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Med surg 2 > Inflammatory Dysfunction and Valvular Dysfunction Focus > Flashcards

Inflammatory Dysfunction and Valvular Dysfunction Focus Flashcards

(58 cards)

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1
Q

what is mitral valve stenosis

A

Scarring of leaflets and chordae tendae decreasing blood flow from LA to LV increasing the pressure in LA

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2
Q

what is mitral valve regurgitation ss

A

loud holystolic murmur in LV, pulmonary edema, thready peripheral pulses

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3
Q

what could cause mitral valve stenosis

A

MI, ineffective endocarditis, chronic rheumatic heart disease, mitral prolapse

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4
Q

what is aortic valve stenosis

A

obstructive blood flow from LV to aorta which cause ventricular hypertrophy

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5
Q

what is the gold standard for diagnosing aortic valve disorders

A

CT scan with contrast

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6
Q

what does LV hypertrophy lead to

A

decreased cardiac output, pulmonary hypertension, HF

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7
Q

what meds prevent HF

A

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

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8
Q

what are the ss of chronic aortic valve regurgitation

A

asymptomatic for years
excertional dyspnea, angina, murmurs

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9
Q

what is the management/treatment of valvular heart disease

A

meds that prevent HF, sodium restriction less then 2 g, anticoagulants, anti dysrhythmias, prophylatic antibiotic (penicillin)

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10
Q

what is the teaching for when to seek medical care after someone gets a mechanical prosthetic

A

infection, HF, if going to have a procedure that requires penicillin

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11
Q

how much fluid can the pericardial space hold

A

10-15ml

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12
Q

what are the ss of mitral valve stenosis

A

congested lungs, exertional dyspnea, diastolic murmur, fatigue, palpitations

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13
Q

what do majority of mitral valve problems result from

A

rheumatic heart disease

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14
Q

when is surgery needed for aortic valve stenosis

A

when opening is 1cm or less

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15
Q

what is mitral valve regurgitation

A

mitral valve doesnt close properly causing back flow into the lungs

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16
Q

what are the ss of chronic mitral valve regurgitation

A

Asymptomatic for years until finally LV failure then weakness, fatigue, palpations, LA enlargement, ventricular hypertrophy

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17
Q

what meds are given for aortic valve stenosis

A

beta-blockers, diuretics, nitroglycerin (cautiously may make chest pain worse)

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18
Q

what is the most common valve issue

A

aortic valve stenosis - congenital

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19
Q

what are the ss of aortic valve stenosis

A

systolic murmur, LV failure triad (angina, syncope, exertional dyspnea)

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20
Q

what is a valvulotomy for and how does it work

A

for stenosis - takes dilator through top of LV into mitral valve opening and can remove clot

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21
Q

what is rheumatic heart disease and what is it caused by

A

caused by rheumatic heart fever = scaring and deformity of the heart valves

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22
Q

what is the therapeutic range for INR with a mechanical prosthetic

A

2.5-3.5 if not in range call doc

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23
Q

what are the ss of acute aortic regurgitation

A

LV failure, cardiogenic shock (angina, decreased BP, severe dyspnea) high pitched diastolic murmur

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24
Q

what is percutaneous transluminal balloon valvuloplasty and what is it used for

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A

for stenosis, a balloon tipped catheter is taken up the femoral artery and inflated to open valve

25
who normally gets a percutaneous transluminal balloon valvuloplasty
someone who is poor surgery candidate
26
can you prevent rheumatic heart fever
if antibiotics started in time
27
who is mostly at risk for getting rheumatic heart fever
young adults, under developed countries
28
what is rheumatic endocarditis
swelling and erosion of valve leaflets
29
what labs diagnosis rheumatic heart disease
elevated erythrocyte sedimentation rate, C-reactive protien
30
when would someone need to take prophylactic antibiotic
any procedure effecting the mouth, infected skin, respiratory biopsy, or angioedema
31
what could be some causes for pericarditis
acute mi, cancer, trauma, lupus, scleroderma, viral/bacterial infections
32
what are the ss of pericarditis
pain worse with inspiration, pain decreased when sitting forward, fever, dyspnea, pericardial rub
33
when listening for pericardial rub what should you ask your patient
to hold their breath so you can hear it better
34
what are the meds of choice for pericarditis
NSAIDs, colchicine
35
what is the treatment for cardiac tamponade
fluid bolus until someone can pull that fluid off
36
what do you want to make sure you do before a pericadiocentesis
stop anticoagulants
37
what are the ss of rheumatic heart disease
polyarthritis, carditis, nodules, heart enlargement, erythema marginatum (skin rash), sydenhams chorea (involuntary movement of muscles), prolonged PR interval
38
how do you diagnosis rheumatic heart disease
ECHO to show heart valves, chest x ray to show heart enlargement, ECG to show prolonged PR interval
39
what are the meds used for rheumatic heart disease
penicillin (erythromycin if allergic), inflammatory NSAIDs or corticosteroids, prophylaxis antibiotic until at least early 20s
40
what do you see on an ECG for pericarditis
wide spread ST elevation
41
what are some complications for pericarditis
pericardial effusions (build up of fluid), cardiac tamponade (fluid compressing the heart)
42
what are the ss of cardiac tamponade
muffled heart sounds, narrowed pulse pressure, neck vein distention, decrease systolic BP on inspiration
43
what is ineffective endocarditis
infection of inner heart layer including the valves caused by staph viridans or strep aureus, viruses, or fungi
44
what are the risks for ineffective endocarditis
age, IV drug abuse, mechanical prosthetic, renal dialysis, rheumatic heart disease
45
what labs would you take to diagnosis ineffective endocarditis
2 blood cultures from 2 different sites, WBC, elevated erythrocyte sedimentation rate, c-reactive
46
what causes myocarditits
virues, bacteria, fungi, radiation, autoimmune
47
how do you confirm myocarditits with diagnostic tests
endomyocardial biopsy in first 6 weeks following infection
48
what are some interventions you can do for HF
elevate head of bed 30 degree or more, rest periods, quiet environment, decrease risk for infection
49
what are the 3 main types of cardiomyopathy
dilated (degeneration of the heart), hypertrophic (LV hypertrophy), restrictive (ventricular is resistant to filling)
50
what are the risks for cardiomyopathy
African Americans, male, middle age, genetics, alcoholism (if only cause is alcohol if they stop drinking the heart will heal)
51
what is the treatment for cardiomyopathy
HF treatment, eventually a new heart
52
what are the ss of ineffective endocarditis
new or worsening murmur, fever, chills, weakness, anorexia,
53
what are the ss of vascular endocardititis
splinter hemorrhages on nails, petechiae, osler nodes on finger tips or toes, lesions of pas of fingers or toes
54
how do you treat endocardititis
IV antibiotics for 4-6 weeks, repeat blood cultures every 24-48 hours, valve replacement if needed, Tylenol for fever
55
what are the ss of myocardititis
7-10 days after viral infection, fever, fatigue, myalgias, pharyngitis, dyspnea, nv
56
what is cardiomyopathy
group of disease that directly effect myocardial structure or function
57
what are the ss of cardiomyopathy
fatigue, dyspnea, orthopnea, nv, anorexia, edema
58
how do you diagnosis cardiomyopathy
ECHO, elevated NT-pBNP or BNP

Med surg 2 (12 decks)

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