T2: Arrhythmias and Cardiomyopathy Flashcards

1
Q

permanent localized dilation of an artery; enlarging artery 2x or more of its normal diameter

A

aneurysm

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2
Q

arterial wall is weakened by congenital or acquired problems

A

True aneurysm

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3
Q

occurs as a result of vessel injury or trauma to all three layers of the arterial wall

A

False aneurysm

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4
Q

formed when blood accumulates in the wall of an artery

A

dissecting aneurysm

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5
Q

Most common aneurysm, usually asymptomatic, frequently ruptures

A

abdominal aortic aneurysm

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6
Q

Abdominal aortic aneurysm is located between the _____ arteries and the aortic ______ (dividing area)

A

-renal arteries
-aortic bifurcation

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7
Q

aneurysm frequently misdiagnosed, often found when imaging is used for other purposes

A

Thoracic aortic aneurysm

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8
Q

TAAs are found between the _______ and _______

A

-origin of the left subclavian artery
-diaphragm

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9
Q

Thoracic aortic aneurysms are located in the _____, _____, and _____ areas of the aorta or the aortic arch

A

descending, ascending, and transverse

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10
Q

T/F: surgical management is most common form of TAA management

A

False; surgical management is very difficult

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11
Q

Symptoms of Abdominal Aortic Aneurysm (4)

A

-abdominal pain
-flank pain
-back pain
-some will report heartburn

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12
Q

Abdominal Aortic Aneurysm can be observed by looking for:

A

pulsation in the upper abdomen slightly left of the midline between the xiphoid process and umbilicus

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13
Q

When patient has an abdominal aortic aneurysm, auscultate for:

A

bruit over the mass

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14
Q

Critical consideration of abdominal aortic aneurysms

A

-Do NOT palpate or auscultate a pulsating mass because it could rupture

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15
Q

Assess for ____ in pts with an abdominal aortic aneurysm (7)

A

-pain in lower back or abdomen
-hypertension
-diaphoresis
-decreased LOC
-Oliguria
-Loss of pulse distal to the rupture dysrhythmias

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16
Q

If pt with abdominal aortic aneurysm has pain in lower back, as if pain radiates to __, ___, or ____

A

-groin
-buttocks
-legs

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17
Q

TAA Assessed: (4)

A

-back pain or chest pain that is very severe
-SOB
-Hoarseness
-Difficulty swallowing

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18
Q

T/F: Physical assessment does not usually detect TAA

A

True

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19
Q

________ may occur if a TAA ruptures

A

Hypovolemic shock

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20
Q

AA Assessed: (2)

A

-CT with contrast used for assessing size and location
-Ultrasonography

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21
Q

AA Nursing actions:
Monitor (3)

A

-blood pressure
-pulse
-peripheral circulation

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22
Q

AA Nursing actions:
Nonsurgical management (3)

A

-Regulate blood pressure if client has hypertension
-Frequent CT or ultrasound to monitor
-Educate client on s/s of possible ruptures

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23
Q

AA surgical management (2)

A

-Cardiothoracic surgeon
-Small aneurysm may be done as elective, larger may be emergency surgery

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24
Q

Surgical management AAA (2)

A

-Commonly a resection
-Endovascular stent grafts

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25
Q

AAA surgery with high mortality rate

A

Resection

26
Q

Endovascular stent grafts have a _______ mortality rate compared to resections,
making it:

A

-improved
-procedure of choice

27
Q

Possible complications of Endovascular stent grafts

A

-bleeding
-rupture
-peripheral embolization
-stent misplacement
-endoleak
-infection

28
Q

blockage of blood flow

A

peripheral embolization

29
Q

blood flow occurs within aortic aneurysm

A

endoleak

30
Q

Aortic aneurysm post surgical client education (3)

A

-lifting restriction for 6-12 weeks
-caution when pushing , pulling, or straining
-Avoid driving for several weeks

31
Q

Aortic aneurysm cues: (7)

A

-Pain describes as sharp. tearing, ripping, or stabbing
-sweating
-Nausea/vomiting
-Fainting
-Pallor
-Rapid weak pusle
-Feeling of impeding doom, apprehension, anxiety

32
Q

Aortic dissection emergency care (5)

A

-2 large bore IVs
-0.9% sodium chloride
-indwelling catheter
-Pain relief: morphine
-HTN management: IV beta blockers

33
Q

chronic disease of cardiac muscle

A

cardiomyopathy

34
Q

4 types of cardiomyopathy

A

-Dilated
-Hypertrophic
-Restrictive
-Arrhythmogenic right ventricular

35
Q

most common type of cardiomyopathy

A

Dilated

36
Q

With Dilated Cardiomyopathy, extensive damage is done to _______, interfering with myocardial ________

A

-myofibrils
-metabolism

37
Q

most of the energy for the contraction of the heart comes from:

A

oxidative phosphorylation of ADP

38
Q

Dilated Cardiomyopathy:
-_________ ventricle(s) are dilated
-_________ function impaired
-Decreased CO2 r/t:

A

-both ventricles
-systolic function
-inadequate pumping of the heart

39
Q

S/S of dilated cardiomyopathy (7)

A

-SOB with exertion
-Decreased ability to exercise
-Fatigue
-Palpitations
-Systemic or pulmonary emboli
-Moderate to severe cardiomegaly
-A-fib in some clients

40
Q

Cause of Dilated cardiomyopathy (7)

A

-alcoholism
-chemo
-infection
-inflammation
-nutritional deficit
-heredity
-CAD

41
Q

Diagnosis of dilated cardiomyopathy (2)

A

-xray
-echocardiography

42
Q

treatment of dilated cardiomyopathy (5)

A

-vasodilators
-surgery
-dysrhythmia control
-treatment of HF
-beta blockers

43
Q

Treatment of HF that can be applied to cardiomyopathy (4)

A

-diuretics
-cardiac glycosides
-antidysrhythmic drugs
-implantable cardiac defibrillator

44
Q

Asymmetric ventricular hypertrophy (thickening) cousin g ti to be harder for the heart to pump blood; reduced cardiac output and stroke volume

A

hypertrophic cardiomyopathy

45
Q

Hypertrophic Cardiomyopathy:
-Obstruction in ________ tract most common
-_____ valve abnormalities common
-Genetic trait

A

-left ventricular outflow
-mitral valve
-single gene autosomal-dominant (1:500ppl)

46
Q

S/S of hypertrophic cardiomyopathy (10)

A

-May be asymptomatic in adolescence or early adulthood
-Shortness of air on exertion
-Syncope
-Dizziness
-Palpations
-Mild cardiomegaly
-Ventricular dysrhythmias
-Sudden death
-Heart failure
-Chest pain at rest, prolonged, not relieved by nitrates

47
Q

Treatment of hypertrophic cardiomyopathy

A

-HF treatment
-Beta blockers
-AFib conversion
-Surgery

48
Q

Surgical treatment of hypertrophic cardiomyopathy: (2)

A

-ventriculomyotomy
-muscle resection w/ mitral valvue replacement

49
Q

Hypertrophic cardiomyopathy diagnosis: (3)

A

-Echocardiography
-X-ray
-Angiocardiography durino a catheterization

50
Q

Stiffening of the lower chambers of the heart making it harder for them to fill with blood

A

Restrictive cardiomyopathy

51
Q

Restrictive cardiomyopathy:
-_______ prognosis
-_______ diagnosis

A

-poor
-rare

52
Q

S/s of restrictive cardiomyopathy:

A

similar to HF

53
Q

Cause of restrictive cardiomyopathy: (3)

A

endocardial or myocardial disease
-sarcoidosis
-amyloidoisis

54
Q

patches of red swollen tissue

A

sarcoidosis

55
Q

amyloid build up in the organ

A

amyloidosis

56
Q

Surgical treatment of restrictive cardiomyopathy (2)

A

-percutaneous alcohol septal ablation
-heart transplant

57
Q

replacement of myocardial tissue with fibrous and fatty tissue

A

arrhythmogenic right ventricular cardiomyopathy

58
Q

arrhythmogenic right ventricular cardiomyopathy:
-may also occur in:
-______ associated: most often affects:

A

-left ventricle
-familial associated- most often affects young adults

59
Q

Medical Energy that needs to be assessed after heart transplant/why

A

-bleeding onto the pericardial sac with potential for cardiac tamponade
-pressure from fluid prevents heart from pumping

60
Q

bleeding onto the pericardial sac with potential for cardiac tamponade:
S/S (3)

A

-low blood pressure
-distention of the jugular veins
-muffled heart sounds

61
Q

S/S of heart transplant rejection

A

-SOB
-fatigue
-fluid gain
-abdominal bloating
-new bradycardia

62
Q

MOST IMPORTANT part of heart transplant post-op care

A

infection control