NUR 2502 MDC 3 Final Exam Study Guide, NUR2502 : Multidimensional Care III / MDC 3 - Rasmussen

MDC 3 Final Exam Study Guide


Cardiac Disorders
Heart failure – 3 types
 Left-sided heart failure – results from ineffective left ventricular contraction causing a
backup of fluid into the lungs, which results in pulmonary congestion.
o Symptoms
 Chest discomfort
 Dyspnea
 Palpitations
 Skipped heartbeats
 Tachycardia
 Weakness
 Dizziness
 Fatigue
 Oliguria (Kidney failure)
 Right-sided heart failure – results from the inability of the right ventricle to effectively
contract to pump blood, causing a backup of fluid into the periphery.
o Symptoms
 Nausea
 Anorexia
 Leg edema
 Ascites
 Nocturia
 Hepatomegaly
 High-output failure – results from an increased metabolic state in which cardiac output
remains normal or above normal. High-output failure is caused by increased metabolic
needs or hyperkinetic conditions, such as septicemia, high fever, anemia, and
hyperthyroidism.
 Patient Education
o Take medication as prescribed. Avoid NSAIDS
o Stay active as tolerated
o Weigh daily
o Limit sodium to 2-3g per day. Limit fluid to 2 L per day
 Diagnostics
o ABG
o Chest x-ray
o EKG
o Echocardiogram – best tool in diagnosing HF.
Mitral stenosis
Is the stiffening/narrowing of the valves preventing normal blood flow from the left atrium into
the left ventricle. This can lead to left atrial dilation and pulmonary congestion.

,  Causes
o Rheumatic fever
o Congenital abnormalities
 Symptoms
o Dyspnea
o Orthopnea (SOB lying down)
o Nocturnal dyspnea
o Hemoptysis
o Dry cough
o Pulmonary HTN
o Hepatomegaly

Mitral Regurgitation
The mitral valve does not close completely causing a backflow of blood into the Left Atrium.
 Can lead to hypertrophy of the left atrium and ventricle due to increased pressure.
 Causes
o Rheumatic fever
o Infective Endocarditis
o Papillary muscle dysfunction
Mitral Prolapse
The enlargement of the mitral valve leaflets which then prolapse into the left atrium.
 Causes
o Marfan syndrome
o Congenital heart disease
o Genetics
 What sound would you anticipate auscultating? – A midsystolic click heard at the
apex of the heart.
Aortic stenosis
Narrowing of the aortic valve, obstructing ventricular outflow
Can lead to ventricular hypertrophy resulting in effective perfusion of oxygenated blood
If left untreated, can progress to right-sided heart failure.
 What sound would you expect to hear if auscultating? - A diamond-shaped, systolic
crescendo-decrescendo murmur
Aortic regurgitation
The valve does not close appropriately allowing blood to backflow into the ventricles.
 Assessment Findings

, o Palpitations
o Dyspnea
o Orthopnea
o Paroxysmal nocturnal dyspnea
o Fatigue
o Angina
o Sinus tachycardia
o Blowing, decrescendo diastolic murmur
 Treatment
o Rest
o ACE inhibitors (-pril)
o O2
o Beta blockers (-lol)
o Digoxin
o Diuretics
o Calcium channel blockers (-dipine)
 Multidimensional Care
o Monitor patient signs and symptoms of heart failure (edema, tachypnea,
tachycardia, fatigue, cough, dyspnea)
o Implementation of transvenous pacing to maintain heart rate
o Administer anti-coagulants as prescribed to prevent thrombus formation
o Manage post-operative pain
o Monitor post-operative bleeding
o Daily weight
o Fluid & Sodium Restriction
 What sounds might you auscultate? – “bounding” apical pulse.

Top 4 Nursing Interventions: Morphine Oxygen Nitroglycerine Aspirin

Infective endocarditis
 Causes
o IV drug use
o Valve replacement
o Streptococcus viridans
o Staphylococcus aureus
 Treatment
o Antibiotics
o Surgery to remove/repair infected valve and shunts
o Maintain proper oral hygiene – soft toothbrush twice a day
 Symptoms
o Fever w/ chills, night sweats, malaise, fatigue