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410 Patho Exam 3 > Valve disease & Cardiac Inflammatory conditions > Flashcards

Valve disease & Cardiac Inflammatory conditions Flashcards

1
Q

5 questions on inflammatory and valve disease on exam 3

A
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2
Q

what is the pericardium ?

A

protect the heart, it covers the heart

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3
Q

what does pericarditis mean ?

A

inflammation of the pericardium causing pericardium to be less elastic and compress the heart

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4
Q

what is pericarditis mainly caused by ?

A

bacteria or virus

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5
Q

pericarditis is often progressive, frequent severe chest pain but worsen when ?

A

inspiration and when lying flat
( deep breath and learning forward )

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6
Q

why do you think patients who have pericarditis avoid taking deep breaths and leaning forward?

A

youre filling your chest, which puts pressure on the heart

and when you lean forward, heart moves and rubs against your chest wall

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7
Q

what are some clinical manifestations of pericarditis ?

A

dyspnea
fever - its an infection
chills
fatigue

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8
Q

what are you going to hear in pericarditis ?

A

pericardial friction rub

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9
Q

if pericarditis is chronic, you may have what ?

A

right ventricular failure - goes into the pitting edema

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10
Q

how do we manage pericarditis ?

A

high fowlers
blood culture - infection
oxygen

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11
Q

what is the medication for pericarditis ?
and why ?

A

NSAIDS or steroids
- this an inflammatory conditions

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12
Q

what is cardiac tamponade?

A

the entire heart fills up with fluid, remember its like drowning

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13
Q

cardiac tamponade is an emergency, so what are some procedures we are going to do in order to help aid all the fluid build up ?

A

pericardiocentesis
pericardial window
pericardectomy

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14
Q

when youre listening for heart sounds, what is it going to sound like in a patient with cardiac tamponade?

A

muffled heart sounds

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15
Q

what are some medications we are going to give to patients with cardiac tamponade ?

A

NSAIDS

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16
Q

what is infective endocarditis ?

A

disease of the endocardium, including the heart valves - usually aortic and mitral

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17
Q

how does infective endocarditis come to be?

A

bacteria enters blood stream, adheres to endocardium and valves, with previous damage and develops into vegetation which can become emboli

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18
Q

left sided vegetation can move to where ?
for infective endocarditis

A

brain, kidneys, spleen

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19
Q

right sided vegetation can move to where?
for infective endocarditis

A

lungs (pe)

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20
Q

notes
some risk factors for infective endocarditis
- age
- prosthetic valves
- hemodialysis
- iv drug abuse
- iv access/infection
-hemodialysis

tongue piercing !

A
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21
Q

what are some clinical manifestation of infective endocarditis ?

A

clubbing - chronic
fever
chills
weakness
malaise
back pain
weight loss

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22
Q

typically in patients who have infective endocarditis, typically you will hear a new or worsening what?

A

systolic murmur

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23
Q

if infective endocarditis is not treated, they may end up getting what?

remember think of how the vegetation plays a part in the body

A

heart failure

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24
Q

what are some manifestations secondary to septic embolism we can potentially see in a patient with a infective endocarditis ? (4)

josr!!

A

splinter hemorrhages in nail beds
( black longitudinal streaks )

osler nodes on fingertips or toes
( painful, red pea size lesson )

janeways lesions on pads of the fingers/toes
( flat, red spots )

Roths sports
( retinal lesions )

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25
Q

what are some diagnostic studies for patients who have infective endocarditis ?

A

history
blood cultures
fluids
rest
valve replacement

26
Q

typically the end treatment for patients who have infective endocarditis is to give them what?

additional information
if you are having procedures, you need to give antibiotics before hand because the risk of progressive disease is at risk

A

prophylactic antibiotics treatment

27
Q

nursing assessment notes
Objective data

Fever
Osler’s nodes
Splinter hemorrhage
Janeway’s lesions
Petechiae, purpura
Peripheral edema, clubbing
Tachypnea, crackles
Dysrhythmia, tachycardia, murmurs, S3, S4
Retinal hemorrhages

A
28
Q

nursing diagnosis notes

Decreased cardiac output
Activity intolerance
Hyperthermia
Impaired comfort
Knowledge deficit

nursing management notes

Assess for risk factors and physical evidence
Patient will be on IV antibiotics for weeks
Teach patient to rest
DVT prophylaxis-compression stockings, ROM,
Prevent atelectasis: turn, cough, deep breathe Q2 hours
Patient to monitor temperature, look for signs of complications, finish antibiotic treatment

A
29
Q

what is rheumatic fever and caused by?

occurs ____(when) after____(what)

how do we prevent rheumatic fever?

A

acute inflammation of the heart resulting from group a stream infection

2-3 weeks after strep infection

proper treatment of strep infections

30
Q

what is rheumatic heart disease ?

what is the treatment for this and for how long?

A

chronic scarring and deformity of the heart valves

5 years and may need lifelong prophylaxis

31
Q

valve disease section time !

A
32
Q

you can have two types of valve conditions, which are?

A

stenosis
regurgitation or insufficiency

33
Q

what does stenosis mean ?

A

valve are stiff and do not open easily

( think a set of doors that sticks and must be pushed hard to open )
openings are smaller

34
Q

what does regurgitation or insufficient mean ?

A

valve do not close completely

35
Q

how does blood flow work for each
stenosis
regurgitation or insufficiency

A

forward blood flow
backward blood flow

36
Q

she mentions how we need to know the valve locations and where it is to listen to
before we do that what are the 5 valves ?

A

aortic
pulmonary
erbs point
tricupsid
mitral

37
Q

now give me the landmark location to where we are going to need to know where to listen to

aortic
pulmonary
erbs point
tricuspids
mitral

A

2nd intercostal space to the right sternal border

2nd intercostal space to the left sternal border

3rd intercostal space to the left sternal border

4th intercostal space to the left sternal border

(apex), 5th intercostal space, midclavical line
(point of maximum impulse)

38
Q

between stenosis and regurgitation or insufficiency, which one is worse and why ?
and why

A

stenosis
- because its very hard for the blood to even move

compared to insufficiency
- because it is at least moving, but just moving backwards

39
Q

mitral valve stenosis goes from the what ?

A

left atrium to left ventricle

40
Q

what is the most common cause for rheumatic heart disease ?

A

mitral valve stenosis

41
Q

what is the result from mitral valve stenosis?

A

decreased blood flow from left atrium to left ventricle, blood can back up into pulmonary vasculature

42
Q

so with mitral valve stenosis, we understand that the blood from the left atrium and left ventricle is decreased causing what to increase and putting risk of getting ?

A

increased in left atrial pressure/volume
increase in pulmonary vasculature

atrial fibrillation

43
Q

what is the most important clinical manifestion for patient who have mitral valve stenosis ?

A

exertion dyspnea due to decreased lung compliance

44
Q

what is mitral valve regurgitation ?

A

when the mitral valve doesn’t close completely

45
Q

what are some examples/causes of mitral valve regurgitation ?

A

myocardial infarction
chronic rheumatic heart disease
mitral valve prolapse
ischemic papillary muscle dysfunction
infective endocarditis

46
Q

what is some acute mitral valve regurgitation clinical manifestations?

remember with acute, the valve is not closing properly, so instead the blood is going backwards, so the patents are going to end up with ?

A

therady peripheral pulses
tachycardia
pulmonary edema - crackles - frothy

47
Q

if we do not fix mitral valve regurgitation, what time of shock can they develop ?

A

cardiogenic shock

48
Q

what are some chronic mitral vital regurgitation clinical manifestions ?

A

left ventricular failure after a long time

  • weakness, fatigue, palpitation
49
Q

what is the treatment of mitral value regurgitation ?

A

fix the valve

50
Q

what is mitral valve prolapse?

A

abnormality of mitral valve leaflets allowing leaflets to prolapse back into left atrium during systole

  • they can close, but they aren’t in the space where its suppose to be
51
Q

most of the time people who have mitral valve prolapse dont have what?

A

symptoms

52
Q

how are we going to manage mitral valve prolapse ? (3)

A

antibiotics
beta blockers - help with chest pain
avoid stimulants

53
Q

the aortic valve goes from you ___to your ?

A

left ventricle to your aorta

54
Q

what is aortic valve stenosis ?

A

obstruction of blood flow from left ventricle to aorta

55
Q

aortic valve stenosis clinical manifestations ?

A

angina
dyspnea on exertion
syncope on exertion

56
Q

aortic valve insufficiciency manifestion?

A

dysonea
fatigue
angina

57
Q

remember stenosis aortic is an emergency and needs to be fixed

insufficiency can be delayed

A
58
Q

what are some diagnostic things we can do?

A

ct scan
echocardiogram
cardiac catherterization

59
Q

with aortic valve stenosis, we want to avoid giving nitroglycerin because why ?

A

reduces preload and blood pressure
can worsen chest pain

60
Q

what are some medications we are going to give to aid aortic problems ?

A

vasodilators
positive inotropes
diuretics
beta blockers
sodium restriction
anticoagulation therapy
antidysrhythmias

61
Q

what is a procedure we can do for valvular heart disease ?

A

percutaneous transluminal ballon valvuloplasty

62
Q

if we can’t repair the valve, we have to replace it.

mechanical (artifical)
last longer, requires anicoagulations
development of clot

biologic (tissue)
bovine (cow)
porcine(pork)
human

no anticoagulation is needed, only last 10 years

A

410 Patho Exam 3 (5 decks)

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