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sav 331 > w3 acquired heart disorders > Flashcards

w3 acquired heart disorders Flashcards

1
Q

which acquired cardiac disorders are the exceptions to no ASA given to kids

A

RF and kawasaki

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2
Q

which acquired cardiac disorders:

Inflammatory process resulting from infection of the valves and inner lining of the heart. Organisms enter bloodstream, grow on endocardium, cause localized infection, causes thrombi/emboli

A

Bacterial (infective) endocarditis (BE)

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3
Q

patients at high risk for developing BE:

A

history of BE

artificial heart valves, repaired defect, heart transplant

CHD

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4
Q

causes of BE:

A

CHD

High risk pt has dental procedure, surgery, intracardiac lines

Strep, staph, or fungi

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5
Q

pt c/o of
- joint pain
- Janeway spots
- Osler nodes
- Splinter hemorrhages under nails
- new or changing heart murmur

which acquired cardiac disorders:

A

BE

  • low grade intermittent fever
  • anorexia
  • malaise
  • weight loss
  • joint pain
  • positive blood cultre
  • new or changing heart murmur
  • Petechiae - tiny, flat spots of bleeding that appear under the skin or mucous membranes
  • Janeway spots
  • Osler nodes
  • Splinter hemorrhages under nails
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6
Q

Therapeutic management for BE:
SATA

Antibiotics

Surgery to remove emboli

Valve replacement

Prevent BE in high-risk patients with antibiotics 1 hour before risky procedures

A

ALL

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7
Q

Nursing considerations for BE:
SATA

Teach prophylactic antibiotic therapy

Teach family to give IV antibiotics at home

Symptomatic relief

Monitor for emboli

A

all

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8
Q

key points:

Inflammation of inner heart

s/s: Janeway spots, Osler nodes, Splinter hemorrhages under nails

concern: High risk pt (history of ____, history of heart surgery/transplant, CHD) has dental procedure, surgery, intracardiac lines, etc. they are at high risk of getting ____ so we need to give them prophylactic antibiotics 1 hour before procedure

A

BE

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9
Q

which acquired cardiac disorders:

Systemic inflammatory disease the follows an untreated strep infection, because it is an autoimmune reaction to strep antibodies

A

Rheumatic fever (RF)

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10
Q

why is it important to test sore throat for strep and teach family to see doctor about sore throat in child

A

untreated strep leads to RF which leads to rheumatic heart disease

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11
Q

pt c/o of:

chorea – shakiness

polyarthritis – multiple joint pain

erythema marginatum – rash

abdominal pain

tests show:

carditis – heart inflammation

elevated ASO titer

aschoff bodies

which acquired cardiac disorders?

A

RF

  • Aschoff bodies – inflammatory hemorrhagic lesions in connective tissue
  • polyarthritis – multiple joint pain
  • carditis – heart inflammation
  • chorea – shakiness
  • erythema marginatum – rash
  • subcutaneous nodules
  • arthralgia – joint pain
  • low grade fever
  • elevated ASO titer = indicated you previously had strep
  • abdominal pain
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12
Q

what do elevated ASO titer indicate

A
  • elevated ASO titer = indicated you previously had strep
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13
Q

therapeutic management of RF: prioritize order of treatment

aspirin, steroids - prevent cardiac damage and relieve symptoms

antibiotic - eradicate strep

prophylactic antibiotics – prevent recurrence and endocarditis, long term, given before risky procedures

A

antibiotic - eradicate strep

aspirin, steroids - prevent cardiac damage and relieve symptoms

prophylactic antibiotics – prevent recurrence and endocarditis, long term, given before risky procedures

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14
Q

why are these nursing considerations important for RF:

complete antibiotics and screen sore throats

teach med compliance

encourage rest, nutrition, and pain management

provide emotional support

A

nursing considerations:

prevent disease – complete antibiotics, screen sore throats,

teach
encourage compliance with drug regimens, antibiotics

recovery – rest, nutrition, pain

emotional support – s/s like corhhea

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15
Q

key points:

follows untreated strep
can lead to heart disease

This is why it is important to test sore throat for strep and teach family to see doctor about sore throat in child

s/s = elevated ASO titer = indicated you previously had strep

treatment: aspirin prevents cardiac damage and relieves symptoms

A

RF

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16
Q

which acquired cardiac disorders:

A disease that causes Acute systemic vasculitis (inflammation)

A

Kawasaki Disease (mucocutaneous Lymph node syndrome)

17
Q

pt complains of:

  • multi day fever unresponsive to antipyretics
  • rash
  • swollen lymph nodes
  • dry, cracked, red lips
  • strawberry tongue
  • bilateral conjunctivitis – looks like pink eye w/ out exudate
  • erythema and swollen palms/soles
A

kawasaki disease

acute phase s/s:
- multi day fever unresponsive to antipyretics
- rash
- swollen lymph nodes
- dry, cracked, red lips
- strawberry tongue
- bilateral conjunctivitis – looks like pink eye w/ out exudate
- erythema and swollen palms/soles

subacute phase s/s:
- vasculitis
- desquamation – peeling skin
- arthritis
- thrombocytosis – increased platelets

recovery phase s/s:
- asymptomatic
- all blood vessels return to normal

18
Q

pt c/o of:

desquamation – peeling skin

A

kawasaki disease

acute phase s/s:
- multi day fever unresponsive to antipyretics
- rash
- swollen lymph nodes
- dry, cracked, red lips
- strawberry tongue
- bilateral conjunctivitis – looks like pink eye w/ out exudate
- erythema and swollen palms/soles

subacute phase s/s:
- vasculitis
- desquamation – peeling skin
- arthritis
- thrombocytosis – increased platelets

recovery phase s/s:
- asymptomatic
- all blood vessels return to normal

19
Q

what is the recovery phase of kawasaki disease and why is it most dangerous?

A

recovery phase s/s:
- asymptomatic
- all blood vessels return to normal
most dangerous!!! – child at home, not monitored as closely, increased platelets and swelling = embolisms = MI

20
Q

s/s of what:

abdominal or back pain
vomiting
restlessness
inconsolable crying
pallor
shock

A

MI in kids

21
Q

therapeutic management of kawasaki disease:

aspirin for what 2 effects =

high dose ASA for what effect =

followed by low dose ASA for what effect =

high dose IVIG

A

therapeutic management:

salicylates (aspirin) for anti-inflammatory and anti-platelet effects

high does ASA – anti-inflammatory effects

low dose ASA – anti-platelet effects

high dose IVIG = blood product

22
Q

discharge teaching for kawasaki disease includes:

A
  • Immunizations – hold for 11 months
  • MI risk
23
Q

Key points:

s/s: multi day fever unresponsive to antipyretics, strawberry tongue, bilateral conjunctivitis – looks like pink eye w/ out exudate, peeling skin

recovery phase most dangerous!!! – child at home, not monitored as closely, increased platelets and swelling = embolisms = MI

discharge teaching – hold immunizations for 11 months, MI s/s and risk

treatment: high dose ASA (anti-inflammatory), low dose ASA (anti-platelets), IVIG

A

kawasaki disease

24
Q

s/s:

high BP
headaches
dizziness
vision changes

A

hypertension

25
Q

Consistent elevation of BP beyond upper limits of normal (based on age, gender, height)

Essential/primary hypertension –

Secondary hypertension –

A

unknown cause

identifiable cause (renal disease, oral contraception, steroids, obesity, adrenal disorders, smoking)

26
Q

causes of secondary hypertension in kids

A

(renal disease, oral contraception, steroids, obesity, adrenal disorders, smoking, heart disorder)

27
Q

pt is overweight and has family history of hypertension and hyperlipidemia - what should we screen for?

A

Selective screening for hyperlipidemia in at risk kids based on:
Family history
Overweight

28
Q

Abnormal or irregular heart beat

A

Dysrhythmias in kids

29
Q

Brady dysrhythmias –

Tachy dysrhythmias –

A

Brady dysrhythmias – slower than normal

Tachy dysrhythmias – faster than normal

30
Q

Sinus bradycardia

Complete atrioventricular block (AV block)

can cause =

A

Brady dysrhythmias – slower than normal

31
Q

Sinus tachycardia

Supraventricular tachycardia - rapid and regular HR, 200-300 BPM

can cause =

A

Tachy dysrhythmias – faster than normal

32
Q

which dysrhythmia in kids is this:

regular irregularity = fast, slow, fast, slow, repeats pattern

Normal in school agers

have child hold breath and it should regulate

A

Sinus arrhythmia

33
Q

which acquired cardiac disorders:

Myocardial abnormalities which impair the cardiac muscle’s ability to contract

A

cardiomyopathy

34
Q

which acquired cardiac disorders s/s:

CHF
Dysrhythmias
Syncope – fainting
Sudden death

A

cardiomyopathy

35
Q

which acquired cardiac disorders therapeutic management:

Digoxin
Diuretics
Beta blockers
Calcium channel blockers
Anticoagulants
Transplant – ultimate fix

A

cardiomyopathy

36
Q

should child with cardiomyopathy restrict activity until transplant?

A

YES

sav 331 (12 decks)

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