T4: Pericarditis & Cardiomyopathy Flashcards
aneruysm
a localized weak spot or balloon-like enlargement of the wall of an artery
Aortic dissection
diagnosis in which the arterial wall splits apart/bursts
pericarditis
*an inflammatory process of the pericardial sac
in pericarditis the pericardial sac contains how much serious fluid
10 to 15 mL
The pericardium serves as
an anchoring function and provides lubrication to decrease friction between heart contractions
HINT HINT main s/s of pericarditis
They have chest pain and you hear GRATING SOUND OF FRICTION RUB
positioning for client with pericarditis
do not lay the patient down HOB UP and give O2
HINT HINT what is the cardinal sign we see on a cardiac monitor for pericarditis
ST elevation in all 12 leads
pericardial centesis
The draining of fluid from the pericardium through needle and test the fluid
we treat pericarditis like its…
bacterial (with antibiotics) until proven other wise
common causes of pericarditis
INFECTION, renal failure, trauma, RF, MI, myxedema, aortic aneurysm. lupus
clinical manifestations of pericarditis
-severe sharp chest pain
pain radiate to neck arm or L shoulder
-PERICARDIAL FRICTION RUB
Cardiac tamponade
pressure/compression on the heart caused by fluid in the pericardial space
Pericardial Tamponade
filling of the pericardial sac with fluid, which in turn limits the filling and function of the heart.
Care for pericarditis
*Antibiotics to treat bacterial pericarditis
*NSAIDS
*Corticosteroids
*Pericardiocentesis
*Pericardial Window for persisting fluid or tamponade
management for pericarditis
*Management of pain and anxiety
*Client on bedrest with head of bed 45degrees
*Administer medications as ordered.
position for pericardiosentesis
FLAT so heart falls back, sedation if at all possible
Infective Endocarditis
inflammation of the endocardial layer of the heart, including the heart valves
causes for infective endocarditis
*Bacterial most common
*Viruses
*Fungi
*Categories of high, moderate, and low risk of developing IE
-iv drug abuse
principal risk factors for infective endocarditis
*Prosthetic valves
*Hemodialysis
*IV drug abuse (IVDA)
vegitation
*Fibrin, leukocytes, platelets, and microbes
*Stick to the valve or endocardium
if a vegitation breaks off and enters into circulation…
*Left-sided vegetation can move to brain, kidneys, spleen
*Right-sided vegetation can move to lungs (PE)
clinical manifestations of infective endocarditis
- may be acute, subacute, or chronic
- fever
- weakness, fatigue, weight loss
- new or changed murmur
- petechial lesion of the skin, conjunctiva and oral mucosa
- osler nodes: painful erythematous nodules on the pads of the fingers and toes
- janeway lesions: non painful hemorrhagic lesions on the palms and soles
-roth spots
-s[linter hemorrhage in nail beds
management for infective endocarditis
*Prophylactic antibiotic treatment for select patients having dental or other procedures
*Accurate identification of organism
*IV antibiotics (long-term)
*Repeat blood cultures
*Valve replacement if needed
*Antipyretics
*Fluids
*Rest
assessment for infective endocarditis
*Weight changes
*Chills
*Hematuria
*Exercise intolerance, weakness, fatigue
*Cough, DOE, orthopnea, palpitations
*Night sweats
*Pain, headache, joint, or muscle tenderness
*Arthralgia and myalgias
*Petechiae, purpura
*Osler’s nodes
*Splinter hemorrhage
*Janeway’s lesions
cardiomyopathy
the term used to describe all diseases of the heart muscle, DECREASE CO BECAUSE HEART ISNT WORKING WELL
diagnoisis for cardiomyopathy
Electrocardiogram
* b-Type natriuretic peptide (BNP)
* Chest x-ray
* Echocardiogram
* Nuclear imaging studies
* Heart catheterization
* Endomyocardial biopsy
clinical manifestations of cardiomyopathy
progresses to HF
*Decreased exercise capacity, Fatigue
*Dyspnea at rest and PND and Orthopnea
*Dry cough
*Palpitations
*Abdominal bloating, hepatomegaly, JVD
*S3, S4, murmurs
*Dysrhythmias
*Pulmonary crackles
*Edema
*Weak peripheral pulses
*Pallor
drug therapy for cardiomyopathy
- Nitrates (except in hypertrophic CMP)
- β-Blockers
- Antidysrhythmics
- ACE inhibitors: drop BP
- Diuretics
- Digitalis (except in hypertrophic CMP unless used to treat atrial fibrillation)
- Anticoagulants (if indicated)
surgical intervention fr cardiomyopathy
- Ventricular assist device
- Cardiac resynchronization therapy
- Implantable cardioverter-defibrillator
- Surgical repair
- Heart transplantation
- Cardiac rehabilitation
- Palliative and hospice care
