Heart failure and cardiac inflammatory disorders

Question 1

Which valves are AV valves?

Answer 1

mitral and tricuspid, referred as leaflets

Question 2

which valves are SL valves?

Answer 2

aortic and pulmonic, referred as cusps

Question 3

what is mitral valve regurgitation?

Answer 3

when blood flows from LV back to left atrium because the mitral valve does not close properly

Question 4

What are the clinical manifestations of mitral valve regurgitation?

Answer 4

SOB w exertion, weakness, palpitations, med-high pitched blowing systolic murmur, often caused by rheumatic fever

Question 5

What is Aortic regurgitation?

Answer 5

Back flow of blood into the left ventricle from the aorta due to the aortic valve not closing correctly

Question 6

what are the clinical manifestations of aortic regurgitation?

Answer 6

SOB w exertion, orthopnea, paroxysmal nocturnal dyspnea, forceful heartbeat in head/neck, med- high pitched blowing diastolic murmur

Question 7

what is mitral stenosis?

Answer 7

decreased blood flow from left atria to left ventricle due to valve not opening completely

Question 8

what are the clinical manifestations of mitral stenosis?

Answer 8

dyspnea w exertion, low exercise tolerance, dry cough, hemoptysis, low pitched rumbling diastolic murmur
pt will not show s/s until 1/2-1/3 of blood flow is decreased

Question 9

what is aortic stenosis?

Answer 9

narrowing orifice between left ventricle and aorta

Question 10

what are the clinical manifestations of aortic stenosis?

Answer 10

Dyspnea on exertion, angina, pulmonary edema, syncope, decreased BP, loud harsh systolic murmur, s4 sound

Question 11

what is a comissurotomy?

Answer 11

type pf valvuloplasty used for mitral valve stenosis, involves separating fused leaflets

Question 12

what are the risks of a mechanical valve replacement?

Answer 12

last longer, but higher risk of thromboembolism, requires long term anticoagulation (Mitral INR: 2-3.5, Aortic INR 1.8-2.2)

Question 13

what is mitral prolapse?

Answer 13

stretching of valve leaflet that backs into atrium during systole

Question 14

what is the most common cardiomyopathy?

Answer 14

dilated cardiomyopathy

Question 15

what is dilated cardiomyopathy?

Answer 15

enlarged LV from heart muscle stretching and becoming thin, leads to impaired contractility

Question 16

what is hypertrophic cardiomyopathy

Answer 16

autosomal genetic disorder that leads to increased heart size which leads to diastolic failure, genetic testing for 1st relatives if pt is positive)

Question 17

clinical manifestations of cardiomyopathy

Answer 17

narrowing pulse pressure and pulsus paradoxus (systolic pressure decreases upon inspiration, HF signs as disease progresses

Question 18

What is infective endocarditis?

Answer 18

caused by streptococcus viridian and staph aureus, leads to vegetation that adheres to valves

Question 19

clinical manifestations of infective endocarditis

Answer 19

fever, murmur, myalgia
cutaneous signs of clustered petechiae, splinter hemorrhages, osler’s nodes (on thumb) and Janeway lesions (palm of hand)

Question 20

medical management for infective endocarditis

Answer 20

abx therapy for 2-6 weeks

Question 21

Nursing management for myocarditis

Answer 21

place patient on bedrest, avoid NSAIDS since it increases viral replication and increases cardiac injury, extra sensitive to digoxin

Question 22

what is dressler’s syndrome

Answer 22

pericarditis that occurs 10-12 months after acute MI, s/s include chest pain worsening with inspiration and pericardial friction rub

Question 23

Stage A Heart failure

Answer 23

high risk for developing left ventricular dysfunction without structural heart disease or s/s of HF

Question 24

stage B heart failure

Answer 24

pt with left ventricular dysfunction or structural heart defect who has not developed s/s of HF

Question 25

Stage C of heart failure

Answer 25

Pt with left ventricular dysfunction or structural heart defects that has current or had s/s of HF

Question 26

Stage D of Heart failure

Answer 26

pt with refractory end stage HF requiring intervention

Question 27

nursing management of Pulmonary Edema

Answer 27

rebreather mask, furosemide, NTG, position pt upright with legs dependent, monitor I/O,

Question 28

what is the first sign of fluid overload with pulmonary edema

Answer 28

auscultating fine crackle in posterior base of lungs

Question 29

when should patient talk to doctor about weight change if they have HF

Answer 29

weight change of 2lbs a day or 5lb a week is not normal

Question 30

what does an echocardiogram indicate

Answer 30

determines EF% and confirms dx of HF, normal ef% is 55-65