VN 36 Cardiac pt.2 S.G 2 Test

Question 1

1. Infective endocarditis causes

Answer 1

 IV drugs & dirty needles (medical use, tattoos, body piercing)
 Valve replacement surgery (congenital heart defects too)
 Dental visits (oral surgery)
 Strep throat or Staph (infectious endocarditis)
 Pacemaker
> resistance 2 major abx

Question 2

1. Infective endocarditis manifestations

Answer 2

 Splinter hemorrhages
 Osler’s nodes (hands)
 Roth spots (eyes)
 Janeway lesions

Question 3

1. Infective endocarditis complications

Answer 3

 Stroke
 PE
 Splenomegaly

Question 4

1. Infective endocarditis client education

Answer 4

 Hx of endocarditis: let provider know (prophylactic abx will be started)
 Monitor for infections
 Complete antibiotic treatment
 Good dental care: brush 2x/day w/soft bristles, no flossing
 Central line care: sterile technique

Question 5

1. Infective endocarditis diagnostic tests

Answer 5

 Cultures
 Echo
 CBC
 Sed rate

Question 6

2. DVT preventions (DVT pp)

Answer 6

 Ambulation
 Passive exercises
 Increase fluids
 Compression stockings

Question 7

3. DVT complications

Answer 7

 PE

Question 8

4. DVT Manifestations

Answer 8

 Sudden SOB
 Chest pain/discomfort that worsens when taking a deep breath
 Feeling lightheaded/dizziness
 Fainting
 Rapid pulse
 Rapid breathing
 Coughing up blood

Question 9

5. Paradoxical BP expectations (pg.304)

Answer 9

 Pulsus paradoxus (during inspiratory phrases there is a > 10mm drop in systolic BP)
 Normally, the difference between the two is 4 to 5 mm Hg.

Question 10

6. Know normal PT value (lab value flashcard 18)

Answer 10

 10-12 seconds
 1.5 - 2.0 x the normal value (on heparin therapy)

Question 11

7. Rheumatic fever and rheumatic carditis pt. education

Answer 11

 Educate client to inform all providers that they’ve had Rheumatic fever (will most likely be given prophylactic abx)
 Educate on the importance of good hand washing (sterile technique)
 Bed rest

Question 12

8. Myocarditis nursing interventions/medical treatment (myocarditis PP)

Answer 12

 Treat the underlying cause & preventing complications
 Abx are prescribed if the infection microorganism is bacterial
 Bed rest, sodium restricted diet
 Cardiotonic drugs (diuretics, beta blockers, ace inhibitors, and ARBS)
 Corticosteroids (commonly used to treat viral myocarditis)

Question 13

9. Pericarditis manifestations

Answer 13

 Pain increases w/movement
 Friction rub (harsh sounding), fever
 Radiating substernal pain to left should neck, back, mid chest
 Increased pain in supine position
 Chest pain: “stabbing”
 Trouble breathing lying down
 Inspiration or coughing causes pain
 Overall feeling sick & weak
 Noticeable ST segment elevation

Question 14

10. Cardiac catheter education

Answer 14

(Preprocedural)
 NPO for 8hrs or more
 Asses for allergies to iodine & shellfish
 Check creatinine and BUN levels
 Assess & mark their distal pulses (dorsalis pedis, posterior tibial)

(Post procedure)
 Check for bleeding at the femoral artery
 Check the extremity distal to the insertion site for : pulse, capillary refill, color and temp
 Closely monitor vital signs every 15 mins for the 1st hr, then take them every 1hr for 4hrs
 Encourage client to increase intake of fluids to flush out contrast die
 Lay flat for 4-6hrs after
 If patient reports pain, tingling or numbness report to provider

Question 15

10.transthoracic echocardiography education

Answer 15

 Noninvasive procedure that takes up to 1hr
 Instruct client to lie supine, remain still & occasionally they will be asked to roll to the left side or hold their breath.

Question 16

11. Cardiomyopathy nursing interventions & assessment (Pg.303)

Answer 16

Interventions :
-high fowlers
-Administer oxygen, either continuously or when dyspnea or arrhythmias develop.
-Ensure that the client’s activity level is reduced and sequences any activity that is slightly exertional between periods of rest.

Assessment : ask patient if they’ve had anyone in the family die unexpectedly

Question 17

11. Cardiomyopathy client education (pg.303)

Answer 17

 Limit sodium & avoid beverages containing caffeine, which contributes to tachycardia.
 Stop using tobacco products because nicotine is a vasoconstrictor and cardiac stimulant.
 Stay within your level of exercise tolerance or stop activity immediately if dyspnea or chest pain develops.
 Restrict driving or operating equipment if syncope is a common symptom.
 Keep appointments for medical follow-up to evaluate the status of the disease and symptom control.
 Receive the pneumonia vaccine & yearly influenza vaccinations to avoid pulmonary complications that may compromise cardiopulmonary function.
 For female clients, seek co-consultation with a cardiologist and an obstetrician if pregnancy is desired.

Question 18

12. Buerger’s disease nursing interventions (pg.310)

Answer 18

 Take smoking hx
 Examine affected areas for redness, swelling & other color changes (cyanosis & mottling)
 Inspect the nails & skin for changes
 Assess temp above & below affected areas
 Monitor presence & quality of peripheral pulses
 Assess capillary refill.
 Meticulous wound care if ulcers are present

Question 19

12. Buerger’s disease client education

Answer 19

 Teach client self-care techniques & stress the importance of smoking cessation & performing prescribed exercises consistently.

Question 20

13. Clients at risk for effusion

Answer 20

(Pericardial effusion: too much fluid in the sac, often after trauma)
 Clients w/pericarditis
 Those who smoke & drink alcohol

Question 21

14. Cardiac tamponade manifestations

Answer 21

(Fluid compressing the heart)
 JVD w/clear lungs
 Heart sounds muffled (build up of fluid in the heart)
 Tachycardia & hypotension
> pulsus paradoxes