NUR 257 Exam 3- Peters (main things
to focus on)
Symptoms and criteria used to diagnose rheumatic fever? - answer-Jones criteria (2
major, or 1 major & 2 minor)
-Carditis, Polyarthritis( arthritis in multiple joints), chorea (uncontrolled muscle spasms),
subcutaneous nodules, rash, fever, arthralgia, etc, etc
-+ Serum strep antibodies (antistreptolysin O titer)
-Assess cardiac function
-Post-group A B-hemolytic streptococcus infection (2-6 weeks prior); un or undertreated
(Strep throat, impetigo, etc)
reliable and best standardized test for rheumatic fever? – answer antistreptolysin O
(ASO)
Treatment of rheumatic fever? - answer-ATB: PCN/erythromycin; encourage drug
compliance
-ASA/salicylates: for inflammation, fever, pain
-Bed rest during acute phase w/ good alignment of joints
High percentage of recurrence of rheumatic fever so its important to complete
______therapy - answer-Antibiotic
major complication of rheumatic fever? - answer-rheumatic heart disease which can
result in cardiac valve damage
Risk factors of CHD for infant? - answer-other anatomic defects
-chromosomal abnormalities (down syndrome)
Risk factors of CHD for mother? - answer-chronic health conditions ie- DM, poorly
controlled PKU
-maternal alcohol/illicit drug use
-teratogenic medications taken by mother during pregnancy
-exposure to infections ie-rebulla
-exposure to environmental toxins
-low birth weight d/t intrauterine growth restrictions
-high birth weight infants
What are the 3 Congenital heart defects that that cause a LEFT to RIGHT shunting of
blood and increased pulmonary blood flow? - answerAtrial septal defect
ventricular septal defect
patent ductus arteriosus
, What is atrial septal defect? - answer-increased pulmonary blood flow: L-R shunt
-Loud, harsh murmur
-may be asymptomatic
-may have enlarged R atrium with increased O2 saturation in R atrium
-extra blood flow: too much pressure (crackles)
What is ventricular septal defect? - answer-increased pulmonary blood flow: L-R shunt
-Most common
-hole in heart
-loud, harsh murmur
-may be asymptomatic if small
-increased O2 sat RV
-often closed during 1st year
-repair: often wait to repair if asymptomatic
What is patent ductus arteriosus? - answer-increased pulmonary blood flow: L-R shunt
-Failure of fetal circulation to close "persistent fetal circulation"
-murmur (machine like)
-wide pulse pressure
-bounding pulses
-may be asymptomatic at rest
-Treatment: ¡Indocin [indomethacin] (prostaglandin inhibitor); promotes closure of PDA;
may require surgery
What is coarctation of aorta? - answer-obstruction of blood flow from ventricles
-Narrowing of lumen of aorta
-increased BP in upper extremities --nosebleeds
-weak or absent lower extremity pulses
-cool lower extremities
What is tetralogy of fallot? - answer-decreased pulmonary blood flow: R-L shunt
-Murmur
-cyanosis
-dyspnea
-digital clubbing
-polycythemia
-FTT
-hypercyanotic/blue/tet spell
-"squat" position to slow pulmonary blood flow
-multiple surgeries
-Tetralogy: pulmonic stenosis, VSD, overriding aorta, R ventricular hypertrophy
Digoxin? - answer-used to treat heart failure
to focus on)
Symptoms and criteria used to diagnose rheumatic fever? - answer-Jones criteria (2
major, or 1 major & 2 minor)
-Carditis, Polyarthritis( arthritis in multiple joints), chorea (uncontrolled muscle spasms),
subcutaneous nodules, rash, fever, arthralgia, etc, etc
-+ Serum strep antibodies (antistreptolysin O titer)
-Assess cardiac function
-Post-group A B-hemolytic streptococcus infection (2-6 weeks prior); un or undertreated
(Strep throat, impetigo, etc)
reliable and best standardized test for rheumatic fever? – answer antistreptolysin O
(ASO)
Treatment of rheumatic fever? - answer-ATB: PCN/erythromycin; encourage drug
compliance
-ASA/salicylates: for inflammation, fever, pain
-Bed rest during acute phase w/ good alignment of joints
High percentage of recurrence of rheumatic fever so its important to complete
______therapy - answer-Antibiotic
major complication of rheumatic fever? - answer-rheumatic heart disease which can
result in cardiac valve damage
Risk factors of CHD for infant? - answer-other anatomic defects
-chromosomal abnormalities (down syndrome)
Risk factors of CHD for mother? - answer-chronic health conditions ie- DM, poorly
controlled PKU
-maternal alcohol/illicit drug use
-teratogenic medications taken by mother during pregnancy
-exposure to infections ie-rebulla
-exposure to environmental toxins
-low birth weight d/t intrauterine growth restrictions
-high birth weight infants
What are the 3 Congenital heart defects that that cause a LEFT to RIGHT shunting of
blood and increased pulmonary blood flow? - answerAtrial septal defect
ventricular septal defect
patent ductus arteriosus
, What is atrial septal defect? - answer-increased pulmonary blood flow: L-R shunt
-Loud, harsh murmur
-may be asymptomatic
-may have enlarged R atrium with increased O2 saturation in R atrium
-extra blood flow: too much pressure (crackles)
What is ventricular septal defect? - answer-increased pulmonary blood flow: L-R shunt
-Most common
-hole in heart
-loud, harsh murmur
-may be asymptomatic if small
-increased O2 sat RV
-often closed during 1st year
-repair: often wait to repair if asymptomatic
What is patent ductus arteriosus? - answer-increased pulmonary blood flow: L-R shunt
-Failure of fetal circulation to close "persistent fetal circulation"
-murmur (machine like)
-wide pulse pressure
-bounding pulses
-may be asymptomatic at rest
-Treatment: ¡Indocin [indomethacin] (prostaglandin inhibitor); promotes closure of PDA;
may require surgery
What is coarctation of aorta? - answer-obstruction of blood flow from ventricles
-Narrowing of lumen of aorta
-increased BP in upper extremities --nosebleeds
-weak or absent lower extremity pulses
-cool lower extremities
What is tetralogy of fallot? - answer-decreased pulmonary blood flow: R-L shunt
-Murmur
-cyanosis
-dyspnea
-digital clubbing
-polycythemia
-FTT
-hypercyanotic/blue/tet spell
-"squat" position to slow pulmonary blood flow
-multiple surgeries
-Tetralogy: pulmonic stenosis, VSD, overriding aorta, R ventricular hypertrophy
Digoxin? - answer-used to treat heart failure
