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MedSurg > T2: Arrhythmias and Cardiomyopathy > Flashcards

T2: Arrhythmias and Cardiomyopathy Flashcards

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1
Q

permanent localized dilation of an artery; enlarging artery 2x or more of its normal diameter

A

aneurysm

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2
Q

arterial wall is weakened by congenital or acquired problems

A

True aneurysm

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3
Q

occurs as a result of vessel injury or trauma to all three layers of the arterial wall

A

False aneurysm

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4
Q

formed when blood accumulates in the wall of an artery

A

dissecting aneurysm

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5
Q

Most common aneurysm, usually asymptomatic, frequently ruptures

A

abdominal aortic aneurysm

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6
Q

Abdominal aortic aneurysm is located between the _____ arteries and the aortic ______ (dividing area)

A

-renal arteries
-aortic bifurcation

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7
Q

aneurysm frequently misdiagnosed, often found when imaging is used for other purposes

A

Thoracic aortic aneurysm

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8
Q

TAAs are found between the _______ and _______

A

-origin of the left subclavian artery
-diaphragm

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9
Q

Thoracic aortic aneurysms are located in the _____, _____, and _____ areas of the aorta or the aortic arch

A

descending, ascending, and transverse

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10
Q

T/F: surgical management is most common form of TAA management

A

False; surgical management is very difficult

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11
Q

Symptoms of Abdominal Aortic Aneurysm (4)

A

-abdominal pain
-flank pain
-back pain
-some will report heartburn

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12
Q

Abdominal Aortic Aneurysm can be observed by looking for:

A

pulsation in the upper abdomen slightly left of the midline between the xiphoid process and umbilicus

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13
Q

When patient has an abdominal aortic aneurysm, auscultate for:

A

bruit over the mass

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14
Q

Critical consideration of abdominal aortic aneurysms

A

-Do NOT palpate or auscultate a pulsating mass because it could rupture

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15
Q

Assess for ____ in pts with an abdominal aortic aneurysm (7)

A

-pain in lower back or abdomen
-hypertension
-diaphoresis
-decreased LOC
-Oliguria
-Loss of pulse distal to the rupture dysrhythmias

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16
Q

If pt with abdominal aortic aneurysm has pain in lower back, as if pain radiates to __, ___, or ____

A

-groin
-buttocks
-legs

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17
Q

TAA Assessed: (4)

A

-back pain or chest pain that is very severe
-SOB
-Hoarseness
-Difficulty swallowing

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18
Q

T/F: Physical assessment does not usually detect TAA

A

True

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19
Q

________ may occur if a TAA ruptures

A

Hypovolemic shock

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20
Q

AA Assessed: (2)

A

-CT with contrast used for assessing size and location
-Ultrasonography

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21
Q

AA Nursing actions:
Monitor (3)

A

-blood pressure
-pulse
-peripheral circulation

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22
Q

AA Nursing actions:
Nonsurgical management (3)

A

-Regulate blood pressure if client has hypertension
-Frequent CT or ultrasound to monitor
-Educate client on s/s of possible ruptures

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23
Q

AA surgical management (2)

A

-Cardiothoracic surgeon
-Small aneurysm may be done as elective, larger may be emergency surgery

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24
Q

Surgical management AAA (2)

A

-Commonly a resection
-Endovascular stent grafts

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25
AAA surgery with high mortality rate
Resection
26
Endovascular stent grafts have a _______ mortality rate compared to resections, making it:
-improved -procedure of choice
27
Possible complications of Endovascular stent grafts
-bleeding -rupture -peripheral embolization -stent misplacement -endoleak -infection
28
blockage of blood flow
peripheral embolization
29
blood flow occurs within aortic aneurysm
endoleak
30
Aortic aneurysm post surgical client education (3)
-lifting restriction for 6-12 weeks -caution when pushing , pulling, or straining -Avoid driving for several weeks
31
Aortic aneurysm cues: (7)
-Pain describes as sharp. tearing, ripping, or stabbing -sweating -Nausea/vomiting -Fainting -Pallor -Rapid weak pusle -Feeling of impeding doom, apprehension, anxiety
32
Aortic dissection emergency care (5)
-2 large bore IVs -0.9% sodium chloride -indwelling catheter -Pain relief: morphine -HTN management: IV beta blockers
33
chronic disease of cardiac muscle
cardiomyopathy
34
4 types of cardiomyopathy
-Dilated -Hypertrophic -Restrictive -Arrhythmogenic right ventricular
35
most common type of cardiomyopathy
Dilated
36
With Dilated Cardiomyopathy, extensive damage is done to _______, interfering with myocardial ________
-myofibrils -metabolism
37
most of the energy for the contraction of the heart comes from:
oxidative phosphorylation of ADP
38
Dilated Cardiomyopathy: -_________ ventricle(s) are dilated -_________ function impaired -Decreased CO2 r/t:
-both ventricles -systolic function -inadequate pumping of the heart
39
S/S of dilated cardiomyopathy (7)
-SOB with exertion -Decreased ability to exercise -Fatigue -Palpitations -Systemic or pulmonary emboli -Moderate to severe cardiomegaly -A-fib in some clients
40
Cause of Dilated cardiomyopathy (7)
-alcoholism -chemo -infection -inflammation -nutritional deficit -heredity -CAD
41
Diagnosis of dilated cardiomyopathy (2)
-xray -echocardiography
42
treatment of dilated cardiomyopathy (5)
-vasodilators -surgery -dysrhythmia control -treatment of HF -beta blockers
43
Treatment of HF that can be applied to cardiomyopathy (4)
-diuretics -cardiac glycosides -antidysrhythmic drugs -implantable cardiac defibrillator
44
Asymmetric ventricular hypertrophy (thickening) cousin g ti to be harder for the heart to pump blood; reduced cardiac output and stroke volume
hypertrophic cardiomyopathy
45
Hypertrophic Cardiomyopathy: -Obstruction in ________ tract most common -_____ valve abnormalities common -Genetic trait
-left ventricular outflow -mitral valve -single gene autosomal-dominant (1:500ppl)
46
S/S of hypertrophic cardiomyopathy (10)
-May be asymptomatic in adolescence or early adulthood -Shortness of air on exertion -Syncope -Dizziness -Palpations -Mild cardiomegaly -Ventricular dysrhythmias -Sudden death -Heart failure -Chest pain at rest, prolonged, not relieved by nitrates
47
Treatment of hypertrophic cardiomyopathy
-HF treatment -Beta blockers -AFib conversion -Surgery
48
Surgical treatment of hypertrophic cardiomyopathy: (2)
-ventriculomyotomy -muscle resection w/ mitral valvue replacement
49
Hypertrophic cardiomyopathy diagnosis: (3)
-Echocardiography -X-ray -Angiocardiography durino a catheterization
50
Stiffening of the lower chambers of the heart making it harder for them to fill with blood
Restrictive cardiomyopathy
51
Restrictive cardiomyopathy: -_______ prognosis -_______ diagnosis
-poor -rare
52
S/s of restrictive cardiomyopathy:
similar to HF
53
Cause of restrictive cardiomyopathy: (3)
endocardial or myocardial disease -sarcoidosis -amyloidoisis
54
patches of red swollen tissue
sarcoidosis
55
amyloid build up in the organ
amyloidosis
56
Surgical treatment of restrictive cardiomyopathy (2)
-percutaneous alcohol septal ablation -heart transplant
57
replacement of myocardial tissue with fibrous and fatty tissue
arrhythmogenic right ventricular cardiomyopathy
58
arrhythmogenic right ventricular cardiomyopathy: -may also occur in: -______ associated: most often affects:
-left ventricle -familial associated- most often affects young adults
59
Medical Energy that needs to be assessed after heart transplant/why
-bleeding onto the pericardial sac with potential for cardiac tamponade -pressure from fluid prevents heart from pumping
60
bleeding onto the pericardial sac with potential for cardiac tamponade: S/S (3)
-low blood pressure -distention of the jugular veins -muffled heart sounds
61
S/S of heart transplant rejection
-SOB -fatigue -fluid gain -abdominal bloating -new bradycardia
62
MOST IMPORTANT part of heart transplant post-op care
infection control

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