Busy. Please wait.
or

show password
Forgot Password?

Don't have an account?  Sign up 
or

Username is available taken
show password

why


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.

Remove Ads
Don't know
Know
remaining cards
Save
0:01
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
Retries:
restart all cards




share
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

68wm6 p2 inf dis

Inflammatory diseases of the heart

QuestionAnswer
What is rheumatic fever? an inflammatory disease caused by Group A hemolytic streptococci pharyngitis or URI.
What is the most affected site of infection from rheumatic fever in the heart and what does it result in? Heart valves, valvular stenosis
What are the generalized S/S of rheumatic fever? *Increased pulse *Epistaxis *Anemia *Nodules found on the joints and subcutaneous tissues *Joint involvement
What are more specific S/S of rheumatic fever? *Joint pain (polyarthritis) *HALLMARK SYMPTOM IS A HEART MURMUR. *Erythema marginatum *Involuntary purposeless movement (Sydenham’s Chorea). *Skin manifestations of small erythemtous circles
What is Erythema Marginatum? wavy lines on the trunk and abdomen that disappear rapidly.
Define pericarditis: Inflammation of the pericardium, the membranous sac enveloping the heart.
How does pericarditis affect normal heart function? Fibrous constriction occurs gradually and causes severe compression to prevent normal filling during diastole.
What can cause pericarditis? Fibrous constriction occurs gradually and causes severe compression to prevent normal filling during diastole. *Bacterial, viral and fungal infection *ESPECIALLY COMMON AFTER THORACIC SURGERY *MI *Chest trauma *Cancer *Azotemia
Pericarditis often mimics the pain of what other serious heart condition? MI
What is the hallmark symptom of pericarditis? Pericardial friction rub
What may occur when blood, excess fluid or pus accumulates in the pericardial space? Cardiac Tamponade (Pericardial tamponade)
What can pericarditis cause the pulse to exhibit? Pulsus Paradoxus (Paradoxical pulse)
What visible sign presents as cardiac tamponade progresses? Distended neck veins due to the right atrium being impaired.
Acute onset of pain from pericarditis begins where, is aggravated by what, and is relieved by what? Pulsus Paradoxus *Acute onset begins suddenly over the sternum and radiates to the neck. *Pain increased by moving and deep breathing. *Relieved by sitting up and leaning forward
If upon auscultating the chest of a PT and you hear 'friction', find the heart sounds muffled and find a rapid forcible pulse and rapid shallow breathing, what do you suspect? Pericarditis
What is rheumatic fever? an inflammatory disease caused by Group A hemolytic streptococci pharyngitis or URI.
What is the most affected site of infection from rheumatic fever in the heart and what does it result in? Heart valves, valvular stenosis
What are the generalized S/S of rheumatic fever? *Increased pulse *Epistaxis *Anemia *Nodules found on the joints and subcutaneous tissues *Joint involvement
What are more specific S/S of rheumatic fever? *Joint pain (polyarthritis) *HALLMARK SYMPTOM IS A HEART MURMUR. *Erythema marginatum *Involuntary purposeless movement (Sydenham’s Chorea). *Skin manifestations of small erythemtous circles
What is Erythema Marginatum? wavy lines on the trunk and abdomen that disappear rapidly.
Define pericarditis: Inflammation of the pericardium, the membranous sac enveloping the heart.
How does pericarditis affect normal heart function? Fibrous constriction occurs gradually and causes severe compression to prevent normal filling during diastole.
What can cause pericarditis? Fibrous constriction occurs gradually and causes severe compression to prevent normal filling during diastole. *Bacterial, viral and fungal infection *ESPECIALLY COMMON AFTER THORACIC SURGERY *MI *Chest trauma *Cancer *Azotemia
Pericarditis often mimics the pain of what other serious heart condition? MI
What is the hallmark symptom of pericarditis? Pericardial friction rub
What may occur when blood, excess fluid or pus accumulates in the pericardial space? Cardiac Tamponade (Pericardial tamponade)
What can pericarditis cause the pulse to exhibit? Pulsus Paradoxus (Paradoxical pulse)
What visible sign presents as cardiac tamponade progresses? Distended neck veins due to the right atrium being impaired.
Acute onset of pain from pericarditis begins where, is aggravated by what, and is relieved by what? Pulsus Paradoxus *Acute onset begins suddenly over the sternum and radiates to the neck. *Pain increased by moving and deep breathing. *Relieved by sitting up and leaning forward
If upon auscultating the chest of a PT and you hear 'friction', find the heart sounds muffled and find a rapid forcible pulse and rapid shallow breathing, what do you suspect? Pericarditis
What is the action of immunosuppressants? Interfere with the ability of the immune system to respond to antigen stimulation by inhibiting cellular and humoral immmunity.
What are used to suppress the immune responses in nephrotic syndrome of childhood and severe rheumatoid arthritis? cyclophosphamide and methotrexate
What are used with corticosteroids for the prevention of transplantation rejection reactions? *azathioprine (Imuran). *cyclosporine (Neoral, Sandimmune, Gengraf). *mycophenolate (CellCept).
What is is a recombinant immunoglobulin antibody that alters T-cell function. Muromonab-CD3
What are some contraindications of muromonab-CD3? *Fluid volume overload *Fever > 100 degrees F *Herpes zoster *Chickenpox or recent exposure to chickenpox
What increases the absorption of muromonab-CD3? Concurrent digestion of grapefruit or grapefruit juice increases absorption and should be avoided.
What can increase the risk of toxicity of methotrexate nephrotoxic drugs, large doses of aspirin, or NSAIDs.
The normal value of neutraphils while on immunosuppressants? 3000-7000 mm3.
What value of neutrophils indicates neutropenia? <1000 mm3
What is the value of severe neutropenia? < 500 mm3.
True or False: Due to the depressing nature of the hospital stay while on immunosuppressants, fresh flowers are highly encouraged to liven up the room. False. Fresh flowers and live plants are discouraged in the room, as well as fresh fruits and vegetables in the diet.
What should be done with doses of chemotherapy while the neutrophil levels are low? Hold until levels are back to normal.
What inhibits the metabolism of azathioprine? Allopurinol
What immunosuppressant is it important to check for fluid overload in? muromonab-CD3
What may be used to treat early reactions to immunosuppressants? Acetaminophen and antihistamines
to prevent or minimize manifestations of Cytokene Release Syndrome (CRS) if given 1-4 hrs before 1st dose of immunosuppressants? Methylprednisolone sodium succinate
What is cytokene release syndrome? When the neutrophils release cytokene prior to destruction when the antibodies bond to them causing a systemic inflammatory response (non-infective fever)
what may be given 30 min after the 1st and possibly 2nd dose to control respiratory side effects of immunosuppressants? Hydrocortisone
What is the lab value for therapeutic serum levels of cyclosporin? 50 - 300 ng/mL
What is the lab value for the toxic serum level of cyclosporin? > 400 ng/mL
What happens if there are subtherapeutic serum levels of cyclosporin? Increased risk of organ rejection.
Why should the PT practice proper mouth care with a topical anti-fungal agent? To prevent candidiases
How should PO cyclosporin be administered? With milk, juice or meals
What should be done with cyclosporin prior to IVPB 1 Dilute each 1 ml (50 mg) immediately before use with 20-100 mL of D5W or 0.9% NaCl for injection
How quickly should cyclosporin be infused? Infuse slowly over 2-6 hrs via infusion pump, or over 24 hours via continuous IV
What foods should the PT avoid while on cyclosporin Grapefruit or Grapefruit Juice
What are the adverse effects of Azathioprine? *Leukopenia I *nfection *Megaloblastic anemia
Define infective endocarditis: infection or inflammation of the inner layer of heart tissue, particularly the heart valves.
What are at risk factors for infective endocarditis? *Cardiac surgery. *Intrusive procedures such as dental procedures, minor surgery, or urinary catheters *IV drug abusers. (Higher Risk)
What are the most common organisms involved in infective endocarditis? *Streptococcus viridians *Streptococcus pyogens *Enterococci *Staphylococcus epidermis *Staphylococcus aureus
What are subjective s/s of infective endocarditis? *Flu-like symptoms. *Chest pain. *Chills. *Joint pain.
What are objective s/s of infective endocarditis? *Purplish painful nodules on the pads of the fingers and nose. *Black longitudinal line (splinter hemorrhages) in the nails. *Petechiae in conjunctiva, mouth and legs *Heart murmur
How are IV antibiotics to be given for infective endocarditis? Large doses of IV antibiotics, over 2-6 week period or longer, after blood cultures done
Define myocarditis: Inflammation of the myocardium or muscle layer of the heart.
How should the bed be kept for a PT with an inflammatory heart condition Head of the bed elevated at 45 degrees.
How often should the vitals be obtained in a PT with an inflammatory heart condition? Every 2-4 hours.
What are three nursing diagnosis R/T nursing care of a patient with pericarditis, endocarditis, and myocarditis? *CO decreased R/T inflammatory process *Fluid volume excess R/T ineffective pumping action *Pain r/t inflammatory process
Created by: Shanejqb