Care of Patients with Cardiac Problems

Question 1

Pulmonary edema

Answer 1

left ventricle fails to eject sufficient blood and pressure increases in the lungs. the increased pressure causes fluid to leak across the pulmonary capillaries and into the lung airways and tissues.

Question 2

causes of pulmonary edema

Answer 2

severe HF
acute MI
mitral valve disease
dysrhythmias

Question 3

symptoms of pulmonary edema

Answer 3

crackles, dyspnea, disorientation, confusion, tachycardia, HTN or hypotension, reduced UO, cough with frothy pink tinged sputum, PVC or other dysrhythmias, anxiety, restlessness, lethargy

Question 4

pulmonary edema interventions

Answer 4

monitor VS, high fowlers if not hypotensive, high flow oxygen therapy, aggressive pulmonary therapy, nitroglycerin, rapid acting diuretics, IV morphine sulfate

Question 5

types of valvular heart disease

Answer 5

mitral stenosis, mitral regurgitation, mitral valve prolapse, aortic stenosis, aortic regurgitation

Question 6

mitral stenosis

Answer 6

narrowing of valve opening
causes pulmonary congestion and right HF

Question 7

mitral regurgitation

Answer 7

valve does not completely close during systole
back flow of blood into the left atrium

Question 8

mitral valve prolapse

Answer 8

valvular leaflets enlarge and prolapse into the left atrium

Question 9

aortic stenosis

Answer 9

most common dysfunction
narrowing of valve opening
increased resistance to ejection and cardiac output is decreased and fixed

Question 10

aortic regurgitation

Answer 10

valve does not close completely during diastole
back flow of blood into the left ventricle

Question 11

key features of valvular disease

Answer 11

fatigue, dyspnea, angina, dysrhythmias, edema

Question 12

diagnostic testing for valvular idease

Answer 12

echocardiogram
TEE
chest xray
ECG

Question 13

non surgical management of valvular disease

Answer 13

medications

Question 14

surgical management of valvular disease

Answer 14

replacement or repair

Question 15

patients with defective or replaced valves are at risk for what

Answer 15

infective endocarditis, requires prophylactic antibiotic therapy before any invasive procedures

Question 16

infective endocarditis

Answer 16

infection of the endocardium
streptococcus viridans or staphylococcus aures

Question 17

causes of infective endocarditis

Answer 17

IV drug use
valve replacement
systemic infection
structural defects

Question 18

portals of entry for infective endocarditis

Answer 18

oral cavity
skin rashes, lesions, abrasions
infections
surgery or invasive procedures, including IV placement

Question 19

key features of infective endocarditis

Answer 19

fever associated with chills, night sweats, malaise, fatigue
anorexia and weight loss
cardiac murmur
petechiae
splinter hemorrhages

Question 20

complications of infective endocarditis

Answer 20

HF and arterial embolization

Question 21

diagnostic assessment of infective endocarditis

Answer 21

positive blood culture and echocardigram

Question 22

interventions for infective endocarditis

Answer 22

IV antimicrobials for 4-6 weeks
rest
surgical management if antibiotic therapy is ineffective

Question 23

acute pericarditis

Answer 23

inflammation or alteration of the pericardium (membranous sac that encloses the heart)

Question 24

features of acute pericarditis

Answer 24

sternal precordial pain that radiates to the left side of the neck, shoulder, or back. pain is grating and oppressive and aggravated by breathing , coughing, and swallowing. pericardial friction rub. fever with elevated WBC

Question 25

interventions for acute pericarditis

Answer 25

NSAIDS- pain
corticosteroids
IV antibiotics
may require pericardial drainage
avoid aspirins and anticoagulants

Question 26

cardiomyopathy

Answer 26

subacute or chronic disease of cardiac muscle. heart muscles becomes enlarged, thick or rigid- may be replaced with scar tissue. high mortality rate for patients who develop heart failure. 4 types on the basis of abnormalities in structure and function

Question 27

treatment for cardiomyopathy

Answer 27

varies with they type
medical treatment includes medications similar to those for heart failure and dysthymias
surgical interventions (heart transplant)