2000- Test 2 Inflammatory Heart Disorders

Front 1

Risk factors for Rheumatic fever are:

Back 1

-crowded living conditions with poor sanitation
-poverty
-immunodeficiency
-genetic factors

Front 2

Rheumatic heart disease is _____ after acute or repeated attacks of rheumatic fever.

Back 2

valvular dysfunction

Front 3

Rheumatic fever is caused by an abnormal immune response to a ______.

Back 3

pharyngeal function

Front 4

In rheumatic fever the abnormal immune response to group A beta-hemolytic streptococci produces an ______.

Back 4

inflammatory response

Front 5

Symptoms of rheumatic fever occur ____ after the initial pharyngeal infection.

Back 5

2-3 weeks

Front 6

S/Sx of rheumatic fever are grouped into 4 categories:

Back 6

-Cardiac
-Musculoskeletal
-Skin
-Neurologic

Front 7

The Cardiac manifestation of rheumatic fever is _____.

Back 7

carditis.

Front 8

Carditis is

Back 8

inflammation of all of the cardiac layers.

Front 9

When carditis occurs the patient will have ____, ____ and ____.

Back 9

chest pain
heart murmur
pericardial friction rub

Front 10

The musculoskeletal manifestation of rheumatic fever is _____.

Back 10

migratory polyarthritis

Front 11

When migratory polyarthritis with rheumatoid fever the patient will have

Back 11

red, hot, swollen joints.

Front 12

Common joints affected by migratory polyarthritis are

Back 12

knee, ankle, elbow and wrist.

Front 13

2 types of skin manifestations with rheumatoid arthritis are

Back 13

erythema marginatum and subcutaneous nodules

Front 14

_____ is a temporary nonpruritic skin rash with pale center and red irregular margin. It is located on the trunk and extremities.

Back 14

Erythema marginatum

Front 15

_____ are painless, pea-sized, palpable nodules of wrists, elbow, ankle, and knee joints.

Back 15

Subcutaneous nodules

Front 16

The neurologic manifestation of rheumatoid fever is _____. This is the least common side effect of rheumatic fever.

Back 16

Sydenham's Chorea

Front 17

Sydenham's chorea is uncoordinated jerking movements affecting primarily the

Back 17

face, hands and feet.

Front 18

S/Sx of acute rheumatic fever often peak within a month and are usually gone by ___.

Back 18

8 months

Front 19

Lab tests that are used to support or confirm the diagnosis of Rheumatic fever are:

Back 19

-Elevated ESR
-Elevated CRP
-Antistreptolysin (ASO) titer (+ for streptococci antibodies)
-Throat culture (+ for group A bhs)

Front 20

An elevated CRP and ESR indicate ______.

Back 20

inflammation

Front 21

Medications used for rheumatoid fever are:

Back 21

-antibiotics
-anti-inflammatory drugs

Front 22

Antibiotics used to treat rheumatic fever are

Back 22

Penicillin and Erythromycin

Front 23

_____ is an infection of the lining of the heart chambers and valves.

Back 23

Infective Endocarditis

Front 24

Infective Endocarditis most commonly occurs as a ______ on heart leaflets.

Back 24

vegetation

Front 25

Infective endocarditis is caused by a wide variety of ____, ____ and ____ organisms.

Back 25

BACTERIAL, fungal, and viral

Front 26

Sub acute infective endocarditis has a _____ onset.

Back 26

more gradual

Front 27

Acute infective endocarditis has a _____ onset.

Back 27

abrupt

Front 28

Risk factors for Infective endocarditis are

Back 28

-valve prosthesis
-IV drug use
-body piercing
-invasive catheters
-pacemakers
-cardioverter-defibrillators
-dental procedures
-congenital deformities
-rheumatic fever

Front 29

With infective endocarditis there is entry of a _____. Vegetations then adhere to the valve surface of the endocardium.

Back 29

pathogen

Front 30

Vegetations of infective endocarditis are composed of

Back 30

fibrin, platelets, and inflammatory cells.

Front 31

If a portion of the vegetation breaks off into circulation, it is called a _____.

Back 31

embolization

Front 32

The diagnostic test used for diagnosing infective endocarditis is ____.

Back 32

echocardiogram

Front 33

Primary manifestations of infective endocarditis are:

Back 33

-fever
-chills
-malaise
-fatigue
-heart murmur
-abdominal pain

Front 34

Peripheral manifestations of infective endocarditis are due to _____.

Back 34

embolization

Front 35

Peripheral manifestations of Infective endocarditis include:

Back 35

-Oslers Nodes
-Janeway's lesions
-Petechiae
-Splinter hemorrhage
-Roth spot

Front 36

____ are painful red nodules on finger and/or toe pads.

Back 36

Osler's Nodes

Front 37

____ are small, flat nontender lesions on the palms of hands and/or soles of feet.

Back 37

Janeway's lesions

Front 38

A ____ is a peripheral manifestation of infective endocarditis that is on the eye.

Back 38

roth spot

Front 39

Diagnostic studies that are used with infective endocarditis are

Back 39

-blood cultures
-echocardiogram
-serologic immune testing
-ESR

Front 40

An echocardiogram is used with infective endocarditis because it allows you to

Back 40

look at heart valves and chambers and visualize vegetations.

Front 41

Infective endocarditis is treated with

Back 41

prolonged course of antibiotics.

Front 42

Possible nursing diagnoses for a pt with infective endocarditis are

Back 42

-Risk for imbalanced body temperature
-Risk for ineffective tissue perfusion
-Ineffective health maintenance

Front 43

Nurses caring for a pt with infective endocarditis must educate the patient that

Back 43

antibiotics must be completed. May take weeks to complete.

Front 44

The common antibiotic used with infective endocarditis is _____.

Back 44

penicillin.

Front 45

Valve disease in adults is most common on the ____ side of the heart.

Back 45

left

Front 46

There are 2 types of valve diseases:

Back 46

Stenosis and Regurgitation

Front 47

The 3 most common types of valve disease in adults are

Back 47

Mitral regurgitation
Aortic Stenosis
Aortic Regurgitation

Front 48

Common causes of valvular heart disease are

Back 48

-degenerative aging process
-RHD
-Infective Endocarditis

Front 49

The most common form of valvular heart disease in the United States is

Back 49

degenerative (aging) disease

Front 50

____ is when the valve leaflets fuse together and cannot fully open or close. The orifice of the valve is narrowed and rigid which increases pump effort.

Back 50

Stenosis

Front 51

____ is the improper closing of a valve which causes the blood to reflux back through the valve into the area it just left.

Back 51

Regurgitation

Front 52

Regurgitation is also called ______.

Back 52

insufficiency

Front 53

3 disorders of the mitral valve are

Back 53

-Mitral valve stenosis
-Mitral valve regurgitation
-Mitral valve prolapse

Front 54

The mitral valve is on the ____ side of the heart.

Back 54

left

Front 55

Mitral valve is a _____ overload.

Back 55

pressure

Front 56

During mitral valve stenosis, there is a pressure overload because of the narrowed valve. This causes impaired blood flow into the ____ and increased workload for the ____.

Back 56

left ventricle
left atria

Front 57

When a pt has mitral valve stenosis, there is a pressure overload. The LA will first ____ and then _____.

Back 57

hypertrophy
dilate

Front 58

Manifestations of Mitral Valve Stenosis are

Back 58

-DOE
-orthopnea
-cough
-paroxysmal nocturnal dyspnea
-murmur

Front 59

An improper closing of the mitral valve is called ______.

Back 59

mitral regurgitation

Front 60

Mitral regurgitation is a ____ overload problem.

Back 60

volume

Front 61

Mitral regurgitation is a volume overload problem. It causes a backflow of blood into the ____.

Back 61

left atria

Front 62

When a patient has mitral regurgitation, there is a volume overload. This causes the LA to _____ and then _____.

Back 62

dilate
hypertrophy

Front 63

Manifestations of mitral regurgitation are

Back 63

-DOE
-orthopnea
-pulmonary congestion
-murmur

Front 64

____ occurs when one or both mitral valve cusps "billow" into the LA during ventricular systole.

Back 64

Mitral Valve prolapse

Front 65

Mitral valve prolapse is often _____ and affects _____ more.

Back 65

asymptomatic
women

Front 66

2 disorders of the aortic valve are

Back 66

-Aortic Valve stenosis
-Aortic Valve Regurgitation

Front 67

Aortic stenosis is a ____ overload problem.

Back 67

pressure

Front 68

When a patient has aortic stenosis there is a pressure overload. The valve orifice is narrowed causing impaired blood flow from the ____ into the ___ which increases the ____ workload.

Back 68

LV
aorta
LV

Front 69

Aortic stenosis is a pressure overload problem that causes LV ____ and then _____.

Back 69

hypertrophy
dilation

Front 70

Manifestations of Aortic stenosis are

Back 70

-DOE
-angina
-murmur

Front 71

Pt with aortic stenosis will have DOE and angina because of

Back 71

decreased tissue perfusion.

Front 72

Aortic regurgitation is a _____ overload problem.

Back 72

volume

Front 73

When a pt has aortic regurgitation, there is a volume overload causing a backflow of blood into the ____ from the ____.

Back 73

LV
aorta

Front 74

Since aortic regurgitation is a volume overload problem, it causes the LV to ____ and then _____.

Back 74

dilate
hypertrophy

Front 75

Manifestations of aortic regurgitation are

Back 75

murmur
DOE
angina

Front 76

Medications that are used to treat valvular heart disease with HF are

Back 76

-diuretics
-ACE inhibitors
-vasodilators
-digitalis

Front 77

Medications used to treat valvular heart disease with A fib are

Back 77

-digitalis
-small doses of beta blockers
-anticoagulants

Front 78

If a patient has valvular heart disease, they will take _____ prior to any dental work or surgery.

Back 78

prophylactic antibiotics

Front 79

Surgeries used for Ts of valvular heart disease are

Back 79

-Percutaneous balloon valvuloplasty
-vlavuloplasty
-open commussurotomy
-annuloplasty
-valve replacement

Front 80

_____ is a procedure for select patients with severe symptomatic aortic stenosis who are not able to have open chest surgery.

Back 80

Transcatheter Aortic Valve Replacement (TAVR)

Front 81

The TAVR is made with ____ pericardium and is supported with a metal stent.

Back 81

bovine/cow