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Med Surg 2 > heart inflammation and value issues > Flashcards

heart inflammation and value issues Flashcards

1
Q

endocarditis

A

Infection of the inner layer of heart, including the cardiac valves.

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2
Q

causative agents of endocarditis

A
  • Staphylococcus aureus (resistent to a lot of antibiotics)
  • Viruses
  • Fungi
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3
Q

risk factors of endo

A

Age
IV drug abuse (IVDA)
Prosthetic heart valves
Use of intravascular devices
Renal dialysis

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4
Q

contributing factors of endo

A
  • Nonspecific in many patients
  • Low-grade fever occurs in 90% of cases
  • Chills
  • Weakness
  • Malaise
  • Fatigue
  • Anorexia
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5
Q

clinical manifestations of endo

A
  • Audible Murmur in most patients
  • Heart failure

Manifestations secondary to embolism
- Spleen
- Kidneys
- Limbs
- Brain
- Lungs

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6
Q

diagnostic studies of endo

A

Laboratory tests
- Blood cultures
- CBC with differential
- ESR, C-reactive protein (CRP)

  • Echocardiography
  • Chest x-ray
  • ECG
  • Cardiac catheterization: camera to visualize around heart
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7
Q

nursing assessment of endo

A

Health history
- Valvular or congenital cardiac disease
- Previous endocarditis
- Staph or strep infection

  • Drug/alcohol abuse
  • Night sweats
  • Hematuria
  • Fatigue, activity intolerance
  • Recent surgeries and procedures
    ***RECENT DENTAL WORK
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8
Q

endo: Prophylactic antibiotic treatment for:

A
  • Certain dental procedures
  • Respiratory tract incisions
  • Tonsillectomy and adenoidectomy
  • GI wound infection
  • Urinary tract infection
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9
Q

nursing care for endo

A
  • Accurate identification of organism
    Blood Cultures!
  • IV antibiotics (long-term)
  • Repeat blood cultures
  • Valve replacement if needed
  • Antipyretics
  • Fluids
  • Rest
  • pig valve: cuamatin for life
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10
Q

home care for endo

A

Home care
- Antibiotic therapy for 4–6 weeks
- Assess home setting
- Monitor laboratory data, including blood cultures
- Assess IV lines
- Coping strategies

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11
Q

patient teaching for endo

A
  • Monitor body temperature
  • Signs and symptoms of complications
  • Nature of disease and reducing risk of reinfection
  • Stress follow-up care, good nutrition, early - treatment of common infections
  • Signs and symptoms of infection
  • Need for prophylactic antibiotic therapy
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12
Q

pericarditis

A
  • Inflammation of the pericardial sac
  • Caused by viruses: Many times cause is unknown
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13
Q

pericarditis clinical manifestations

A
  • Progressive severe sharp chest pain
  • Pain is worse with deep breath in and with lying down
  • Hallmark finding is pericardial friction rub
  • High pitch, scratching, grating sound when auscultating heart sounds.
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14
Q

pericarditis complication

A

pericardial effusion
cardiac tamponade

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15
Q

pericardial effusion

A

Build up of fluid in the pericardium
May occur rapidly

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16
Q

cardiac tamponade

A
  • Pericardial effusion gets bigger and compresses the heart.
  • Patient has chest pain, tachypnea
  • Distended neck veins
  • Pulsless paradoxux
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17
Q

paradozical bp

A

high s, decrease d
- high pulse pressure

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18
Q

If patient is in tamponade:

A

Pericardiocentesis: remove heart fluid by drain or needle

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19
Q

A nurse is caring for a client following an angioplasty that was inserted through the femoral artery. While turning the client, the nurse discovers blood underneath the client’s lower back. Which of the following findings should the nurse suspect?
a. Retroperitoneal bleeding
b. Cardiac tamponade
c. Bleeding from the incisional site
d. Heart failure

A

c

20
Q

stenosis

A

Result in narrowing of heart valve that prevents or impedes blood flow

21
Q

regurgitation

A

Impaired closure that allows backward leakage of blood

22
Q

valvular disorders may affect

A

mitral
aortic
tricuspid

23
Q

contributing factors valvular disorders

A

History of endocarditis
History of rheumatic fever

24
Q

right side heart failure

A

Mitral stenosis
Mitral regurgitation
Tricuspid stenosis

25
Q

what does mitral valve stenosis results from

A

rheumatic heart disease.
- Scarring of valve leaflets and chordae tendineae

26
Q

effects of mitral valve stenosis

A
  • Results in decreased blood flow from left atrium to left ventricle.
  • Increased left atrial pressure and blood volume.
  • Increased pressure in pulmonary vasculature.
  • Risk for atrial fibrillation-why
27
Q

mitral valve stenosis clinical manifestations

A

Exertional dyspnea
Loud S1
Murmur
Fatigue
Palpitations
Hoarseness, hemoptysis
Chest pain, seizures/stroke

28
Q

Mitral Valve Regurgitation damage caused by

A

MI
Chronic rheumatic heart disease
Ischemic papillary muscle dysfunction
Infective endocarditis

29
Q

what happens during mitral valve regurgitation

A
  • Incomplete valve closure
  • Backward flow of blood
  • Valve is prolapsed
  • Acute MR
    + Pulmonary edema
  • Chronic MR
    +Left atrial enlargement, ventricular hypertrophy → decrease in CO
30
Q

acute clinical manifestations of mitral valve regurgitation

A

Thready peripheral pulses and cool, clammy extremities.

31
Q

Chronic clinical manifestations mitral valve regurgitation

A

Asymptomatic for years until development of some degree of left ventricular failure
- Weakness, fatigue, palpitations
- Murmurs
- Decreased cardiac output

32
Q

left sided heart failure

A

Aortic stenosis
Aortic regurgitation

33
Q

aortic valve stenosis discovered in

A
  • Congenital stenosis usually discovered in childhood, adolescence, or young adulthood
  • Can also be degenerative or caused by rheumatic fever
34
Q

what is aortic valve stensosis

A
  • Obstruction of flow from left ventricle to aorta.
  • Causes left ventricular hypertrophy and ↑ myocardial oxygen consumption.
  • Leads to ↓ CO, pulmonary hypertension, and HF.
35
Q

aortic valve stenosis clinical manifestations

A
  • Angina
  • Syncope
  • Exertional dyspnea
  • Murmur
  • Abnormal heart sounds
36
Q

prognosis of aortic valve stenosis

A

Poor prognosis if symptomatic and not corrected

37
Q

what should you use cautiously in aortic valve stenosis

A

Use nitroglycerin cautiously
- Reduces preload and BP
- Can worsen chest pain

38
Q

aortic valve regurgiutation

A
  • Backward blood flow from aorta into left ventricle.
  • With chronic AR, left ventricular dilation and hypertrophy.
  • Decreased myocardial contractility.
  • Pulmonary hypertension and right ventricular failure.
39
Q

Clinical manifestations of acute AR

A

Severe dyspnea
Chest pain
Hypotension
Cardiogenic shock
Life-threatening emergency

40
Q

ar nursing assessment

A
  • Fever
  • Diaphoresis, flushing, cyanosis, clubbing, peripheral edema
  • Crackles, wheezes, hoarseness
  • S3 and S4
  • Dysrhythmias
  • ↑ or ↓ in pulse pressure; hypotension
  • Water-hammer or thready peripheral pulses
  • Hepatomegaly, ascites
  • Weight gain
41
Q

valvular heart disease diagnostic studies

A
  • Patient’s history/physical exam
  • CT scan of chest
  • Echocardiogram
  • Chest x-ray
  • ECG
  • Cardiac catheterization
42
Q

valvular heart disease: percutaneous balloon valvuloplasty

A
  • Post-procedure is similar to PCI.
  • Balloon-tipped catheter inserted via femoral artery.
  • Inflated to separate valve leaflets.
  • Watch for signs of systemic emboli, which may have dislodged from the valve.
43
Q

Valve Replacement mechanical

A

will require lifelong anticoagulants.
Coumadin
Maintain INR 2.0-3.0

44
Q

Valve Replacement biologic

A

will only require prophylactic anticoagulants for 3 months.

45
Q

health promotion valvular heart disease

A
  • All patients who have undergone valve surgery will require prophylactic antibiotics prior to invasive procedures and tests.
  • Includes dental procedures
  • Goal is to prevent infective endocarditis
45
Q

health promotion valvular heart disease

A
  • All patients who have undergone valve surgery will require prophylactic antibiotics prior to invasive procedures and tests.
  • Includes dental procedures
  • Goal is to prevent infective endocarditis

Med Surg 2 (35 decks)

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