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22 Cards in this Set
- Front
- Back
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Endocarditis
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Inflammation of the endocardium that lines inside of heart
-causes lesions and vegetations to form -caused by bacteria that enters the body(IV drug users, oral lesions, IV caths, urinary caths, body piercing, prosthetic valves) |
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Signs and symptoms of endocarditis
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infective endocarditis:
-temp above 101.5F and flu-like symptoms -cough, shortness of breath, joint pain acute staphylococcal endocarditis: -more severe, sudden onset of chill and high fever *splenomegaly is common *peripheral symptoms stem from microemboli or circulating immune complexes(petechiae: small purplish-red hemorrhagic spots on the trunk, conjuntiva, and mucous membranes), splinter hemorrhages(streaks under nails), osler's nodes(small, reddened painful growths on finger and toe pads), janeway lesions(small nontender, purplish-red macular lesions on the palms of the hands and soles of feet), roth's spots(small, whitish spots seen on the retina |
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Treatment of endocarditis
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diagnosis:
-blood culture(positive from at least 2 different sites, 2 different times) -echocardiography *endocarditis has increased risk of emboli resulting from vegetation break off treatment: -antibiotics *prosthetic valve endocarditis need longer therapy of antibiotics -surgery to replace damaged valves, removal of large vegetations |
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Diagnostics and nursing implications
Stress/exercise test |
stress test/exercise test:
-work rate increased q3min for 15min by increasing speed and degree of incline -exercise until fatigued, develop symptoms, or reach max HR nursing care: -wear comfortable shoes -avoid food, fluid, and smoking for at least 2-3hrs *thallium can be used to evaluate perfusion of myocardium(BP/HR affecting meds should be held for 24-36 hrs before) |
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Pericarditis
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Inflammation of outer layer of the heart:
-chest pain, pericardial friction rub, fever, decreased cardiac output -relieved by position change -aggravated by coughing or deep breaths -cardiac tamponade(filling of the pericardial sac with blood or fluid that compresses the heart) is relieved by pericardial centesis |
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Conditions that require pacemaker
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-partial or complete heart block
-intermittent sinus arrest -sinus bradychardia -dysrhythmias |
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Which condition requires biventricular pacing?
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CHF
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Types of Pacemakers
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-fixed rate-fires at a predetermined rate
-demand-fires only when needed -atrial triggered -atrial/ventricular sequenced |
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Nursing care for pacemaker patients
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-teach pt to take pulse q am before getting up and reporting if pace is 5 or more beats slower than preset rate
-teach signs of infection -teach signs of malfunction:chest pain, dizziness, palpitation -no heavy lifting for 2mo -no machines with magnets -carry id with type and rate of pacemaker |
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implantable cardiac defibrillator
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-delivers high energy pulse to heart during dysrhythmias
-can store information -senses v-fib, v-tach, a-fib |
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What is the purpose of the foramen ovale during fetal circulation
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it allows blood to flow from right atrium to left atrium and usually closes within 1-2 years after birth
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What is the purpose of ductus arteriosus during fetal circulation?
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it is a shunt that connects the pulmonary artery to the aorta; the high levels of O2 after birth usually closes the opening
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What are some of the causes of congenital heart defects?
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-viral infection during pregnancy(rubella)
-maternal alcoholism or DM -maternal smoking -maternal age >40 -heredity |
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Symptoms of congenital heart defects
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-increased pulse
-increased respirations -delayed growth -fatigue -frequent upper respiratory infection -pale, not active, weak *increased risk for sudden fetal death, sudden infant death, sudden adult death |
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Nursing care for pediatric catheterization
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-affected leg straight 4-6hrs
-bed can only be raised 20 degrees -IV fluids until taking adequate PO fluids -locate and mark pulses before surgery |
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Classification of pediatric heart defects
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1. cyanotic/acyanotic
2. increased pulmonary blood flow/decreased pulmonary blood flow |
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Acyanotic: atrial septal defect
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- left to right shunt between atria
-increased pulmonary blood flow -symptoms:fatigue, dypsnea, atrial dysrhythmias, palpitation, murmur during systolic ejection -close with open heart surgery -asymptomatic: treat with digoxin, diuretics, antiarrythmics *monitor for CHF |
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Acyanotic: ventricular septal defect
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-left to right shunt between ventricles
-increased pulmonary blood flow -symptoms:tachypnea, dyspnea, undernourished *moderate to large defects develop CHF accompanied by poor feeding and failure to thrive |
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Acyanotic: patent ductus arteriosus
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-failure for ductus arteriosus to close after birth
-left to right shunting between pulmonary and aorta -symptoms:tiring quickly, tachypnea, decreased cardiac output, machine-like murmur *untreated develops CHF; increased risk for endocarditis or aneurysm |
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Acyanotic: coarctation of aorta(COA)
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-partial or complete obstruction of blood flow through constriction of aorta
-causes obstruction to left ventricular output -decreases blood flow in lower body -discrepancy between upper and lower extremities BPs -weak or absent femoral pulses -weakness or tingling in lower extremeties -murmur with ejection click |
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Acyanotic: Pulmonary Stenosis/Aortic stenosis
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Pulmonary:
-defective pulmonic valve-thickened, hardened, rigid -decreases CO -causes right ventricle to pump harder->hypertrophy symptom:murmur w/ palpable thrill, exercise intolerance, CHF if severe, right ventricular failure Aortic: -defective aortic valve -decreased CO -symptoms: faint peripheral pulses, poor peripheral perfusion, severe CHF, chest pain, dizziness, syncope on exertion |
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Cyanotic heart defects
-defects with decreased pulmonary blood flow(hypoxemia) |
-tetralogy of fallot
-truncus arteriosus -transposition of the great vessels |
