Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nursing 2005: Clinical Pathophysiology > Nursing 2005: Cardiovascular Disorders (Part 2) Disorders of the Heart Wall > Flashcards

Nursing 2005: Cardiovascular Disorders (Part 2) Disorders of the Heart Wall Flashcards

1
Q

Pericardium

A
  • double walled membranous sac that
    encloses heart
  • Layers separated by a clear serous fluid
  • 30cc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Myocardium

A
  • cardiac muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Endocardium

A
  • internal lining

- composed of connective tissue and squamous cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Disorders of Pericardium

  1. Acute Pericarditis
A
  • acute (short term problem) inflammation of pericardium

- etiology unknown or infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the pathophysiology of pericarditis?

A
  • membrane becomes inflamed
  • roughened
  • exudate may form = fluid becomes thick, cloudy, bloody
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the clinical manisfestations of acute pericarditis?

A

a. chest pain
- d/t inflam
- sharp, abrupt, and radiates
- pain worsens with breathing and laying down
- leaning forward = takes pressure of lungs and is somewhat helpful

b. restlessness, anxiety

c. low grade fever
- d/t inflam

d. friction rub
- heard w/ stethoscope over heart
- sounds like sandpaper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 2 complications of acute pericarditis?

A

a. pericardial effusion

b. cardiac tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

a. Pericardial effusion

A
  • excess pericardial fluid
  • increase in fluid = pressure =
    • SOB
    • cough
    • inc resp rate
    • heart can’t beat as strongly
  • Can compress adjoining structures - pulmonary tissues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

b. Cardiac tamponade

A
  • effusion inc in size or occurs rapidly
    • a lot of fluid at one time
  • Fluid and pressure compromises heart’s ability to fill and empty
  • dec filling of heart, can’t expand
  • dec cardiac output

** dec R atrial filing -> dec ventricular filing -> dec stroke vol and cardiac output**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the s/s of acute pericarditis?

A
  1. pulses paradoxus
    - exaggeration of a normal due in systolic bp in inspiration
  2. muffled heart sounds
  3. poorly palpable pulses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the diagnostic tests for acute pericarditis? What are the results?

A
  1. EKG
    - P and R changes
  2. Echocardiogram
    - ultrasound of the heart
    - shows pericardial sac
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the types of treatment for acute pericarditis?

A

a. treat cause
- it’s acute

b. pain meds
- aspirin or antibiotics

c. pericardiocentesis
- if a lot of excess fluid
- stick needle in pericardial sac to take out fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is constrictive pericarditis?

A
  • chronic inflammation of pericardium
  • develops slowly
  • starts acutely, maybe from pericarditis
  • etiology unknown
    • associated with radiation, cancer, rheumatoid arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the pathophysiology of constrictive pericarditis?

A
  • fibrous scarring
  • pericardial layers adhere.
    • no more fluid so it sticks together
  • Encases heart in rigid shell
    • cardiac output dec
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are clinical manifestations of constrictive pericarditis?

A
  • same s/s of heart failure
    a. fatigue, weakness
    b. SOB on exertion
    c. exercise intolerance

d. edema (fluid)
- kidneys can’t filer blood which causes fluid retention

e. distention of jugular vein

f. hepatic congestion​
- in liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the diagnostic tests for constrictive pericarditis?

A

a. EKG
- inflam in heart
- t wave inversions
- a fib

b. Echocardiogram
- no fluid
- layers stick together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the types of treatment for constrictive pericarditis?

A

a. digoxin
- positive inotropic agent that inc contractility
- slows down HR
- inc filing of heart to inc cardiac output

b. diuretics
- inc urine output to dec fluid
- less preload on heart

c. Na restrictions
- dec water/fluid retention

d. surgery
- cut out part of pericardium to inc more during HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some additional facts about cardiomyopathy?

A
  • inherited
  • dominant gene in men
  • diagnosed in young adulthood
  • usually in active, athletic people
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the pathophysiology of dilated cardiomyopathy?

A
  • unknown

** heart chambers dilate= impaired pumping func = dec cardio output

  1. inflam and degenerarion of myocardial fibers that dec contraction func
  2. inc blood vol
  3. dec left ven ejection
  4. dec CO
    ex: pregnancy, alcohol abuse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the clinical manifestations of dilated cardiomyopathy?

A

a. fatigue​

b. edema
- peripheral: hands, ankles, feet

c. SOB
- blood isn’t pumping from left side of lungs

d. cough​

e. murmurs
- abnormal heart sounds and rhythms

f. dysrhythmias
- abnormal heart sounds and rhythms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What kind of diagnostic tests are done to check for dilated cardiomyopathy? What are the results?

A
  • CXR
    • shows enlarged heart
  • Echocardiogram
    • can measure the chambers of the heart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the types of treatment for dilated cardiomyopathy?

A

a. digoxin
- inc contractility

b. diuretics
- inc urine output to dec preload

c. vasodilators
- dec bp and easy for heart to pump

d. heart transplant
- only chance for cure
- 50% of heart surgeries is for this condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the patho for hypertonic cardiomyopathy?

A
  • myocardial hypertrophy without dilation
  • ** dec vol and obstruction = dec cardiac output
  • inc in myocardial tissue
  • Walls = hypertrophy
  • thick septum = small volumes
  • Hypertrophy also causes impaired relaxation.
  • Possible aortic outflow obstruction
  • strong contraction but dec in blood flow d/t lack of blood
24
Q

What are the clinical manifestations of hypertonic cardiomyopathy?

A
  • similar to dilated CMP = dec CO

b. syncope
- dizziness d/t dec cardiac output

c. angina
- chest pain d/t thick heart wall = more oxygen by coronary arteries

25
Q

What types of diagnostic tests are done? What are the results?

A

a. CXR
- chest X-ray

  • wont show diff, just enlarged heart

b. echocardiogram
- can see thick muscle and small vessels

26
Q

What are the types of treatments?

A

a. Beta blockers:
- meds to dec HR and dec contractility
- inc filling of ventricles and dec HR

b. antiarrythmics​
- control abnormal HR and rhythm
- keeps heart regular

c. Surgery
- take out part of heart muscle to inc chamber size = inc blood vol

26
Q

What are the patho to restrictive cardiomyopathy?

A
  • stiff muscle fibers
  • loss of compliance
  • Ventricles resistant to filling
    • a lot of pressure to fill ventricles
27
Q

What is additional info to restrictive cardiomyopathy?

A
  • scarring d/t radiation

- systemic coronary disease

29
Q

What are the clinical manifestations to restrictive cardiomyopathy?

A
  • similar to dilated CMP d/t dec CO
  • exercise intolerance
    • most common in restrictive because its worse
    • ventricles won’t fill even more
30
Q

What kind of diagnostic tests are done for restrictive cardiomyopathy? What are the test results?

A
  • CXR
    • enlarged heart
  • echocardiogram
    • small or normal sized heart chambers
31
Q

What type of treatment is used for restrictive cardiomyopathy?

A
  • treat the underlying cause
  • improve diastolic filling

a. digoxin
- dec HR to improve filing of heart

b. meds to dec SVR (systemic vascular resistance)
- diuretics
- anti hypertensive
- heart transplant

32
Q

Disorder of the endocardium

A. Infective endocarditis

A
  • infection of endocardium aka bacterial endocarditis

– development of lesions filled with microorganisms

Ex: staph

33
Q

What is the patho of infective endocarditis?

A
  • endocardium damage exposes basement membrane
    • prepositions valve issue
  • attracts platelets = thrombus.
  • Microorganisms adhere to endocardial surface.
    • through dental, IV drug use, skin infection
  • Vegetative lesions form, grow and cause valve dysfunction.Ex: blood clot, debri, “garden in heart”
  • Lesions can break apart =emboli
    – get lodged
    • hemorrhage
34
Q

What are the clinical manifestations of infective endocarditis?

A

a. fever

b. weakness, fatigue
- d/t infection and inflam

c. arthralgias
- back pain
- joint pain

d. splinter hemorrhages
- lodged in fingers
- make longitudinal lines in nail bed

e. petechiae
- red pin point lesions on skin and eyes

f. oslers nodes
- lesions on fingers and toes
- pea sized
- r/t micro emboli

g. Janeway lesions
- red painless lesions on palm of hands and feet

h. murmur
- damage of valves in chambers
- hear turbulence, irregular heart sounds

i. systemic embolization in organs​
- emboli can got to diff organs

35
Q

What are the diagnostic tests for infective endocarditis? What are the results?

A

a. blood cultures

b. WBC
- inc in WBC

c. echocardiogram
- see lesions on lining of heart and valves

36
Q

What are the treatments for infective endocarditis?

A

antibiotics:

  • long term
  • by IV for 4-6 weeks
  • multiple kinds
37
Q

B. Rheumatic fever

A

– inflammatory disease caused by delayed infection by group A beta-hemolytic strept.
- mainly with elderly because it was prevalent in the 60s, now its curable

  • scarring and deformity of cardiac structures -> RHD.
  • develop strept throat
  • not treated with antibiotics= RF = scarring = valve problems
38
Q

What is the patho to rheumatic fever?

A
  • inflam in skin, throat
  • RF = pharyngeal infection.
  • Delayed and Abnormal immune response to group A strept cell membrane antigen.
  • Antigens bind to receptors in heart as well as other parts of the body -> damage valves.
    • scarring = RH
39
Q

What are the clinical manifestations for rheumatic fever?

A

a. carditis
- inflam of heart
- heart murmur
- chest pain

b. polyarthritis
- inflam in joints

c. chorea
- disorder of CNS
- involuntary body movements
- fixed with treatment

d. erythema marginatum
- red rash in abdomen
- worse with heat

40
Q

What are the diagnostic tests for RF?

A

a. throat culture​
- look for strept

b. anti-streptolysin O titer
- exposure to strept

c. WBC
- inc

d. echocardiogram
- to look at valve function
- if closing properly

41
Q

What are the types of treatment for RF?

A

a. antibiotics
- to clear stept but damage of RF

b. aspirin
- dec inflam and clots from developing

c. cardiac drugs
- improve contractility of heart
- depends how severe

d. surgical repair of valve
- to repair valve if that damaged

42
Q

Valvular Disease

  • 2 types
A
  • d/t endocarditis and RH
  • left side of heart = more problems
  1. Stenosis
    - valve opening constricted
    • narrow valves
  • hypertrophies
    • valves gets bigger because pumping blood though little opening
  1. Regurgitation:
    – valve doesn’t close all the way = leaking valve
  • allows blood to flow in reverse -> inc volume
  • hypertrophy and dilation of chamber d/t getting more blood to put out and get in
43
Q

Types of vavluar disease:

1. What is the patho for Aortic Stenosis

A
  • results in obstruction of flow from L ventricle to aorta
  • L ventricle must pump harder -> hypertrophy -> inc O2 consumption
  • congenital disorder
  • found when younger
  • develops slowly = obstruction of flow from left ventricle
  • pumps harder to get blood through aortic valve = hypertrophy
  • inc myocardial oxygen consumption = angina
44
Q

What are the clinical manifestations for aortic stenosis?

A
  1. dec HR
    - d/t less blood
  2. dec SBP
    - less blood being pumped out
  3. dec stroke volume
    - <70 cc of blood vol
    - dizziness
  4. systolic murmur
    - can hear a longer or extra sound in heart
  5. angina
    - needs more oxygen
45
Q
  1. What is the patho of aortic regurgitation?
A
  • caused by heart disease, HTN, syphilis
  • valve does not close -> retrograde blood flow from ascending aorta into Left ventricle
  • Volume overload.
    • blood from L atrium and aorta
  • Left ventricle dilation and hypertrophy.
  • Dec contractility d/t it’s getting overworked
  • blood backs up into pulmonary system = goes into the lungs
  • Can lead to Right ventricle failure
46
Q

What are the clinical manifestations of aortic regurgitation?

A
  1. inc in stroke volume
    - early on because blood from both directions
    - strong, throbbing pulses
  2. murmur
    - from not closed valves
  3. S&S of heart failure
    - d/t blood back up in left ventricles with makes right side work harder
47
Q
  1. What is the patho of mitral stenosis
A
  • narrowing and fibrosis of valve

– obstruction causes incomplete emptying of L atrium = atrium enlarges

  • inc L atrial pressure/volume - > pulmonary congestion
  • CO and stroke volume dec
    • d/t less filling of left ventricle
  • L atria hypertrophy
  • d/t endocarditis, heart disease
48
Q

What are the clinical manifestations of mitral stenosis?

A
  1. pulmonary congestion
    - d/t blood backup into lungs
    - SOB
  2. palpitations
    - abnormal heart rate d/t change in size of atria
  3. diastolic murmur
  4. fatigue, weakness
    - dec cardiac output
49
Q
  1. What is the path of mitral regurgitation?
A

Ex: RH, congenital, coronary heart disease

  • backflow of blood from L ventricle into L atria and right side of heart
  • L atria dilates due to inc volume
  • L ventricle dilates
  • hypertrophies to maintain CO
  • L ventricle fails d/t backup of blood
    • then right side fails
50
Q

What are the clinical manefestation of mitral regurgitation?

A
  1. fatigue, weakness, palpitations

2. systolic murmur

51
Q

What re the types of diagnostic tests for mitral regurgitation?

A

a. CXR​
- can see enlargement of heart and valves

b. EKG
- look for damage to heart
- ischemia

c. echocardiogram
- see valves
- measure it

d. cardiac catheterization
- insert catheter into femoral artery to measure pressure of heart

52
Q

What are the types of treatment for mitral regurgitation?

A

a. digoxin
- inc contractility to inc cardiac Output

b. vasodilators
- dec after load

c. diuretics
- dec vol of blood
- dec fluid retention

d. anticoagulants
- prevent clotting

e. antiarrhythmics
- to normalize HR

F.surgery

  1. Balloon valvuloplasty
    - stretch valves= stenosis
    - good for elderly
  2. Repair placement
53
Q

What is the patho for mitral valve prolapse?

A
  • failure of one or both valves leaflets to fit together
  • Usually benign
  • can lead to mitral regurgitation and inc risk of endocarditis
54
Q

Additional info for mitral valve prolapse

A
  • most common valve disorder in women 8x more
  • can live with it for years w/o problems
  • dangers = infection d/t damage of valve
55
Q

What are the clinical manifestations for mitral valve prolapse?

A
  • murmur​

- dysrhythmias

56
Q

What types of treatment is prescribed for mitral valve prolapse?

A

a. antibiotics prophylactically

b. meds to control palpitations

Nursing 2005: Clinical Pathophysiology (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions