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NRSG 200: Med Surg 3 > [Exam 2] Chapter 28: Managment of Patients with Structural, Infecious, and Inflammatory Cardiac Disorders > Flashcards

[Exam 2] Chapter 28: Managment of Patients with Structural, Infecious, and Inflammatory Cardiac Disorders Flashcards

1
Q

Valvular Disorder: What is Regurgitation?

A

Valve does not close completely, and blood backflows through the valve

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2
Q

Valvular Disorder: What is stenosis?

A

Valve does not open completely, and blood flow through valve is reduced

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3
Q

Valvular Disorder: What is valve prolapse?

A

Stretching of an atrioventricular valve leaflet (Mitral and Tricuspid) into the atrium during diastole and don’t close properly.

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4
Q

Valvular Disorder: What valves does regurgitation effect?

A

Mitral and aortic valve

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5
Q

Valvular Disorder: How is patient affected in mitral valve regurgitation?

A

Sits in left atrium and ventricle and will flow back toward the lungs.

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6
Q

Valvular Disorder: Why can stenosis be problematic through aortic valve?

A

The body will not get enough blood.

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7
Q

Valvular Disorder: Where is the Tricuspid valve?

A

Between the right atrium and ventricle

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8
Q

Valvular Disorder: Where is the pulmonic valve?

A

Between right ventricle and left atrium

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9
Q

Valvular Disorder: Where is the mitral valve?

A

Between left atrium and ventricle

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10
Q

Valvular Disorder: Where is the aortic valve?

A

Between the aorta and left ventricle

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11
Q

Valvular Disorder: How to remember order of valves?

A

Tissue (Tricuspid)
Paper (Pulmonic)
My (Mitral)
Assets (Aortic)

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12
Q

Leaflets in Mitral valve?

A

2

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13
Q

Leaflets in TRicuspid valve?

A

3

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14
Q

Leaflets in Aortic Valve?

A

3

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15
Q

Where leaflets meet is called what?

A

Commissures

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16
Q

What does Aortic Stenosis cause to happen to the body?

A

Backward HF.

Aortic stenosis limits limits flow of blood from left ventricle. Causes increased blood volume and pressure in LF. Causes left ventricular hypertrophy and blood from left atrium cannot get into left ventricle

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17
Q

Left Ventricular Hypertrophy causes what to happen in body?

A

Increased blood pressure and volume in all of the parts of the heart behind this.

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18
Q

Valvular Disorder: What problems can not enough blood flow through aorta cause?

A

Angina pectoris, postural hypotension, fatigue, dizziness

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19
Q

Valvular Disorder: Why is hypertrophy a problem?

A

It is not able to push blood through as effectively.

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20
Q

Valvular Disorder: What problem does mitral stenosis cause?

A

Limits foward flow of blood into the left ventricle . Causes mitral regurgitation where blood flows into left atrium

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21
Q

Valvular Disorder and Surgical Mx, Repair - Valvuoplasty: What is this?

A

They run a catheter through septum and deploy balloon into mitral valve. It then stretches valve out and leaflets to help them open better. This helps eliminate open heart surgery.

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22
Q

Valvular Disorder and Surgical Mx, Repair - Valvuoplasty: What is a Commissurotomy?

A

This is when the valves are normally fused together, and they will go in and attempt to create some separation on the valves.

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23
Q

Valvular Disorder and Surgical Mx, Repair - Valvuoplasty: What is a Annuloplasty?

A

A ring is placed around outer edges of valve and helps it to open and close betteer.

24
Q

Valvular Disorder and Surgical Mx, Repair - Valvuoplasty: What is a leaflet repair?

A

They go and clip the edge of the stretched out leaflet to help with the opening.

25
Q

Valvular Disorder and Surgical Mx, Repair - Valvuoplasty: What is a Chordoplasty?

A

Done on Mitral/Tricupid valve. Repair the cords that hold this to the ventricular wall.

26
Q

Valvular Disorder and Surgical Mx, Repair - Valve Replacement: What are mechanical valves?

A

They last longer than tissues valves, but do end up causing blood clots.

27
Q

Valvular Disorder and Surgical Mx, Repair - Valve Replacement: What will patients need to be on when they have mechanical valves?

A

Will need to be on long-term anticoagulants (warfarin, INR at 2-3) and dental care antibiotics (don’t want infection to develop into endocarditits) since these cause blood clots.

28
Q

Valvular Disorder and Surgical Mx, Repair - Valve Replacement: Why can hemolysis of cells occur with mechanical valves?

A

Because the valves can open and close.

29
Q

Valvular Disorder and Surgical Mx, Repair - Valve Replacement: What type of tissue valves are available?

A

Bioprostheses (Pig, Cow Valve). .Homografts (From a Donor), Autografts (Patient own valve is used , maybe pulmonic valve)

30
Q

Valvular Disorder and Surgical Mx, Repair - Valve Replacement: Benefit of tissue valves?

A

Don’t require anticoagulants but they are less durable and will likely need to be replaced.

31
Q

Valvular Disorder and Surgical Mx, Repair - Valve Replacement: Care for these patients will require what?

A

Will be similar to the open heart patient.

32
Q

Valvular Disorder and Surgical Mx, Repair - Valve Replacement: What is a transaortic valve replacement?

A

Pt treated like heart cath patient. Will drop new aortic valve on top of old one and will push those old leaflets out of the way.

33
Q

Valvular Disorder and Surgical Mx, Repair - Valve Replacement: Who would a transaortic valve replacement be recommended for?

A

For those who cannot go through open heart surgery.

34
Q

Cardiomyopathy: What is this?

A

Disease of the heart muscle that makes it harder for your heart to pump blood to the rest of your body

35
Q

Cardiomyopathy - Hypertrophic: How does the heart appear here?

A

Thickened left ventricular wall, smaller right side. Bulging out of septum and obstructs blood going into body.

36
Q

Cardiomyopathy - Hypertrophic: What usually causes this?

A

Usually a result of genetics

37
Q

Cardiomyopathy - Hypertrophic: What risk does this cause?

A

Risk of sudden death in young athletes

38
Q

Cardiomyopathy - Hypertrophic: What kind of dysfunction does this cause?

A

Diastolic dysfunction

39
Q

Cardiomyopathy - Dilated: How common is this

A

This is the most common

40
Q

Cardiomyopathy - Dilated: What changes does this cause in the heart?

A

Increased ventricular volume but decreased injection fraction. Ventricles get bigger but ventricular muscles don’t thicken, so poor systolic function.

41
Q

Cardiomyopathy - Dilated: Why is this a problem for the body?

A

Poor ejection fraction means body is not getting the proper nutrients that it needs.

42
Q

Cardiomyopathy - Dilated: What is enlarged here?

A

All cardiac chambers

43
Q

Cardiomyopathy - Dilated: What function is affected here?

A

Systolic dysfunction

44
Q

Cardiomyopathy - Restrictive: This can be caused by what

A

Genetics, sometimes amyloidosis.

45
Q

Cardiomyopathy - Restrictive: How are the heart walls here?

A

they are very rigid and the heart cannot fill. Diastolic dysfunction and leads to restrictive disease.

46
Q

Cardiomyopathy - Restrictive: Is this common?

A

It is the least common type

47
Q

Cardiomyopathy: What problems does this lead to?

A

HF and Dysrhythmias, and may eventually lead to death because they need a new heart. Will mimick heart failure.

48
Q

Cardiomyopathy: What will you hear in heart?

A

Heart murmurs.

49
Q

Cardiomyopathy: How will patients be treated?

A

Like heart failure patient.

50
Q

Cardiomyopathy Mx: What will they be put on before it gets bad?

A

Heart transplant list

51
Q

Cardiomyopathy Medical Mx: What medical management will be done while they wait for new heart?

A

Beta blockers, fluid restrictions, and wil likely get ICD placed because RF dysrhythmias.

52
Q

Cardiomyopathy Medical Mx: Education will have to be done on what?

A

What heart transplant will be like.

53
Q

Cardiomyopathy Medical Mx: What is the ultimate treatment for cardiomyopathy?

A

Heart Transplant

54
Q

Cardiomyopathy Surgical Mx: What may be given to patients as they get worse and are waiting on a new heart?

A

LVAD, a left ventricular assistive device.

55
Q

Cardiomyopathy Surgical Mx: Can this reverse?

A

Some can, especially seen in pregnant women. When used with LVAD

56
Q

Cardiomyopathy Surgical Mx: Why may an LVAD be used?

A
  1. Bridge to Death
  2. Bridge to Recovery
  3. Pregnancy Induced Cardiomyopathy
57
Q

Cardiomyopathy Surgical Mx: What does an LVAD do?

A

Takes over function of the left ventricle. IF this malfunctions, patient won’t live.

NRSG 200: Med Surg 3 (46 decks)

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