NUR 445 EXAM 1 QUESTIONS AND
ANSWERS
Infective Endocarditis - answer- -From strep bug and rheumatic fever
Effects:
-Impairs pumping function, muscle tissue, pericardium and valves due to scar tissue
Valvular heart disease - answer- -valvular stenosis: narrowing and hardening of
valves and blood cant get through (door is hard to open)
-valvular insufficiency/regurgitation: valves dont close and blood flows back (door
has trouble closing)
Mitral Stenosis - answer- Caused by rheumatic carditis
Valve is thickened by fibrosis and calcification
Sx:
-DOE, fatigue, orthopnea, NVD
PE
-diastolic murmur
-"lub swish"
Mitral Regurgitation (insufficiency) - answer- Caused by RHD
LA and LV dilate and hypertrophy
-papillary muscle dysfunction causes this too
Sx:
-May be symptom free for years
-common complains are anxiety, CP and palpitations
-fatigue and weakness followed by DOE and orthopnea
PE:
-holosystolic (prolonged) murmur
Mitral valve prolapse - answer- Valve leaflets enlarge and prolapse (slip forward or
down) into the LA during systole (regurgitation)
Sx:
-benign and asymptomatic
Etiology:
-familial occurence
-associated with Marfan's syndrome
-young to middle aged women
, Aortic stenosis - answer- Increased resistance to to ejection during systole-->LV
failure-->RV failure
Common in elderly
Sx:
-dyspnea, angina and syncope
PE:
-systolic crescendo/decrescendo murmur
Aortic Regurgitation - answer- -Caused by non RHD: endocarditis, congenital, HTN,
Marfan's syndrome
-Creates dilation of LV
Sx:
-asymptomatic for years before Sx of LV failure occur
-DOE, orthopnea and PND
PE:
-Diastolic murmur
Management of Valvular Heart disease - answer- -Not treated if asymptomatic, teach
about what to report
-Anticipate treating HF
-Valve repair or replacement
Medications: BBs, CCBs, digoxin to improve ventricular filling times
Nursing: focus on activity tolerance, monitor for SE of treatments, education
Structural abnormalities--> - answer- increased risk for infection (infective
endocarditis)
*a need for prophylactic antibiotics*
Nursing care with post-op cardiac surgery patients - answer- -Maintain hemodynamic
stability
-assist recovery from anesthesia
-pain management
-wound care
-progressive activity
-nutrition
-education about meds and activity
-psychosocial support
Cardiogenic Shock - answer- AKA heart failure
-ineffective pumping; decreased CO
Sx:
ANSWERS
Infective Endocarditis - answer- -From strep bug and rheumatic fever
Effects:
-Impairs pumping function, muscle tissue, pericardium and valves due to scar tissue
Valvular heart disease - answer- -valvular stenosis: narrowing and hardening of
valves and blood cant get through (door is hard to open)
-valvular insufficiency/regurgitation: valves dont close and blood flows back (door
has trouble closing)
Mitral Stenosis - answer- Caused by rheumatic carditis
Valve is thickened by fibrosis and calcification
Sx:
-DOE, fatigue, orthopnea, NVD
PE
-diastolic murmur
-"lub swish"
Mitral Regurgitation (insufficiency) - answer- Caused by RHD
LA and LV dilate and hypertrophy
-papillary muscle dysfunction causes this too
Sx:
-May be symptom free for years
-common complains are anxiety, CP and palpitations
-fatigue and weakness followed by DOE and orthopnea
PE:
-holosystolic (prolonged) murmur
Mitral valve prolapse - answer- Valve leaflets enlarge and prolapse (slip forward or
down) into the LA during systole (regurgitation)
Sx:
-benign and asymptomatic
Etiology:
-familial occurence
-associated with Marfan's syndrome
-young to middle aged women
, Aortic stenosis - answer- Increased resistance to to ejection during systole-->LV
failure-->RV failure
Common in elderly
Sx:
-dyspnea, angina and syncope
PE:
-systolic crescendo/decrescendo murmur
Aortic Regurgitation - answer- -Caused by non RHD: endocarditis, congenital, HTN,
Marfan's syndrome
-Creates dilation of LV
Sx:
-asymptomatic for years before Sx of LV failure occur
-DOE, orthopnea and PND
PE:
-Diastolic murmur
Management of Valvular Heart disease - answer- -Not treated if asymptomatic, teach
about what to report
-Anticipate treating HF
-Valve repair or replacement
Medications: BBs, CCBs, digoxin to improve ventricular filling times
Nursing: focus on activity tolerance, monitor for SE of treatments, education
Structural abnormalities--> - answer- increased risk for infection (infective
endocarditis)
*a need for prophylactic antibiotics*
Nursing care with post-op cardiac surgery patients - answer- -Maintain hemodynamic
stability
-assist recovery from anesthesia
-pain management
-wound care
-progressive activity
-nutrition
-education about meds and activity
-psychosocial support
Cardiogenic Shock - answer- AKA heart failure
-ineffective pumping; decreased CO
Sx:
