Endocarditis
1. True or false, IVD users can have a PIC line
2. What is the Priority nursing discharge assessment for patients with IE?
1. False, IVD users CANNOT have a PIC line( they'll use it for drugs)
2. Home assessment for continued antibiotics care!!!
What is the difference between acute pericarditis and Dressler's syndrome?
Acute pericarditis occurs within the first 48-72 hours after MI; ASAP
Dressler's syndrome is a delayed/late immune reaction after the heart has been damaged (MI); DELAYED
You are caring for a patient who is diagnosed with aortic stenosis and mitral valve regurgitation. How would you explain the difference between stenosis and regurgitation to this patient?
Stenosis: valves do not open well, so forward flow is restricted (a lack of enough blood getting through the valve when it’s supposed to be open).
Regurgitation: “Incompetent” or regurgitant valve does not close well, so backward flow occurs (blood going back through the valve when it’s supposed to be closed).
1. What are the 2 most common infecting organisms for Infectious Endocarditis?
2. What are 3 risk factors for IE?
1. Staph Aureus & Strep Viridians
2. Prosthetic heart valve
Acquired valve disease
Some congenital heart disease
Pacemaker
Marfan's syndrome
IVDA
Mitral valve replacement
Invasive procedures
1. When the volume in the pericardial sac is increased to the point the heart is compressed is defined as Cardiac ___________
2. Some symptoms of this heart complication are called Beck's Triad. Name them
2. Distended Jugular vein, Low blood pressure, muffled heart sounds
(Not everyone with cardiac tamponade will show all 3 signs of Beck's triad; other signs include tachycardia, Tachypnea, and SOB)
A client is scheduled for a transesophageal echocardiogram. Which of the following client statements demonstrates to the nurse a need for further teaching?
a. “The test will show how well my heart valves are working.”
b. “A flexible tube will be placed down my throat.”
c. “The test will provide information about the electrical conduction of my heart.”
d. “I can have nothing to eat or drink for several hours before the procedure.”
c. “The test will provide information about the electrical conduction of my heart.”
1.True or False, Vegetation sticks on the valve surface of the heart and affect valve function and cardiac rhythm
2.Name 3 things Vegetation can cause after breaking off and moving to the systemic circulation
1. True
2.
CVA
Limb infarction
Pulmonary infarction
Bacterial invasion of the myocardium(sepsis, heart failure, heart block)
1. What is the first line of treatment for Acute Pericarditis
2. True or False: Corticosteroids may prolong the course of recovery or increase the risk of recurrent pericarditis
1.NSAIDS and aspirin
2.True
1. Name 3 Nonspecific clinical manifestations of endocarditis
2. Name 3 Vascular clinical manifestations of endocarditis
1. Nonspecific: Fever, chills, weakness, anorexia, weight loss, arthalgia(joint pain), myalgia(muscle pain), back pain, abdominal discomfort, headache, nail bed clubbing
2. Vascular: Osler's nodes: Painful, tender, red/purple spots on fingertips or toes. Janeway lesions: flat, painless, small, red spots on fingertips, soles of feet, and toes. Roth's spot: hemorrhagic retinal lesions
What are some main diagnostics used for Pericarditis(at least 3)
1. ECG: diffuse ST elevations
2. Pericardial friction rub
3. Troponin elevation
4.HIV & ANA testing
5.ECHO
6.CBC
7.CT & MRI
8.Elevated CRP & ESR
9. Biopsy or culture of fluid from pericardiocentesis
1. What diagnostic tests would be used to rule out IE? (Be specific.)
2. What is the difference between depolarization and repolarization?
1. 3 blood cultures from 3 different sites obtained over 24 hours apart, ESR(erythrocyte)& CRP(C-reactive protein)elevation, ECHO, Chest X-ray, EKG
2. Depolarization is the ability to acquire a more positive charge(become less negative), while repolarization is when the internal charge returns to a more negative value
TLDR: Depolarization: negative to positive, Repolarization: positive to negative
1. True or false: The most common symptom of pericarditis is leg edema
2. Define Pericardial Effusion and 2 manifestations of large effusions
1.False: The most common symptom is chest pain
2. Increase in fluid in the pericardial sac, it's acute from trauma or bleeding, and may accumulate slowly from infection
Large effusions may compress structures, manifesting as cough, dyspnea, hiccups, hoarseness, and distant/muffled heart sounds(indicating impaired gas XD)