Term
|
Definition
An infection of the endocardium
Usually affects the valves
Origin
- Usually bacterial in origin
- Rheumatic heart disease |
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Term
| Contributing factors to endocarditis |
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Definition
- Aging
- IV drug abuse
- History of congenital heart disease
- Invasive procedures |
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Term
| Complications of endocarditis |
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Definition
- Vegetation forms on valves
- Microembolization into lungs and systemic circulation
- Valvular dysfunction and infection leads to HF, generalized myocardial dysfunction, sepsis, necrosis in tissues and organs due to emboli |
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Term
|
Definition
- Fever, chills, malaise, fatigue
- Arthralgia, myalgia
- Petechiae in dital extremities
- Splinter hemorrhages in nail beds
- New or worsened murmur
- HR symptoms
- Symptoms related to emboli |
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Term
| How to diagnose endocarditis |
|
Definition
- PMH
- Blood cultures
- Echo
= CXR
- EKG
- Cardiac cath |
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Term
| Treatment of endocarditis |
|
Definition
Antibiotics
- Usually at least 6 weeks
- Needs long-term IV access (PICC)
- Teach pts to adhere to schedule
- Do follow up blood cultures
Valve surgery
Prophylactic antibiotics before invasive procedures (teeth cleaning, endoscopy) |
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Term
| Nursing diagnoses for endocarditis |
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Definition
- Decreased cardiac output
- Activity intolerance
- Hyperthermia
- Knowledge deficit: discharge teaching |
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Term
|
Definition
- Infections
- Acute MI
- Neoplasms
- Trauma
- Invasive cardiac surgery
- Uremia
- Autoimmune diseases |
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Term
|
Definition
- Pericardial friction rub
- Muffled heart sounds
- Acute sharp chest pain that's worse when lying down, during deep inhalation, and when moving the trunk
- Dyspnea: rapid shallow breaths in response to pain
- Anxiety |
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Term
| Treatment of pericarditis |
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Definition
- NSAIDs
- Treat underlying cause |
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Term
| Pericardial effusion and cardiac tamponade |
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Definition
- A complication of pericarditis
- Tamponade is a medical emergency
- Rapid or slow fluid accumulation that compresses the heart and decreases CO |
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Term
| Signs and symptoms of pericardial effusion and cardiac tamponade |
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Definition
- SOB
- Tachycardia, tachypnea
- Confusion, agitation
- Pulsus paradoxus (drop in BP on inspiration) |
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Term
| How to diagnose pericardial effusion and cardiac tamponade |
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Definition
- EKG
- Echo
- CXR
- BUN/creatine
- Pericardial tap to determine cause and relieve pressure |
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Term
| Nursing implications for pericardial effusion and cardiac tamponade |
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Definition
- Careful assessment of chest pain
- Manage pain with positioning, NSAIDs
- Manage anxiety
- Prepare for possible pericardial tap |
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Term
| Stenosis vs insufficiency |
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Definition
Stenosis: narrowing of valve
Insufficiency (imcompetence, regurgitation): incomplete closure |
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Term
| Mitral valve stenosis origin |
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Definition
- Most commonly due to rheumatic HD
- Less commonly due to congenital, RA, lupus |
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Term
| Mitral valve stenosis symptoms |
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Definition
Murmur
Dyspnea
Pressure overload
May have emboli from stagnant blood in RA |
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Term
| Mitral valve regurgitation |
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Definition
- Acute (due to damage from MI, rupture of chordae tendineae) is an emergency
- Chronic is due to rheumatic HD, endocarditis |
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Term
| Mitral valve regurgitation symptoms |
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Definition
Acute
- Symptoms of PE and shock
- New murmur
- Treat emergently
Chronic
- Weakness
- Fatigue
- Exertional dyspnea |
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Term
|
Definition
- Most common form of valvular HD in US
- Valve leaflets buckle back into the LA
- Usually benign
- Complications: endocarditis, mitral regurgitation |
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Term
| Treatment of valvular disorders |
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Definition
- Prophylactic antibiotics
- Digoxin
- Diuretics
- Antiplatele/anticoagulants
- Nitrates
- Antiarrythmics
- Beta blockers
- Percutaneous balloon valvuloplasty
- Valve repair or placement (mechanical = lifelong anticoagulants, biologic=don't last long) |
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Term
| Peripheral artery disease (PAD) symptoms |
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Definition
- Comes from atherosclerotic progress, symptoms appear with 60-75% blockage
- Primarily involves lower extremities
- Intermittent claudiaction: leg pain with activity, relieved by rest
- Impotence with aortoiliac occlusion
- Parensthesias
- Constant pain with severe disease
- Symptoms can be unilateral or bilateral depending on severity
- Decreased or absent pulses, long cap refill
- Smooth round ulcers "punched out"
- Skin: shiny, thin, taut, hair loss
- Elevation pallor, dependent rubor
- Cool to touch |
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Term
|
Definition
- Non healing ulcers over the bony prominences of the feet and lower leg
- Gangrene
- Amputation |
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Term
|
Definition
- Doppler to assess pulse
- Ankle-brachial index (ABI)
- Duplex imaging: noninvasive, maps blood flow
- Angiogram
- MRA |
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Term
|
Definition
- Similar to CAD: treat hyperlipidemia and BP, decrease platelet aggregation, stop smoking
- Exercise therapy
- Wound care, prevent further skin breakdown
- IR- PTCA
- OR: atherectomy, bypass surgery |
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Term
| Nursing diagnoses for PAD |
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Definition
- Ineffective tissue perfusion
- Impaired skin integrity
- Acute pain
- Activity intolerance |
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Term
| Venous thromboembolus (VTE) |
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Definition
- Most common venous disorder
- Superficial (due to IV therapy) or deep (due to post op or immobility) |
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Term
|
Definition
Hypercoagulable state
Vascular wall injury
Circulatory status |
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Term
| Superficial thrombophlebitis: symptoms |
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Definition
Palpable firm cord-like vein
Surrounding area tender to palpation, warm, red
May be edematous |
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Term
| Superficial thrombophlebitis: treatment |
|
Definition
Application of warm moist heat
Discontinue IV if related
TEDs for legs to decrease venous stasis
NSAIDs |
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Term
|
Definition
- May be asymptomatic
- Unilateral leg edema, extremity pain, skin warm to tough, red
- Positive Homan's sign (can be false positive)
- Complication: PE (emergency) |
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Term
|
Definition
- Severity of symtpoms depend on size of emboli and number of involved vessels
- Sudden onset of dyspnea, tachypnea, tachycardia
- Cough, hemoptysis
- Pleuritic chest pain
- Anxiety, MS changes due to hypoxia
- Sudden death |
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Term
|
Definition
- Early ambulation
- TEDs
- Sequential/intermittent compression devices
- Anticoagulation for high risk patients |
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Term
|
Definition
Anticoagulation
Bedrest?
Oxygen for PE
Vena cava filter |
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