ATI 20 - Cardiovascular Disorders Flashcards
(63 cards)
1
Q
Cardiomyopathy
A
disorder of heart’s muscle
- affects chamber size, wall thickness, or contraction
- leads to problems w VENTRICULAR systolic or diastolic function
2
Q
most common form of cardiomyopathy
A
DILATED cardiomyopathy
3
Q
Dilated Cardiomyopathy
A
ventricular stretches + dilates
» poor pumping
- genetic (myocarditis or neuromuscular disease)
- treated for CHF
4
Q
most common cause of sudden unexpected death
A
HYPERTROPHIC cardiomyopathy
5
Q
Hypertrophic Cardiomyopathy
A
myocardial cells become enlarged> causes scarring
|»_space;>poor filling fr still walls
6
Q
Pulmonary Artery HTN
pathophysiology
A
- blood backs up in lungs» pulmo vasoconstriction
- rt.vent hypertrophy as RV tries to push past pressure
- cause inflammtn, hypertrophy of sm. arteries, + fibrosis
- rt to lft shunt if pressure gets too high
7
Q
Pulmonary Artery HTN
symptoms
A
- dyspnea w activity
- chest pain
- syncope
8
Q
Pulmonary Artery HTN is ____ and eventually _____
A
progressive + eventually fatal
9
Q
Pulmonary Artery HTN
education
A
- avoid high altitude (hypoxia)
- adhere to med schedule
10
Q
Congenital Heart Disease
occurrence
A
8-12 per 1,000 live birth
11
Q
Congenital Heart Disease
genetic + environmental causes
A
- drug exposure
- maternl viral infectn
- maternl metab disorder
- incr maternl age
- multifactorial genetc pattern
- chrmsml abnorm
12
Q
Congenital Heart Disease
etiology
A
inadequate CO
-hypertrophy followed by failure
13
Q
Congestive HF
EARLY signs in INFANTS
A
- wt loss or lack of wt gain
- tire easily
- irritable
- diaphoresis
- freq resp infectn
14
Q
Congestive HF
EARLY signs in OLDER CHILDREN
A
- exercise intolerance
- dyspnea
- ab pain or distention
- periph edema
- change in skin color
15
Q
Congestive HF
LATE signs in INFANTS
A
- tachypnea
- tachycardia
- pallor/cyanosis
- nasal flaring
- grunting
- retraction
- cough
- crackles
16
Q
Congestive HF
LATE signs in OLDER CHILDREN
A
- anorexia
- cough
- wheeze
- crackle
- fluid vol excess
- JVD
17
Q
Congestive HF
nursing mgmt
A
- I+O
- serial ab measurment
- freq dvlpt assessment Q2-3MO
- admin meds
18
Q
Congestive HF
medications [6]
A
1 digoxin (Lanoxin) 2 furosemide (Lasix) 3 thiazide (Diuril) 4 spironolactone (Aldactone) 5 ACEi (-pril) 6 carvedilol (Coreg)
19
Q
digoxin (Lanoxin)
moa
A
- slows HR
- incr filling time
- incr CO
20
Q
digoxin (Lanoxin)
nursing mgmt
A
-assess HR for brady (full 1 min)
-withhold if pulse is <90bmp for infants
<70bmp for children
-monitor for digoxin toxicity
21
Q
withhold digoxin if pulse is ___ for infants; ___ for children
A
<90bmp
<70bmp
22
Q
furosemide (Lasix)
moa
A
- rapid diuresis
- blocks reabsorb of Na + H2O in renal tubes
23
Q
furosemide (Lasix)
nursing mgmt
A
- monitor pt during rapid diuresis for VS, I+O, fluid + electrolyte balance
- monitor for hypo-K + hypo-Cl
- assess digoxin toxicity if hypo-K is present
24
Q
thiazide (Diuril)
moa
A
maintain diuresis
-decr absorption of Na, H2O, K, Cl, bicarb in renal tubules
25
thiazide (Diuril)
| nursing mgmt
- monitor BP
- I+O
- lab for hypo-K
- assess for digoxin toxicity
26
spironolactone (Aldactone)
| moa
K sparing diuresis
27
ACEi (-pril)
| moa
- promote vasc relaxtn
- reduce periph vasc resistance
- reduce afterload
28
ACEi (-pril)
| nursing mgmt
-monitor HTN w start of therapy + dosage changes
| common SE: cough, hyper-K, worsening renal functn
29
carvedilol (Coreg)
| moa
- improve lft.vent function
- vasodilatn of systmc circltn
-for chronic HF + dilated cardiomyopathy
30
Infective Endocarditis
| clinical manifestations
- fever
- fatigue
- muscle aches
- new/change in murmur
- signs of congestive HF
31
Infective Endocarditis
| Tx
- abx, antifungal (2-8wk)
- Tx congestive HF
- assess valve damage (surgcl valve replacement)
32
Congenital Heart Condition
| nursing care
- limit feeding to 30min unless instructed otherwise
- careful w fluid + O2
- breastmilk preferred (possibly pumped, fortifd, or supplmtd)
- infectn prevention
- maybe transpyloric, nasogastric, gastronomy tube
33
___ is required before cardiac catheterization
baseline assessment
| -make sure no allergies to iodine or shellfish bc contrast
34
cardiac catheterization
| post op care
- continuous cardiac + pulse ox
- assess pulse for symmetry
- assess skin
- assess insertion site for bleed/hematoma
- prevent bleeding by keeping extremity in straight position
35
cool extremity that blanches after cardiac catheterization can indicate
arterial obstruction
36
sudden sustained incr in pulse/resp + decr in perfusn may indicate...
early hemorrhage
37
INCREASED pulmonary BF
| clinical manifestations
- tachypnea
- tachycardia
- murmur
* *CHF**
- poor wt gain
- diaphoresis
- periorbital edema
- freq resp infection
38
DECREASED pulmonary BF
| clinical manifestations
* *cyanosis**
- hypoxic spells
- poor wt gain
- polycythemia
39
OBSTRUCTION to systemic BF
| clinical manifestation
* *CHF w pulmo edema**
- diminished pulse
- poor color
- delayed cap refill time
- decr UO
40
MIXED Defects
| clinical manifestations
* *cyanosis**
* *CHF can occur w incr shunting**
- poor wt gain
- pulmo congestn
41
Patent Ductus Arteriosus
| occurrence
common
| -5-10% of all infants w congenital heart disease
42
normal ductus arteriosus
blood goes fr pulmo artery to aorta
- closes 10-15 hr after birth
- complete seal after 10-21 days after birth
43
normal closure of ductus arteriosus is triggered by...
high O2 saturation
44
Patent Ductus Arteriosus
| pathophysiology
at birth, SVR incr + PVR decr
| >>reverses flow across ductus arteriosus
45
Patent Ductus Arteriosus
| is common in...
preterm infants w resp distress syndrome or hypoxemia
46
Arrhythmias
| **bradycardia leads to...
- hypothermia
- hypoxia
- incr ICP
-hyper-K
47
Arrhythmias
| **supraventricular tachycardia for infants
>220bpm
signs poor feed, irritable, pallor
-vagal maneuvers
48
Arrhythmias
| **supraventricular tachycardia for children
>180 bpm
| -vagal maneuvers
49
Rheumatic Fever
| **pathophysiology
inflammatory disorder of connective tissue
>>autoimmune
***caused by group A beta-hemolytic streptococcus
50
Rheumatic Fever
| **etiology/age
5-15 yo
51
Rheumatic Fever
| **clinical manifestations
-begin 2-6wk after untreated or partially treated strep infectn w GABHS
52
**with Rheumatic Fever, a new mrmr may indicate...
carditis of mitral or aortic valve
53
Tx for carditis, inflammation in Rheumatic Fever
aspirin
54
Kawasaki Disease
| **acute (1-2wk) clinical manifestations
* high fever >5dy
* unresponsive to antipyretics
* red throat
* red/chapped lips
* strawberry tongue
* swollen limbs
55
Kawasaki Disease
| **subacute clinical manifestations
subacute is >2wks
* cardiac disease
- no fever
- joint pain
56
Kawasaki Disease
| **tx
aspirin
- anti-inflammatory
- anti-platelet dose after fever decr
57
Shock + types
inadequate delivery of O2 to tissues
types: compensated + decompensated
58
Decompensated shock vs compensated shock
decomp: hypotension, delayed cap refill, pallor
comp: tachycard, normotensive or HTN
59
hypovolemic shock
| *cause
loss of volume
60
vasogenic shock
| *cause
vasodilation
61
cardiogenic shock
| *cause
pump failure
62
obstructive shock
| *cause
obstruction to flow
63
Rheumatic fever diagnostics
Blood antistreptisin O tiger is elevated
