NUR 240 ch 24 Management of Patients with Structural, Infectious, and Inflammatory Cardiac Disorders

Question 1

Regurgitation

Answer 1

The valve does not close properly, and blood backflows through the valve

Question 2

Stenosis

Answer 2

The valve does not open completely, and blood flow through the valve is reduced,
NARROWING (Loud when assessing)

Question 3

valve prolapse

Answer 3

The stretching of the valve leaflet into the atrium during systole

Question 4

cardiomyopathy

Answer 4

a series of progressive events that culminated in impaired cardiac output

Question 5

types of cardiomyopathy

Answer 5

dilated cardiomyopathy (DCM)
Hypertrophic cardiomyopathy (HCM)
Restrictive/constrictive cardiomyopathy (RCM)
Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D)
Unclassified cardiomyopathy

Question 6

what is the main electrolyte involved in cardiomyopathy

Answer 6

sodium

rationale:
cardiomyopathy often leas to heart failure with develops in part from fluid overload. fluid overload is often associated with elevated sodium levels

Question 7

cardiomyopathy leads to

Answer 7

low cardiac output leading to reduce amount of oxygen supply

Question 8

secondary cardiomyopathy

Answer 8

normally due to HTN or valve disease

Question 9

Renin Angiotensin aldosterone system (RAAS)

Answer 9

kidneys hold on to fluid increasing BP

Question 10

early symptoms of hypoxia (low O2)

Answer 10

restlessness and agitation

Question 11

assessment of patient with cardiomyopathy

Answer 11

history (family history, risk factors)
chest pain
presence of orthopnea or syncope
review of diet
physical assessment: VS, pulse pressure; pulsus paradoxus; weight gain or loss; PMI; murmurs; S3 or S4; pulmonary auscultation for crackles, JVD, and edema

Question 12

nursing intervention for patient with cardiomyopathy

Answer 12

improve cardiac output and peripheral blood flow
- rest, positioning (legs down), supplemental O2, medications, lows NA diet, avoid dehydration

Question 13

infective endocarditis

Answer 13

is a microbial infection of the endothelial surface of the heart

rare and up to 40% of die within 1 year of diagnosis

Question 14

risk factors for infective endocarditis

Answer 14

Prosthetic cardiac valves or prosthetic material used for cardiac valve repair

*Implanted cardiac devices (e.g., pacemaker, implanted cardioverter defibrillator)

*History of bacterial endocarditis (even without heart disease)

*Congenital heart disease:
- Unrepaired cyanotic disease, including patients with palliative shunts and conduits
- Repaired with prosthetic material or device either by surgery or catheter intervention during the first 6 mo after the procedure
- Repaired with residual defects at the site or adjacent to the site of a prosthetic patch or device

*Cardiac transplant recipients with valvulopathy

*IV drug abuse

*Body piercing (especially oral, nasal, and nipple), branding, and tattooing

*Hemodialysis

Question 15

primary presenting symptoms of endocarditis are

Answer 15

fever and heart murmur

others: clusters of petechiae, small painful nodules on pads of fingers and toes, Irregular, red or purple, painless flat macules (Janeway lesions) may be present on palms, fingers, hands, soles, and toes. Hemorrhages with pale centers (Roth spots) caused by emboli may be observed in fundi of the eyes. Splinter hemorrhages (i.e., reddish-brown lines and streaks) may be seen under the proximal half of fingernails and toenails. Petechiae may appear in conjunctiva and mucous membranes.

Question 16

Rheumatic endocarditis

Answer 16

Occurs most often in school-age children after group A beta-hemolytic streptococcal pharyngitis; need to promptly recognize and treat “strep” throat to prevent rheumatic fever

Question 17

pericarditis

Answer 17

inflammation of the pericardium

leads to an accumulation of fluid in the pericardial sac (pericardial effusion) and increase pressure on the heart leading to cardiac tamponade

Question 18

signs and symptoms of pericarditis

Answer 18

chest pain, creaky or scratchy friction rub heard (mostly at left lower sternal border), mild fever, increased WBC, anemia, and elevated ESR, nonproductive cough or hiccup , dyspnea

Question 19

myocarditis

Answer 19

an inflammatory process involving myocardium, can cause heart dilation, thrombi on the heart wall, infiltration of circulating blood cells around the coronary vessels and between the muscle fibers, and degeneration of the muscle fibers

Question 20

signs and symptoms of myocarditis

Answer 20

fatigue, dyspnea, syncope, palpitations, and occasional discomfort in the chest and upper abdomen
most common symptoms are flulike

Question 21

medical management of myocarditis

Answer 21

patients are placed on bed rest to decrease cardiac workload