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Med surg 2 > Inflammatory Dysfunction and Valvular Dysfunction > Flashcards

Inflammatory Dysfunction and Valvular Dysfunction Flashcards

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1
Q

what is a stenosis valve

A

constriction/narrowing - valve opening is smaller so the forward blood flood is restricted

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2
Q

what is a regurgitation valve

A

incomplete/insufficiency - incomplete closure of valve causing back flow of blood

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3
Q

majority of mitral valve cases result from…

A

rheumatic heart disease

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4
Q

what is mitral valve stenosis

A

scaring of leaflets and chordae tendinae

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5
Q

what happens in mitral valve stenosis

A

decreased blood flow from left atrium to left ventricle inhibiting ventricular filling which increases left atrial pressure and causes congested lungs

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6
Q

why would someone with mitral valve stenosis be at risk for a fib

A

because the stretching of the atrium because blood cant go through

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7
Q

what are some common ss of mitral valve stenosis

A

exertional dyspnea, diastolic murmmur, fatigue, palpitations

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8
Q

what is mitral valve regurgitation

A

mitral valve doesn’t close tightly, which allows blood to flow backward in the lungs where it just came

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9
Q

what are some causes for mitral valve regurgitation

A

MI, infective endocarditis, chronic rheumatic heart disease, mitral valve prolapse

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10
Q

what are some ss of mitral valve regurgitation

A

loud holystolic murmur heard in left ventricle, pulmonary edema, thready peripheral pulses

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11
Q

what are some ss of chronic mitral valve regurgitation

A

asymptomatic for years until eventually left ventricle failure -> weakness, fatigue, palpitations, left atrial enlargement, ventricular hypertrophy

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12
Q

when is aortic valve stenosis usually diagnosed

A

most are congenital so child hood- young adult - can have wear and tear problems too

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13
Q

what is the most common valve issue

A

aortic valve stenosis

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14
Q

what is aortic valve stenosis

A

obstruction flow from left ventricle to aorta which cause left ventricular hypertrophy

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15
Q

what does left ventricle hypertrophy lead to

A

decreased CO, pulmonary hyerptension, HF

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16
Q

when would someone need surgery for aortic valve stenosis

A

when surface area of valve is 1cm or less

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17
Q

what are some ss of aortic valve stenosis

A

systolic murmur, left ventricular failure triad (angina, syncope, excertional dyspnea)

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18
Q

what is the treatment for aortic valve stenosis

A

BETABLOCKERS, diuretics, use nitroglycerin carefully (may make chest pain worse)

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19
Q

what is aortic valve regurgitation

A

backward blood flow from ascending aorta to left ventricle which decreases myocardial contractility

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20
Q

what are the ss of acute aortic valve regurgitation

A

left ventricular failure, and cardiogenic shock (angina, hypotension, severe dyspnea) , high pitched diastolic murmur

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21
Q

what are some ss of chronic aortic valve regurgitation

A

asymptomatic for years, excertional dyspnea, angina, murmur

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22
Q

what is the gold standard for evaluating aortic disorder and most valvular disorders

A

CT scan with contrast

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23
Q

what drugs prevent heart failure

A

vasodilators (nitrates, ACE), positive inotroped (digoxin), diuretics (furesimide or bumetanide), beta blockers (METOPROLOL)

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24
Q

what is the treatment for valvular hear disease

A

drugs that prevent heart failure, sodium restrictions (2 g), anticoagulants, antidysrhythmias, prophylatic antibiotic (penicillin)

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25
what is a percutaneous translumin ballon valvuoplasty
stenosis for valvular heart disease - a balloon tipped catheter inserted through the femoral artery and inflated to separate valve leaflets - generally for poor surgery candidates
26
what is a valvulotomy
stenosis - surgeon inserts a dilator through the apex of the left ventricle into the opening of the mitral valve and then can remove the clot from the atrium
27
what is a valvuloplasty
regurg - repair of the valve by suturing the torn leaflets, chordae tenineae or papillary muscles
28
what is a mechanical (artifical) prostetic
valve replacement - more durable and last longer then biologic, requires long term anticoagulants, so the main risk is bleeding
29
what is biologic (tissue) bioprosthetic
valve replacement via tissue not as durable or lasting as long but you dont have to be on anticoagulants long term
30
what does APe To Man stand for
Aortic(persons right) pulmonary (persons left 2nd intercostal) Tricuspid (4th intercostal left inner) mitral (5th intercostal space more left of tricuspid)
31
what are therapeutic valve for INR after mechanical valve replacement
2.5-3.5 if decreases or increases call doc
32
when should you teach a patient to seek medical care
infection, hf, bleeding, and if going to have procedure that requires penicillin
33
what is myocardium
muscles of the heart
34
what is endocardium
innermost - valves
35
what is epicardium
outer layer
36
how much can the pericardium space hole
10-15ml
37
which ventricular wall is thicker
left 2-3x
38
what is rheumatic heart disease
chronic condition resulting from rheumatic fever resulting in scarring and deformity of heart valves
39
what is rheumatic fever
complication of group a strep pharyngitis
40
can rheumatic fever be prevented
if antibodies started in time
41
where is rheumatic fever mostly seen
young adults and underdeveloped countries
42
what is rheumatic endocarditis
swelling and erosion of valve leaflets
43
what are the ss of rheumatic heart disease
polyarthritis, carditis, nodules, heart enlargement, erythema marginatum, sydenhams chorea, fever, prolonged PR interval prolonged
44
what labs would show rheumatic heart disease
elevated erythrocyte sedimentation rate, C-reactive protein (inflammation)
45
what other tests could you do to diagnosis rheumatic heart disease
ECHO (valvular issues), chest xray (heart enlargement), ECG (PR interval prolonged)
46
what is the treatment for rheumatic heart disease
penicillin 10 day course (erythromycin if allergic), inflammatory (NSAIDS or corticosteroids), prophylaxis antibiotic atleast till early 20s
47
why would someone need to restart prophylaxis for rheumatic heart disease
any procedures affecting the mouth, infected skin or mucous layer, respiratory biopsy, or adenoidectomy
48
what is pericarditis
inflammation of the pericardial sac
49
what is the most common cause for pericarditis
idiopathic aka no one knows
50
what could be some other causes for pericarditis
acute mi, cancer, trauma, lupus, scleroderma, viral/bacterial infections
51
what are some ss of pericarditis
pain that worsens with deep inspiration but lessens when sitting forward, fever, dyspnea, pericardial friction rub (ask them to hold their breath)
52
what labs would you take for pericarditis
CRP and ESR (inflammation)
53
what would you see on an ECG for pericarditis
widespread ST elevation
54
what could be some complications of pericarditis
pericardial effusion (build up of fluid making heart sound muffled), cardiac tamponade (all the fluid is compressing the heart),
55
what are some ss of cardiac tamponade
muffled heart sounds, narrowed pulse pressure, neck vein distension, decrease in systolic BP on inspiration,
56
what is the treatment for pericarditis
NSAIDs, Colchicine
57
what is the treatment for cardiac tamponade
fluid bolus to dilate and allow the heart to pump until someone can get in there a pull that fluid out
58
what is a pericardiocentesis
echo guided needle inserted to pull the extra fluid out
59
what is something the nurse should do before pericardiocentesis
stop anticoagulants
60
what is infective endocarditis
infection of the inner layer of heart including the valves (step viridans or strep aureus) can also be caused by viruses or fungi
61
what are the risk factors for endocarditis
age, IV drug abuse, mechanical prosthetic devices, renal dialysis, rheumatic heart disease
62
what are the ss for endocarditis
new or worsening murmur, fever, chills, weakness, anorexia,
63
what are some vascular ss of endocarditis
splinter hemorrhages on nail beds, petechiae, Osler nodes on fingertips or toes, lesions on pads of fingers and toes
64
what are some manifestations second to embolism for endocarditis
LUQ pain, hematuria, renal failure, necrotic toes, changes in mental status (worried about stroke), pulmonary emboli
65
what kind of labs will you take for endocarditis
2 blood cultures from 2 different places, WBC, elevated erythrocyte sedimentation rate, c-reactive protien
66
what is the treatment for endocarditis
IV antibiotics 4-6 weeks, repeate blood cultures every 24-48 hours, valve replacement if needed, Tylenol for fever, fluids, rest,
67
what is myocarditis
focal or diffuse inflammation of the myocardium
68
what could be the cause of myocarditis
viruses, bacteria, fungi, radiation, autoimmune, and idiopathic
69
what are some ss of myocarditis
usually happens 7-10 days after viral infection - fever, fatigue, myalgias, pharyngitis, dyspnea, nv
70
what is myocarditis usually the progression of
pericarditis and then myocarditis then heart failure
71
how do you confirm myocarditis
endomyocardial biopsy in the first 6 weeks following infection
72
what are some interventions for heart failure
elevate head of bed 30 degrees or more, rest periods, quiet enviornment, reduce risk for infection
73
what is the main reason for heart transplant
cardiomyopathy
74
what is cardiomyopathy
a group of diseases that directly affects myocardial structure or function
75
what are the three main types of cardiomyopathy
dilated (degeneration of the heart), hypertrophic (left ventricular hypertrophy), or restrictive (ventricle is resistant to filling impairing diastolic filling)
76
what are the risk factors for cardiomyopathy
african american, males, middle age, genetic, alcoholism (if just alcohol if they stop the heart can recover)
77
what are the ss of cardiomyopathy
fatigue, dyspnea, orthopena, nv, anorexia, edema
78
how do you diagnosis cardiomyopathy
ECHO, elevated NT-pBNP, or BNP
79
what is the treatment for cardiomyopathy
heart failure treatment and eventually maybe a new heart

Med surg 2 (12 decks)

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