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Risk of infective endocarditis is increased by? recent dental, urologic, surgical, GYN procedures, hx of IV drug abuse, heart disease, cardiac catherization, renal dialysis, infections
Acute left-sided infective endocarditis is? a life-threatening form of infective endocarditis
S/S of acute left-sided infective endocarditis abrupt onset of CNS complications resulting from embolization from infected valvular vegetations
Acute left-sided infective endocarditis diagnosis is best confirmed with? blood cultures
Transesophageal echocardiograms can identify? vegetations on valves and are used when blood cultures are negative
Splinter hemorrhages, manifestation of endocarditis? black longitudinal streaks in nail beds
Janeway's lesions, manifestation of endocarditis? flat, red, painless spots on the palms and soles of feet
Osler's nodes, manifestation of endocarditis? painful red or purple lesions on fingers or toes
Roth's spots, manifestation of endocarditis? hemorrhagic retinal lesions
Petechiae, manifestation of endocarditis? small hemorrhages in conjunctiva, lips, and buccal mucosa
Pt. with prosthetic mitral valve develops left hemiparesis and visual changes, nurse expects management will be? surgical replacement of valve
Usual S/S of pt. with aortic valve endocarditis in 80% of patients? dyspnea, crackles in lungs, and restlessness
Vegetative embolization from the aortic valve occurs where in the body? throughout the arterial system and may affect any organ
Pulmonary emboli occur in (left / right)-sided endocarditis? right-sided
Prevention of endocarditis infection recurrence can be addressed by? pt. obtaining prophylactic antibiotic therapy before invasive medical and dental procedures
To establish presence of a pericardial friction rub, nurse listens to pt. chest ...? with diaphragm to auscultate a high-pitched continuous rumbling sound
When excess pericardial fluid compresses the heart and prevents adequate diastolic filing, S/S would be? markedly distended jugular veins, ↓ BP, tachycardia, tachypnea, muffled heart sounds
Cardiac tamponade is? pressure on the heart that occurs when blood or fluid builds up in the myocardium and pericardium
Chronic constrictive pericarditis is manifested by? fibrin accumulation, a scarred and thickened pericardium and adherent pericardial membranes
Pulses paradoxus is? drop in systolic pressure > 10 mm Hg with expiration
Acute pericarditis may be diagnosed with ECG showing? diffuse ST segment elevation
Pt. with acute pericarditis should be positioned? in Fowler's position with a padded over-the-bed table for patient to lean on
Medications to help control pericardial pain include? anti-inflammatory medications, opioids are not usually indicated
Nurse should question pt. with myocarditis specifically about? recent viral illness (e.g. fever and malaise)
Most common cause of myocarditis in the US? viruses
The heart has increased sensitivity to the drug _____ in myocarditis. digoxin; and it is rarely (if ever used)
Nursing role in prevention of rheumatic fever? early diagnosis and immediate Tx of group-A streptococcal pharyngitis
Antibiotics (should / should not) be used to treat viral infections? should not
Diagnosis of rheumatic fever is strongly supported in pt. with? carditis, polyarthritis, erythema marginatum
Erythema marginatum is described as? the presence of pink rings on the trunk and inner surfaces of the limbs which come and go for as long as several months
Antibiotics - use to treat rheumatic fever eliminate residual group-A heolytic streptococci, prevent spread /recurrence of infection
Aspirin - use to treat rheumatic fever anti-inflammatory and arthritic and joint manifestations
Corticosteriod - use to treat rheumatic fever anti-inflammatory and severe carditis
NSAIDs - use to treat rheumatic fever anti-inflammatory and joint manifestations
Activity is restricted for pt. with rheumatic heart disease with carditis for how long? until symptoms of heart failure are controlled; confined to bed
Valvular stenosis leads to? ↓blood flood and hypertrophy of preceding chamber
Valvular stenosis causes? a pressure gradient difference across an open valve
Heart valve most commonly affected by stenosis or regurgitation? mitral valve
Most common valvular disease in the US is? mitral valve collapse
Mitral stenosis, characteristics? dyspnea, embolization may result from chronic atrial fibrillation
Acute mitral regurgitation hypertension, characteristics? rapid development of pulmonary edema and cardiogenic shock; rapid onset prevents left chamber dilation
Cardiogenic shock occurs when? the heart has been damaged so much that it is unable to supply enough blood to the organs of the body
Chronic mitral regurgitation, characteristics? loud pansystolic or holosystolic murmur; brisk carotid pulses present
Mitral valve prolapse, characteristics? ballooning of valve into left atrium during ventricular systole
Aortic stenosis, characteristics? characteristic systolic crescendo-decrescendo murmur; angina and syncope result from ↓ CO
Acute aortic regurgitation, characteristics? sudden onset of cardiovascular collapse
Chronic aortic regurgitation, characteristics? water-hammer pulses
Tricuspid valve disease, characteristics? may be caused by pulmonary HTN; major symptoms related to systemic venous pressures
Drugs most often prescribed for pts. with mechanical valve placement? anticoagulants; due to risk of thrombus formation
Drugs contraindicated for pts. with aortic stenosis? nitrates; because an adequate preload is necessary to open stiffened aortic valve
Dysrhythmias frequently cause what S/S? palpitations, lightheadedness, dizziness > falls risk
Hypervolemia and paroxysmal nocturnal dyspnea would be apparent in pt. with? heart failure
Percutaneous transluminal balloon valvuloplasty is indicated for? older patients with stenosis of any valve
The operative mortality rate is (higher / lower) in valve repair than replacement? lower in valve repair
Open valve repair is (less / more) precise than closed? more and requires cardiopulmonary bypass during surgery
Mechanical prosthetic valves require long-term anticoagulation, and is contraindicated in? women of childbearing age, pts. at risk for hemorrhage, non-compliant w/anticoagulant therapy
The greatest risk to a patient who has an artificial valve is the development of? endocarditis
The hyperdynamic systolic function creates a diastolic failure in? hypertropic cardiomyopathy
Systemic embolization may occur because of stasis of blood in the ventricles in? dilated cardiomyopathy
The most uncommon type of cardiomyopathy? restrictive cardiomyopathy
Heart transplant is often required in? dilated cardiomyopathy
About 1/2 of the cases of _____ _____ have a genetic basis. hypertropic cardiomyopathy
No ventricular hypertrophy is found in? dilated cardiomyopathy
ECG reveals cardiomegaly with thin venricular walls in? dilated cardiomyopathy
Syncope during increased activity resulting from an obstructed aortic valve outflow occurs in? hypertropic cardiomyopathy
Infective myocarditis or exposure to toxins or drugs is often follows? dilated cardiomyopathy
Surgery to remove myocardial tissue may be indicated for symptoms refractory to treatment in? hypertropic cardiomyopathy
Ventricular stiffness is characteristic of? restrictive cardiomyopathy
Massive thickening of intraventricular septum and ventricular wall is characteristic of? hypertropic cardiomyopathy
Hypertrophic cardiomyopathy is? a condition in which the heart muscle becomes thick. Often, only one part of the heart is thicker than the other parts
Restrictive cardiomyopathy refers to ? changes in and weakening of the heart muscle, which causes the heart to fill poorly, squeeze poorly, or both
Dilated cardiomyopathy is? a condition in which the heart becomes weakened and enlarged. As a result, the heart cannot pump enough blood to the rest of the body
Created by: fluency
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