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T2 possible test ?s
chpt 33, 37, and 38
| Question | Answer |
|---|---|
| risk factors for endocarditis | IVDA, noscomial bacteremia, prosthetic valves, or pacemaker |
| s/s endocarditis | arthralgia, chills, fever, pain, splinter hemmorhage, Osler's nodes(painful), Janeway lesions (not painful), changes in murmur |
| endocarditis Dx | 3 blood samples from 3 different venipuncure sites |
| what should you do before you give antbx, or ASA | take blood 1st so the results will be accurate |
| endocarditis tx | IV antbx 2-6 weeks, then 4-6 weeks (home health nurse for IV)flu shot, ensure rest, turn cough and breathe Q2H |
| cause of acute pericarditis | cocksackie virus B group & MI |
| pericarditis nursing intervention | have pt sit up and lean forward on pillows/table to relieve pain |
| rapid shallow breaths d/t pericarditis caused by | trying to avoid chest pain |
| Pericarditis Hallmark finding | pericardial frx rub heard over left sternal border-- time the frx rub w/pulse, not RR |
| Collaboritive care for pericarditis | NSAIDS used, not morphine to relieve inflammation + pain, steroids avoided for 10 days, give ANBX w/food & milk, colchesine (for gout/recurrent pericarditis) |
| acute MI vs pericarditis | pain relieved by high fowler's position. Pain located in precordial area |
| Rhematic fever caused by... | complication of delayed sequela of Group A streptococcal pharyngitis- effects heart, joints, skin, & CNS |
| Rheumatic fever effects | all 3 layer of the heart- endocardium, pericardium and myocardium |
| rheumatic pericarditis | effects BOTH layers of pericardium. Serosanguinous pericardial effusion |
| most common finding in rheumatic fever | mono/poly- arthritis in large joints |
| what is chorea | major CNS manifestation, involuntary movement of the face, ataxia, involent |
| rheumatic heart dz causes what with the heart | prolonged PR interval |
| rheumatic fever complications | chronic rheumatic carditis, rheumatic heart dz |
| rheumatic heart dz is leading cause of | mitral valve stenosis, and valve replacement |
| Health promotion for rheumatic heart disease | tx of streptococcal pharyngitis, monthly injections of LA PNCN, rest, teaching on prevention (ANBX), caution w/respiratory secretions |
| endocarditis #1 teaching | handwashing |
| mitral valve s/s | fish mouth |
| prevention of mitral valve stenosis | prevent endocarditis, rheumatic fever, PE, HF, thromboembolism |
| MEDS FOR MITRAL VALVE STENOSIS | DIGOXIN, DIURETICS, DECREASED Na+ diet, BB and anticoagulants |
| post surgery valve replacement have what checked | anticoagulant tx; check INR regularly (2.5-3.5 for mechanical valves) |
| prevention for rheumatic heart failure | handwashing |
| pt w/mitral valve regurgitation should avoid what | caffeine |
| Aortic valve stenosis is an... | obstruction between LV and aorta (LV hypertrophy) |
| causes of aortic valve stenosis | congenital, rheumatic fever |
| s/s aortic valve stenosis | angina, syncope, LV failure |
| what is contraindicated w/aortic valve stenosis? | Nitroglycerine b/c it decreases preload- which is necessary to push blood |
| valve surgery is... | palliative, not curative |
| valvulotomy is for... | pure mitral stenosis |
| mechanical valves | for younger pts, last longer (10yrs),increased risk for thrombus from anticoagulants |
| biologic valves | made from bovine, porcine, & dacron |
| women of childbearing age | recieve biologic valves b/c they cannot take anticoagulants |
| prosthetic valve replacement requires... | lifelong coumadin |
| plavix and ASA can be taken together for... | antiplatelet |
| most effective for intermittent claudication | walking |
| Ticlid to ASA | 1st line oral |
| synthetic bypasses uses what drugs? | anticoagulants, heparin--> followed by coumadin (remember coumadin takes longer) |
| post valve replacement tx | pt should be out of bed and ambulated several times a day |
| post PAD surgery the pt should avoid | knee flexed positions |
| s/s of acute arterial ischemia include... | the six P's |
| acute arterial ischemic tx | IV heparin |
| drug warning w/anticoagulant tx | tell pt to avid NSAIDS/ASA- assess/report excessive bleeding |
| Buerger's dz teaching | complete cessation of tobacco- pt has choice between smoking or limbs- but not both |
| pseudoaneurysm | tear can be d/t cath lab procedures |
| arterial ulcers and leg position | do not elevate, no compression |
| venous ulcers and leg position | elevate w/moist compress |
| post aortic aneurysm | NPO and do NOT remove NGT until pt passess flatulence |
| right-sided endocarditis is due to | IVDA |
| what's the difference between Janesway lesions and Oslers nodes | Oslers nodes are painful |
| endocarditis causes changes in ____________ | murmur |
| what do u monitor frequently with endocarditis | fever |
| Acute pericarditis is caused by ________ virus. and can be caused by _________. | Cocksakie B virus, can be caused by MI |
| pericarditis hallmark finding | frx rub heard over left sternal border- timed w/pulses, not RR |
| what drug is given for pericarditis? what drug is avoided? | NSAIDS (w/food/milk) & colchecine (for recurrent) steroids |
| what causes acute rheumatic fever? | group A streptococcal pharyngitis |
| meds for mitral valve stenosis | digoxin, BB, diuretics, anticoagulants, low Na+ dyet |
| drug tx for PAD | aspirin, plavix, ticlit (antiplatelets), & ACEI |
| is critical limb ischemia chronis or intermittent? | chronic |
| Thoracic aortic aneurysm S/S | DYSPHAGIA(cannot swallow), distended neck veins, edema in bilateral upper extremities, hoarseness, & chest pain which radiates to the back |
| Abdominal aortic aneurysm | bruit, abdominal & back pain, embolism can go down to toe and cause "blue toe" |
| what don't you do to an abdominal aortic aneurysm | palpate the mass |
| endovascular graft procedure vs conventional graft procedure | endovasular is less invasive, good for the elderly |
| pt education on abdominal aortic aneurysm | NO HEAVY LIFTING |
| anterior aortic rupture complication | massive hemmorhage into abdomen, hypovolemic shock w/tachycardia, , plale & clammy skin, hypotension |
| goal for aortic aneurysm | PREVENT RUPTURE |
| 1st measure for post-op aortic aneurysm | MAINTAIN adequate blood pressure, monitor graft patency, hydration, diuretics, and HTN meds |
| antidote for heparin | protamine sulfate |
| antidote for coumadin | vitamin k- advise against green, leafy veggies |
Created by:
arsho453
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