Med/Surg III Exam 1 - Eldridge - Cardiovascular Disorders/ Cardiovascular Drugs
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Created by:
emilyj4888 on January 22, 2011
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45 terms
Terms | Definitions |
|---|---|
 What would the nurse assess for as a causative agent in patient who presents to the clinic with Rheumatic Heart Disease? | pharyngeal infection by Lancefield Group A beta-hemolytic Strep |
| In a patient with Rheumatic Heart Disease, how long does it for the symptoms to develop? | Several weeks after the initial respiratory infection occurs. (1-6 weeks) |
| What is a unique symptom of Rheumatic Heart Disease? | Erythema marginatum (red raised rash); usually on chest, back, or abdomen |
| What will the nurse assess for on the EKG of a patient with Rheumatic Heart Disease? | Prolonged P-R interval |
| A patient presents to the ER with pain in the left chest that radiates to the L shoulder, neck and back.What disorder would the nurse suspect the patient to have? | Pericarditis |
| How is pericarditis pain different from Myocardial pain? | It increases with inspiration, cough, movement of the trunk, and deep breathing. It is worse when lying flat and better when sitting up leaning forward. |
| What will the nurse assess for on the EKG of a patient with Pericarditis? | PR interval depression; tachycardia; bradycardia; Atrial Fibrillation |
| With a patient diagnosed with pericarditis who is having chest pain, what would the nurse assess for on the EKG? | ST segment elevation; T wave inversion without Q wave changes - these changes can remain for weeks to months |
| The nurse is listening to the heart sounds of a patient diagnosed as having a Pericardial Friction Rub. What is the KEY diagnostic tool in assessing for this disorder? | Heart sounds described as grating, scraping, squeaking, or crunching; the sounds are a result of friction between the roughened inflamed areas of the pericardium |
| What assessment tool would the nurse use to distinguish between a pericardial and pleural friction rub? | Have the patient hold his/her breath for a few seconds. If it continues, it's a pericardial rub not pleural. |
| The nurse knows that if the onset of Pericardial Effusion is rapid, an 80mL increase of fluid may cause enough compression of the heart to cause? | Shock and death |
| The nurse knows what three things are included in the "Beck's Triad" of Cardiac Tamponade? | decreased b/p, jugular vein distention, muffled heart sounds |
| When assessing a patient with Cardiac Tamponade, the nurse notices that the patient has developed Pulsus paradoxus. The nurse knows that this means? | It is a 10mmHg decrease of systolic b/p on inspiration as a result of pericardial swelling. |
| What are bacterial antibiotics and TB drugs used for in Cardiac Tamponade? | Used to treat the causative organism |
| The nurse knows that in a patient with myocarditis, the inflammation can affect what key function of the heart? | Affects the heart's ability to pump; can present as an emergency |
| What will the nurse assess for on the EKG of a patient diagnosed with Myocarditis? | Diffuse ST segment abnormalities, T wave changes, dysrhythmias and heart block |
| What are classification of drugs are used as part of immunosuppressive therapy of Myocarditis? | steroids; to reduce cardiac damage if autoimmune factors are present |
| What would antimicrobials be used for in a patient with Myocarditis? | If the myocarditis developed from a bacterial infection |
| What are classification of drugs are used in Myocarditis to prevent thrombi on heart walls? | Anticoagulants |
| What classification of drugs are used as needed in Myocarditis? | Anti-arrhythmics |
| What classifications of drugs are used in patients with Myocarditis with CHF? | ACE inhibitors, Beta blockers, Dig, Diuretics |
| A nurse is taking care of a patient who recently had a prosthetic heart valve procedure from having Infective Endocarditis. The nurse knows that the patient can still develop an infection up to how many days and more post op? | Up to more than 60 days post op |
| The nurse knows that the most common skin bacteria causing Infective Endocarditis is? | Staph aureus |
| What classifications of drugs are used as IV antibiotic therapy for patients with Infective Endocarditis? | penicillins, cephalosporins, antitubercular drugs or if fungal organism - may require a combination of drugs |
| The nurse knows that after how many days, a patient with Infective Endocarditis who has no response to antibiotic therapy will need a valve replacement? | 7-10 days |
| What is the blood culture procedure for a patient with Infective Endocarditis? | Blood cultures obtained from different sites 2x or 3x over a 24 hour period and may be incubated over 3 weeks. |
| What is important for the nurse to remember regarding cultures and antibiotics? | The nurse should always do cultures before administering antibiotics. |
| The nurse knows that a patient with Infective Endocarditis who is having a tracheo-esophageal echocardiogram (TEE) should be NPO before the procedure for how long? | 6 hrs because conscious sedation is used; also observe pt for return of gag reflexes |
| What is the medical management for a patient with a nursing diagnosis of: Ineffective Tissue Perfusion r/t emboli formation, dislodging of a vegetative growth? | Administer anti-coagulants and monitor for therapuetic levels to keep emboli from forming throughout the body |
| What is the medical management for a patient with a nursing diagnosis of: Decreased Cardiac Output r/t action of diseased valve, increased body demands 2nd to infection, and 2nd to CHF? | Administer diuretics, inotropic agents, and Na diet to decrease fluid retention |
| What is the medical management for a patient with a nursing diagnosis of: Hyperthermia r/t the response to the cardiovascular disease process? | Administer antibiotics and anti-pyretic as necessary to treat the causative organism. |
| The nurse knows that a unique clinical manifestation of Aortic Valve Regurgitation is? | Musset's sign: head bobbing with each heartbeat |
| What does the nurse know when listening for heart sounds of a patient with Tricuspid Valve Disease? | Murmurs heard become louder with inspiration |
| The nurse knows that a patient who recieves a biological valve replacement does not usually require what classification of drugs? | Anticoagulants |
| The nurse knows that a patient on anticoagulant therapy should avoid? | ASA or anti-inflammatory drugs, foods high in vitamin K (green leafy vegetables, brocolli, asparagus, brussel sprouts, cabbage) |
| What should the nurse teach the patient on anticoagulant therapy about dental procedures? | The need to take antibiotics prior to invasive dental work to prevent endocarditis |
| Why are anticoagulants used in patients with Dilated Cardiomyopathy? | to prevent emboli |
| Why are diuretics used in patients with Dilated Cardiomyopathy? | to decrease fluid overload |
| Why are beta blockers and ACE inhibitors used in patients with Dilated Cardiomyopathy? | They may be able to slow or stop heart muscle damage |
| Why are antiarrythmics used in patients with Dilated Cardiomyopathy? | Control muscle irritability |
| Why is Dig used in patients with Dilated Cardiomyopathy? | For symptoms of HF |
| What classifications of drugs are used in patients with Hypertrophic Obstructive Cardiomyopathy to decrease obstruction and hypercontractility? | Negative inotropic meds (beta-blocking agents, calcium antagonist) |
| What classifications of drugs are used in patients with Hypertrophic Obstructive Cardiomyopathy and also have atrial fib? | Anticoagulants and Antiarrhythmic agents to prevent sudden cardiac death |
| What classifications of drugs are used in patients with Restrictive Cardiomyopathy? | antiarrhythmics, diuretics, beta or calcium channel blockers, anticoagulants |
| What classifications of drugs are used in patients with Arrhythmogenic Right Ventricular Cardiomyopathy? | beta blockers, antiarrythmics |
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