting a transplant

Question 23

How can you aid cardiomyopathy pts in decreasing the feeling of powerlessness?

Answer 23

Help them see what they can control i.e. diet and exercise, can manage weight and diuretic therapy