Inflammatory Heart Disorders

Question 1

ineffective endocarditis

Answer 1

disease of the endocardial layer of the heart, including the heart valves

Question 2

which valves do ineffective carditis mostly affect

Answer 2

aortic and mitral

Question 3

classification by cause for ineffective endocarditis

Answer 3

IV drug use (IV drug abuse), fungal

Question 4

classification by involvement for ineffective endocarditis

Answer 4

prosthetic valve endocarditis (PVE)

Question 5

causative organisms for ineffective endocarditis

Answer 5

bacterial, virus, fungi

Question 6

which bacteria are the most common for ineffective endocarditis

Answer 6

s. aureus; streptococcus viridians; coagulase negative staphylococci

Question 7

risk factors for IE

Answer 7

categories of high, moderate, and low risk of developing ineffective endocarditis

Question 8

principal risk factors for ineffective endocarditis

Answer 8

prosthetic valves; hemodialysis; IV drug abuse

Question 9

etiology and physiology for ineffective endocarditis

Answer 9

there are 3 stages: bacteremia, adhesion, and vegetation

Question 10

vegetation

Answer 10

fibrin, leukocytes, platelets, and microbes; stick to the valve or endocardium; parts break off and enter circulation

Question 11

left sided vegetation moves to

Answer 11

brain, kidneys, spleen

Question 12

right sided vegetation moves to

Answer 12

lungs

Question 13

clinical manifestations of IE

Answer 13

nonspecific, fever, chills, weakness, malaise, fatigue, anorexia

Question 14

subacute forms of IE

Answer 14

arthralgias, myalgias, back pain, abdominal discomfort, weight loss, headache, clubbing of fingers

Question 15

vascular manifestations

Answer 15

splinter hemorrhages in nail beds; petechiae; osler’s nodes on fingertips/toes; janeway’s leisons on pads of the fingers and toes; roth’s spots; new or worsening systolic murmur in most patients; heart failure

Question 16

manifestations secondary to septic embolism

Answer 16

CNS, extremities, spleen, and kidneys

Question 17

diagnostic studies

Answer 17

history, lab tests (blood cultures, CBC with differential, ESR, c-reactive protein); echocardiography; chest x-ray; ECG; duke criteria

Question 18

interprofessional care

Answer 18

prophylactic antibiotic treatment; acute identification of organism; IV antibiotics; repeat blood cultures; valve replacement if needed; antipyretics; fluids; rest

Question 19

prophylactic antibiotic treatment is given to patients who are experiencing…

Answer 19

certain dental procedures; respiratory tract incisions; tonsillectomy and adenoidectomy; surgical procedures involving infected skin, skin structures, or musculoskeletal tissue

Question 20

nursing assessment

Answer 20

health history (valvular, congenital, or syphilitic heart disease; previous endocarditis; staph/strep infection); dugs (immunosuppressive therapy); recent surgeries and procedures; subjective and objective data

Question 21

nursing diagnoses/problems

Answer 21

impaired CO; activity intolerance

Question 22

overall goals for nursing

Answer 22

normal baseline function; ability to perform ADLs without fatigue; understanding of treatment plan to prevent recurrence

Question 23

health promotion (implementation)

Answer 23

identify those at risk; assess history and understanding of disease process; teach importance of adherence to treatment regimen

Question 24

patient teaching (implementation)

Answer 24

stress need to avoid infectious people; avoidance of stress and fatigue; plan rest periods; good oral hygiene; prophylactic antibiotics; drug rehab; monitor body temp; s/s of complications; nature of disease and how to reduce risk of reinfection; stress follow-up care, good nutrition, prompt treatment of common infection; need for prophylactic antibiotic therapy

Question 25

ambulatory care (implementation)

Answer 25

antibiotic therapy for 4-6 weeks; assess home setting; monitor lab data, including blood cultures; assess IV lines; coping strategies; adequate rest; moderate activity; compression stockings; ROM exercises; deep breath and cough Q2 hrs

Question 26

acute pericarditis

Answer 26

inflammation of pericardial sac (pericardium)

Question 27

common causes of acute pericarditis

Answer 27

infectious agents (coxsackle B virus: most common); noninfectious; hypersensitive; or autoimmune

Question 28

clinical manifestations of acute pericarditis

Answer 28

left/center chest pain; SOB when reclining; heart palpitations

Question 29

complications of acute percarditis

Answer 29

pericardial effusion, cardiac tamponade, chronic constructive pericarditis

Question 30

myocarditis

Answer 30

inflammation of myocardium; linked to dilated cardiomyopathy

Question 31

causes of myocarditis

Answer 31

infectious agents (coxsackle A&B virus: most common); radiation therapy; chemical; drugs; autoimmune disorders

Question 32

rheumatic heart disease

Answer 32

scarring and deformity of heart valves, resulting from rheumatic fever; complication of strep A pharyngitis affects heart, also skin, joints, and CNS

Question 33

which audience does rheumatic heart disease affect

Answer 33

young adults

Question 34

pathophysiology of rheumatic heart disease

Answer 34

cardiac lesion and valve deformities- thickening of valve leaflets, causing regurgitation (mitral and aortic valves are most affected)

Question 35

complication of rheumatic heart disease

Answer 35

chronic rheumatic carditis

Question 36

treatment of rheumatic heart disease

Answer 36

anti-inflammatory agents

Question 37

cardiomyopathy

Answer 37

lead to cardiomegaly and heart failure; primary reason for heart transplant

Question 38

what are the three major types of cardiomyopathy

Answer 38

dilated, hypertrophic, and restrictive

Question 39

dilated cardiomyopathy

Answer 39

heart's ability to pump blood decreases because the heart's main pumping chamber; left ventricle is enlarged and weakened

Question 40

hypertrophic cardiomyopathy

Answer 40

heart muscle cells enlarge and cause the walls of the ventricles to thicken; without ventricular dilations; symmetric left ventricular hypertrophy occurs less common than dilated CMP

Question 41

restrictive cardiomyopathy

Answer 41

rare form of heart muscle disease that is characterized by RESTRICTIVE filling of the ventricles; myocardium diseased and impaired diastolic filling and stretch

Question 42

evaulation

Answer 42

maintain adequate tissue and organ perfusion; maintain normal body temperature; report an increased in physical and emotional comfort