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Test 1
na
78
Nursing
Graduate
02/13/2013

Additional Nursing Flashcards

 


 

Cards

Term
Inflammation of the heart muscle in the absence of acute or chronic ischemia
Definition
Myocarditis
Term
Myocarditis is rare in kids, usually cause by
Definition
Coxsackie or flu
Term
Patho of myocarditis
Definition
Myocardium invaded by infectious mycardium --> activated t-cell mediated response --> cd4 and b-cell activation with worsening inflammation and producing antiheart antibody prouction
Term
Pt c/o low urine output and fainting in myocarditis
Definition
Going into HF
Term
How long is myocarditis viral prodrom
Definition
2-3 wks
Term
Type of heart sounds in myocarditis
Definition
S3 or 4, pericardial friction rub, other arrhythmia's, sinus tachy
Term
S/s of peripheral hypoperfusion
Definition
Cold, bluish fingers/toes, poor cap refill
Term
When to do ECG in myocarditis
Definition
Immediately
Term
Purpose of Diagnostic evaluation in myocarditis
Definition
To find underlying cause: viral, bacterial, fungal, or allergic infections. Autoimmune diseases
Term
Dallas criteria is used in what type of myocarditis
Definition
Acute
Term
How are pts classified into the NY heart association functional classification (chronic myocarditis)
Definition
1- no limitations, 2- mild limitations, 3- limitation of activity with exertion, 4- SOB at rest
Term
What do pts need to avoid or reduce with myocarditis
Definition
Avoid stimulants and alcohol. Limit stress and exercise
Term
Main valve affected by native valve endocarditis
Definition
Mitral valve (50%)
Term
Main cause of native valve endocarditis in those who don’t use injectable drugs
Definition
Main cause of native valve endocarditis in those who don’t use injectable drugs
Term
Declining disease that causes native valve endocarditis
Definition
Rheumatic heart disease
Term
Other than heart anomalies, other causes of endocarditis
Definition
Age, diabetes, injectable drugs, long-term hemodialysis, poor dental hygiene.
Term
Main agent for native valve endocarditis in non injectable drug users
Definition
Streptococcal species 50-80%
Term
Late prosthetic valve endocarditis is caused how
Definition
By transient bacteria from a dental, GI, or GU procedure without or inadequate prophylaxis abx.
Term
Demographics of endocarditis caused by IV drug use
Definition
Males 20-40 yrs of age
Term
Valve that is usually damaged from IV drug use
Definition
Tricuspid valve (60%)
Term
Co-morbidities seen with right side endocarditis
Definition
Pneumonia and septic pulmonary emboli
Term
Examples of what pts get health care associated endocarditis
Definition
Dialysis centers, out patient IV abx clinics, nursing homes
Term
Time of onset of symptoms caused by health care associated endocarditis
Definition
Days to weeks
Term
Development of what should give you suspicion of health care associated endocarditis
Definition
Regurgitation murmur or new murmur and fever of unknown origin
Term
Fever may be absent in what pts with health care associated endocarditis
Definition
Older pts, immunocompromised, those with CHF or ESRD, or those previously tx with abx
Term
Splenomegaly is associated with?
Definition
Subacute disease of health care associated endocarditis
Term
Petechiae is found where in long-term infect endocarditis
Definition
Conjunctivae, palate, buccal mucosa, and extremities
Term
Non-tender, hemorrhagic macules on palms and soles and are result of septic embolization
Definition
Janeway’s lesions
Term
Painful nodules on the finger and toe pads that last hrs to days,
Definition
Osler’s nodes
Term
Retinal hemorrhages with a pale center near the optic disc
Definition
Roth’s spots
Term
How to diagnose pathogen of infective endocarditis
Definition
3 different sets of blood cultures from simple vein punctures.
Term
Treatment if abx therapy fails in treatment of endocarditis
Definition
Surgery-valve replacement.
Term
Who treats endocarditis
Definition
Infectious disease specialist, cardiac surgeon, and pathologist
Term
If myocarditis is found or suspected, who treats it
Definition
Cardiology
Term
reason for x-ray in myocarditis
Definition
To find signs of HF or cardiomegly
Term
What will seen on ECG in myocarditis
Definition
Can be normal, ST-segment and T-wave abnormalities
Term
Can the pt have a normal ECG after having an abnormal ECG from myocarditis that is now resolved
Definition
Yes.
Term
All myocarditis patients should avoid what?
Definition
Smoking, alcohol, and caffeine
Term
Why should NSAID’s be avoided in acute phase of myocarditis
Definition
Suppression of the early immune response with NSAID’s has shown to increase viral replication and inflammation producing more cardiac injury
Term
This form of myocarditis is more seen in young children and teenagers
Definition
Acute myocarditis
Term
What OTC medication should be avoid it myocarditis
Definition
Cold medications
Term
In myocarditis, why should the pt be assessed periodically
Definition
Looking for s/s of cardiomyopathy
Term
Yellow or greenish discoloration of the skin, sclerae and mucous membranes
Definition
Jaundice
Term
Prehepatic Jaundice
Definition
Conditions that produce excessive bilirubin
Term
Hepatic Jaundice
Definition
Hepatic injury- infections, toxins, autoimmune disorders, and tumors
Term
Posthepatic Jaundice
Definition
Obstructive Jaundice, complete or partial obstruction of the bile ducts
Term
Byproduct of hemolysis
Definition
Bilirubin
Term
Protein bound bilirubin
Definition
Indirect/unconjugated
Term
Increase in indirect bilirubin
Definition
Increase in destruction of RBC’s
Term
Increase in direct bilirubin
Definition
Usually liver dysfunction or obstruction
Term
Excreted in the urine
Definition
Conjugated Billy Rubin
Term
Pruritus is often seen in what type of Jaundice
Definition
Obstructive Jaundice
Term
Obstructive jaundice will cause what color change in stools
Definition
Light colored stools
Term
Gynecomastia testicular atrophy splenomegaly are strongly associated with what
Definition
Cirrhosis
Term
Hemolytic disorder will see what type of hyperbilirubenemia
Definition
Unconjugated or indirect hyperbilirubenemia
Term
When will you see increased bilirubin without liver enzyme abnormalities
Definition
Pregnancy, in sepsis, or after recent surgery
Term
Liver biopsy can be indicated when in jaundice
Definition
Liver enzymes fail to return to normal with in six months
Term
In most cases this is the cause of hypokalemia
Definition
Drug induced
Term
This is the main cause of hyperkalemia
Definition
Renal failure
Term
How does vomiting cause hypokalemia
Definition
Because of secondary hyperaldosteronism related to volume depletion
Term
Kidneys can maintain potassium balance until GFR falls to be low what
Definition
10 mL/min
Term
Flaccid paralysis beginning in the extremities and moving centrally can eventually lead to respiratory paralysis
Definition
Hypokalemia
Term
Peaked T waves ST segment depression widening of the QRS and pr intervals and loss of the P-wave
Definition
Hyperkalemia
Term
Calcium can treat this life-threatening symptom
Definition
Acute hyperkalemia
Term
The quickest way to treat acute hyperkalemia that has not resulted in life-threatening sequelae
Definition
IV administration of glucose and insulin
Term
Most common management for chronic hyperkalemia
Definition
Dialysis
Term
What is the most common type of female genital tract cancer
Definition
Endometrial cancer
Term
What are risk factors for endometrial cancer
Definition
Obesity nulliparity Endogenous or Exogenous  estrogen excess diabetes mellitus hypertension
Term
Which type of endometrial cancer is related to estrogen
Definition
Type I endometrial carcinoma
Term
How does pcos cause endometrial cancer
Definition
Keeps secreting estrogen and no progesterone, lining doesn't slough off
Term
How long does hormonal contraceptives keep protecting from endometrial cancer once they are stop
Definition
Up to 15 years
Term
When to be suspicious of endometrial cancer
Definition
Abnormal bleeding in postmenopausal women
Term
Main risk factor for ovarian cancer
Definition
The BRCA gene
Term
When is the CA 125 Lab good to do with ovarian cancer
Definition
After the patient has already been diagnosed
Term
What HPV infections can cause vulvar cancer
Definition
HPV 16 and 33
Term
What demographic has a high incident of vulvar cancer
Definition
Northern European ancestry
Term
How might vulvar cancers present on a patient
Definition
As a plaque ulcer mass or as pruritus
Term
What is the diagnostic test for vulvar cancer
Definition
Punch biopsy of the gross lesion
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