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Med surg 2 > Inflammatory Dysfunction and Valvular Dysfunction Focus > Flashcards

Inflammatory Dysfunction and Valvular Dysfunction Focus Flashcards

1
Q

what is mitral valve stenosis

A

Scarring of leaflets and chordae tendae decreasing blood flow from LA to LV increasing the pressure in LA

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2
Q

what is mitral valve regurgitation ss

A

loud holystolic murmur in LV, pulmonary edema, thready peripheral pulses

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3
Q

what could cause mitral valve stenosis

A

MI, ineffective endocarditis, chronic rheumatic heart disease, mitral prolapse

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4
Q

what is aortic valve stenosis

A

obstructive blood flow from LV to aorta which cause ventricular hypertrophy

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5
Q

what is the gold standard for diagnosing aortic valve disorders

A

CT scan with contrast

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6
Q

what does LV hypertrophy lead to

A

decreased cardiac output, pulmonary hypertension, HF

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7
Q

what meds prevent HF

A

vasodilators (nitrates, ACE), positive inotroped (digoxin), diuretics (furesimide, bumetanide), beta blockers (metoprolol)

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8
Q

what are the ss of chronic aortic valve regurgitation

A

asymptomatic for years
excertional dyspnea, angina, murmurs

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9
Q

what is the management/treatment of valvular heart disease

A

meds that prevent HF, sodium restriction less then 2 g, anticoagulants, anti dysrhythmias, prophylatic antibiotic (penicillin)

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10
Q

what is the teaching for when to seek medical care after someone gets a mechanical prosthetic

A

infection, HF, if going to have a procedure that requires penicillin

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11
Q

how much fluid can the pericardial space hold

A

10-15ml

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12
Q

what are the ss of mitral valve stenosis

A

congested lungs, exertional dyspnea, diastolic murmur, fatigue, palpitations

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13
Q

what do majority of mitral valve problems result from

A

rheumatic heart disease

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14
Q

when is surgery needed for aortic valve stenosis

A

when opening is 1cm or less

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15
Q

what is mitral valve regurgitation

A

mitral valve doesnt close properly causing back flow into the lungs

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16
Q

what are the ss of chronic mitral valve regurgitation

A

Asymptomatic for years until finally LV failure then weakness, fatigue, palpations, LA enlargement, ventricular hypertrophy

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17
Q

what meds are given for aortic valve stenosis

A

beta-blockers, diuretics, nitroglycerin (cautiously may make chest pain worse)

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18
Q

what is the most common valve issue

A

aortic valve stenosis - congenital

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19
Q

what are the ss of aortic valve stenosis

A

systolic murmur, LV failure triad (angina, syncope, exertional dyspnea)

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20
Q

what is a valvulotomy for and how does it work

A

for stenosis - takes dilator through top of LV into mitral valve opening and can remove clot

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21
Q

what is rheumatic heart disease and what is it caused by

A

caused by rheumatic heart fever = scaring and deformity of the heart valves

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22
Q

what is the therapeutic range for INR with a mechanical prosthetic

A

2.5-3.5 if not in range call doc

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23
Q

what are the ss of acute aortic regurgitation

A

LV failure, cardiogenic shock (angina, decreased BP, severe dyspnea) high pitched diastolic murmur

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24
Q

what is percutaneous transluminal balloon valvuloplasty and what is it used for

A

for stenosis, a balloon tipped catheter is taken up the femoral artery and inflated to open valve

25
Q

who normally gets a percutaneous transluminal balloon valvuloplasty

A

someone who is poor surgery candidate

26
Q

can you prevent rheumatic heart fever

A

if antibiotics started in time

27
Q

who is mostly at risk for getting rheumatic heart fever

A

young adults, under developed countries

28
Q

what is rheumatic endocarditis

A

swelling and erosion of valve leaflets

29
Q

what labs diagnosis rheumatic heart disease

A

elevated erythrocyte sedimentation rate, C-reactive protien

30
Q

when would someone need to take prophylactic antibiotic

A

any procedure effecting the mouth, infected skin, respiratory biopsy, or angioedema

31
Q

what could be some causes for pericarditis

A

acute mi, cancer, trauma, lupus, scleroderma, viral/bacterial infections

32
Q

what are the ss of pericarditis

A

pain worse with inspiration, pain decreased when sitting forward, fever, dyspnea, pericardial rub

33
Q

when listening for pericardial rub what should you ask your patient

A

to hold their breath so you can hear it better

34
Q

what are the meds of choice for pericarditis

A

NSAIDs, colchicine

35
Q

what is the treatment for cardiac tamponade

A

fluid bolus until someone can pull that fluid off

36
Q

what do you want to make sure you do before a pericadiocentesis

A

stop anticoagulants

37
Q

what are the ss of rheumatic heart disease

A

polyarthritis, carditis, nodules, heart enlargement, erythema marginatum (skin rash), sydenhams chorea (involuntary movement of muscles), prolonged PR interval

38
Q

how do you diagnosis rheumatic heart disease

A

ECHO to show heart valves, chest x ray to show heart enlargement, ECG to show prolonged PR interval

39
Q

what are the meds used for rheumatic heart disease

A

penicillin (erythromycin if allergic), inflammatory NSAIDs or corticosteroids, prophylaxis antibiotic until at least early 20s

40
Q

what do you see on an ECG for pericarditis

A

wide spread ST elevation

41
Q

what are some complications for pericarditis

A

pericardial effusions (build up of fluid), cardiac tamponade (fluid compressing the heart)

42
Q

what are the ss of cardiac tamponade

A

muffled heart sounds, narrowed pulse pressure, neck vein distention, decrease systolic BP on inspiration

43
Q

what is ineffective endocarditis

A

infection of inner heart layer including the valves caused by staph viridans or strep aureus, viruses, or fungi

44
Q

what are the risks for ineffective endocarditis

A

age, IV drug abuse, mechanical prosthetic, renal dialysis, rheumatic heart disease

45
Q

what labs would you take to diagnosis ineffective endocarditis

A

2 blood cultures from 2 different sites, WBC, elevated erythrocyte sedimentation rate, c-reactive

46
Q

what causes myocarditits

A

virues, bacteria, fungi, radiation, autoimmune

47
Q

how do you confirm myocarditits with diagnostic tests

A

endomyocardial biopsy in first 6 weeks following infection

48
Q

what are some interventions you can do for HF

A

elevate head of bed 30 degree or more, rest periods, quiet environment, decrease risk for infection

49
Q

what are the 3 main types of cardiomyopathy

A

dilated (degeneration of the heart), hypertrophic (LV hypertrophy), restrictive (ventricular is resistant to filling)

50
Q

what are the risks for cardiomyopathy

A

African Americans, male, middle age, genetics, alcoholism (if only cause is alcohol if they stop drinking the heart will heal)

51
Q

what is the treatment for cardiomyopathy

A

HF treatment, eventually a new heart

52
Q

what are the ss of ineffective endocarditis

A

new or worsening murmur, fever, chills, weakness, anorexia,

53
Q

what are the ss of vascular endocardititis

A

splinter hemorrhages on nails, petechiae, osler nodes on finger tips or toes, lesions of pas of fingers or toes

54
Q

how do you treat endocardititis

A

IV antibiotics for 4-6 weeks, repeat blood cultures every 24-48 hours, valve replacement if needed, Tylenol for fever

55
Q

what are the ss of myocardititis

A

7-10 days after viral infection, fever, fatigue, myalgias, pharyngitis, dyspnea, nv

56
Q

what is cardiomyopathy

A

group of disease that directly effect myocardial structure or function

57
Q

what are the ss of cardiomyopathy

A

fatigue, dyspnea, orthopnea, nv, anorexia, edema

58
Q

how do you diagnosis cardiomyopathy

A

ECHO, elevated NT-pBNP or BNP

Med surg 2 (12 decks)

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