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Med surg 2 > Test 2 > Flashcards

Test 2 Flashcards

1
Q

What is infective endocarditis?

A

an infection of the endocarditis the most inner layer of the heart this includes the valves

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2
Q

What valves does infective endocarditis usually affect?

A

Aortic and mitral

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3
Q

What are the classifications for endocarditis 3

and two more ways to classify

A

IV drug use, Fungal, or at site

Acute and subacute

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4
Q

What bacteria are responsible for IE and how do they work

A

Strep viridans, and staph aureus

make a biofilm that protects them

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5
Q

What are the risk factors for IE 9

A

Heart damage, marfan syndrome, pacemaker, prostethtic vavles, mitral valve regurg, rheumatic heart disease, dialysis, IV use, age

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6
Q

What are vegetations and what disease are they associated with and one concern

A

fibrin, leukocytes, platelets, microbes IE can cause embolism

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7
Q

What can IE cause 2. to remember

A

sepsis and heart block

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8
Q

Manifestations with IE general with 3 things

A

General dont feel well low grade fever is the biggest

systolic murmur

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9
Q

Subacute form of IE s/s 8

A

arthalagias and myo back pain ab discomfprt weight loss HA clubing fingers

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10
Q

Vascular manifestations with IE 5

A

Splinter hem, petechiae, osler nodes-PAINFUL raised legions on hands and feet, janeways roth spots

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11
Q

What to look for in hx for patient with IE and what is the time frame 6

A

3-6 months

IV stuff, dental work, downstairs procedures, recent cath lab, infections of skin resp or urinary, dialysis

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12
Q

Diagnositics for IE 8

A

Keep neg cultures for 3 weeks transesoph echo to see veg, EKG for av block, cath for valve function, reg echo. mild leukocytes, erythrocyte sedementaiton and crp increased

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13
Q

criteria for IE diagnosis

A

2 of the following, positive culture, new or changed murmur, mass or vegetationon echo

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14
Q

tx for IE

A

antibiotics for 4-6 weeks IV antibiotics

heart compensation people need to prophylactically tx with any incision, infection, uti

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15
Q

What causes acute pericarditis?
Examples for infection-
non infection
autoimmune

A

infections (limes) noninfection- radition trauma autoimmune- rheumatic fever, rhem arth, systemic lupus, sclerosis

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16
Q

Acute pericarditis s/s 6

A 
severe sharp chest pain- worse when laying down or with inspiration relieved by sitting up and forward 
pericardial friction rub
angina like pain
dyspnea
fever
anxiety
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17
Q

Complications of pericarditis with examples

A

effusion-couch, tachy hickups

cardiac tamp-confused, anxious, becks (Low art BP, DNV, muffled heart sounds)

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18
Q

Diagnostics for Acute pericarditis 5

A

WIde spread ST elevation or depression, cardiomegaly, increase crp, esr and leukocytosis

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19
Q

Tx for acute pericarditis

A

Antibiotics pericardial centesis

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20
Q

Rheumatic fever and rheumatic disease

A

inflam disease from abnormal immune response to group A strep after about 3 weeks affects skin, joints, cns

chronic scaring and deformity of heart valves vegetations

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21
Q

Manifestations of rhematic fever 7

A

Erythemia marg, arthritis, carditis, subcut nodules, sydenhams chorea, increase in esr and cpr prolonged PR,

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22
Q

What is the most common thing that rheumatic fever will lead to

A

mitral valve stenosis or other valve disease

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23
Q

2 things about RF

A

Antibiotics for 5 yrs maybe life and assess for pulmonary edema and clear lung sounds

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24
Q

patho of MV regurg and major risk

A

LV thickens, LA enlarges, blood backs up to lungs, makes heart work harder,
cardiogenic shock

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25
Q

S/s of pulmonary edema

A

Cool, clammy, pink frothy speutum, s3

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26
Q

s/s of mitral valve regurg 6

A

Thready weak pulse, new holostolic murmur, signs of left vent fail, and peripheral edema, PVC, nitro dosent work

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27
Q

Tx of mitral valve regurg

A

valve repair

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28
Q

Marfins syndrome risk for

A

IE and mitral valve prolapse

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29
Q

TX for mitral valve stuff

A

Beta blockers, keep hydrated, exercise, avoid caffeine or stimulants, if symptomatic-valve surg

30
Q

Aortic valve stenosis and adults vs kids

A

Generally found in kids. If found in adults it is due to deterioration or RF ( if associated with mitral valve)

31
Q

Complications of aortic valve stenosis

A

dec co, pulm hypertn, heart fail

32
Q

Symptoms of aortic valve stenosis and one thing to remember

A

(SAD) Angian, syncope, exertional dyspnea, soft systolic murmur
Dont use nitroglycerin

33
Q

Aortic Valve regurg caused by

A

Syphalyis, connective tissue disorder, post surg

34
Q

Manifestations 1 acute

and 3 others aortic regerg

A

Sudden vascular colapse
hammer pulse
soft or absent s1
diastolic murmur

35
Q

TAVR vs TMVR

A

TAVR- with cath lab and or

TMVR for those who cant have surg and have a long expected life

36
Q

How do we treat heart fail 3 drugs you really need to know

A

vasodilators, positive intropes, adrenergic blockers, diuretics, low sodium diet

37
Q

how do we measure if someone should get a replacement or a repair?

A

New YOrk assosiation calssification for functional disability

38
Q

Acid base numbers

A 
Ph 7.35-7.45
Paco2-35-45
Pa02- 80-100
HCO3-22-26
spo2 above 95
39
Q

s/s of respiratory acidosis 7

A

skin pale, HA, Hyperk, Dysr, drowsiness, mm weaknees, hyperreflexia

40
Q

s/s of repiratiory alk 9

A

tachy, low to normal bp, hypok, numbness and tingling, hyper reflexes, mm cramping, seixures, anxiety, tremmors,

41
Q

MEtabolic acidosis 8

A

HA, hyper k, mm twitching, warm flushed skin, NV, decreased mm tone, decreased reflexes, kussumal

42
Q

Metabolic acidosis s/s 9

A

confusion, dysr, dizzy, n/v/d/ seixures, tremors, mm cramps, tingling, decreased ca

43
Q

Cardiogenic shock diastolic vs systolic

A

d-heart cant fill s-heart cant pump

44
Q

What is the most common cause of a systolic cardio shock what are the others? 5

A

MI cardiomyopathy, blunt cardiac injury, systemic or pulmonic HTN =, medibolic problems like diabetes

45
Q

Patho behind diastolic cardioshock

A

increase pulm pressure increase edema decrease o2

46
Q

causes of diastolic cardio shock 6

A

cardiac tamp, vent hypertrophy, cardiomyopathy, brady or tachy, valve issues tension pneumo

47
Q

what are the stages of shock give examples in each

A

initial- no signs lactic acid , compensatory signs, decrease in bp blood shunts , progressive-changes in mental status edema, organs start to fail , refractory organs fail

48
Q

some risks you did not know about pulmonary emboli2

A

Oral contraceptives, hormone therapy

49
Q

s/s of PE 3

A

Cough, crackles, wheezing, fever,

50
Q

complications from PE 2

A

Abcess, pleural effusion,

51
Q

Best test for PE

A

CT

52
Q

What is the movement with fillet chest?

A

Paradoxical

53
Q

What is a spontaneous pneumo

A

Rupture of blebs on surfece of lungs- little air sacs

54
Q

What is a tension pneumo and one thing about it

A

air can get in but not out

EMERGENCY

55
Q

Where does a chest tube go in?

A

4th or 5th space anterior to midaxil

56
Q

how is tube secured in chest tube

A

Heavy no absorbant sutur

57
Q

What to wrap chest tube in

A

petrolium gauze and sponge gauze

58
Q

What is suction on for chest tube?

A

80

59
Q

Submurge in how much water for chest tube

A

250ml

60
Q

Aortic an measurement for surg

A

5.5 or bigger

61
Q

s/s for AA 6

A

Low back pain, mild heart fail, dyspnea, edema, blue areas, bruit

62
Q

What is the best diagnostic for AA

A

CT scan

63
Q

EVAR proceedure

A

For AA shorter hospital stay, graft, must have ct rest of life

64
Q

What is cardiomyopathy 3 types

A

disease that affects myocardial structure or finction

dilation, hypertrophic, restrictive

65
Q

Dilatercardiomyop and biomarkers

A

consistant with heart fail but cath lab rules it out

66
Q

7 things about cardiomyopathy dilations

A

follows IE, maybe autoimmune, inflammation and deterioration of mm fibers=vent dilation, blood stasis
causes megaly and contractile dysfunction but no hypertrophy in walls

67
Q

S/s od dilated cardiomyop

A

dry cough, palp, ab bloating, abnormal s1 or s4

68
Q

5 about cardiomyopathy and hypertorpic

A

LV hypertrophy without dilation, septum inbeteween vents can enlarge and block blood flow
happens in young healthy people
use echo

69
Q

restirictive cardiomyopathy 3

A

impairs filling and stretch, stiff walls, can cause pulm issues including effusion

70
Q

What is something to teach someone with cardiomyop 2

A

CPR for family members, no drinking

Med surg 2 (18 decks)

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