NSG223 Exam 1 Study Guide
Cardiomyopathy diagnostic tests – answer Chest x-ray (cardiomegaly)
Echocardiography
ECG
Cardiac catheterization
Endomyocardial biopsy
Cardiomyopathy pharmacological mgt - answer beta blockers; potassium channel
blockers, angiotensin-converting enzyme (ACE) inhibitors; digoxin, diuretics, and
dysrhythmic agents.
Aortic or mitral valve débridement, excision, or replacement is required in what kind of
patients? - Answer- Develop congestive heart failure despite adequate medical
treatment
- Have more than one serious systemic embolic episode
- Develop a valve obstruction
- Develop a periannular (heart valve), myocardial, or aortic abscess
- Have uncontrolled infection, persistent or recurrent infection, or fungal endocarditis
Surgical valve replacement
- Have prosthetic valve endocarditis
Endocarditis primary symptoms - answerfever & heart murmur
Additional are petechiae, Olsner nodes, Janeway lesions, Roth spots, headache, stroke,
HF, tachycardia, cardio/splenomegaly
Endocarditis medical mgt - answer- NSAIDs as antipyretics
- Long-term IV microbial therapy
Endocarditis Pathophysiology - answer- Deformity or injury leads to clot formation
- Bacterial infections (Staph & Strep)
- Infection most frequently occurs from clustering vegetations
- Vegetations > 10mm = Left-sided heart endocarditis
- Pulmonary emboli = Right-sided heart endocarditis
Meds for Myocarditis - answerPenicillins, Amphotericin B
Myocarditis pathology - answerViral infections or immune related (rheumatic fever,
Crohn's, Lupus)
, Pericarditis - nursing mgt - answerAnalgesics, forward-leaning or sitting position to
relieve pain, gradual increases in acivity
Pericarditis assessment - answer- Evaluate patient in various positions
- presence of pericardial friction rub (hallmark sign) (creaky/scratch, louder at
exhalation)
- pt has to sit, lean forward, and hold their breath for rub to be heard
Pericardial effusion - answerabnormal accumulation of fluid b/w pericardial linings
- can accumulate and choke the heart (i.e., cardiac tamponade, impair v-filling &
pumping)
Cardiac tamponade - answer- acute compression of the heart
- SOB, chest tightness, dizziness
- Beck triad is hallmark (hypotension, muffled heart sounds, elevated jugular venous
pressure)
- heart sounds go from distant to imperceptible
Angina pectoris pathophysiology - answer- Atheroslerosis
- Associated w/angina pain: physical exertion, exposure to cold, eating a heavy meal, or
stressful situation
Types of Angina - answerstable, unstable, intractable/refractory, variant, silent ischemia
Intractable or refractory angina - answersevere incapacitating chest pain
Variant angina - answerpain at rest with reversible ST-segment elevation; thought to be
caused by coronary artery vasospasm
Silent ischemia - answerObjective evidence of ischemia (ECG changes w/stress test)
but no pain
Angina nursing mgt - answer- Treat it: stop activities, semi-Fowler's, 12-lead ECG, nitro,
oxygen
- Reduce anxiety: guided imagery, music therapy, spiritual needs
- Promote care: education, symptoms, prevention
Angina pharmacological mgt - answer
Atherosclerosis pathology - answer- Narrowing (stenosis) of lumen, obstruction by
thrombosis, aneurysm, ulceration, and rupture
- cells die due to lack of blood flow
- vulnerable where arteries bifurcate/branch
- males have more below-the-knee pathology
Cardiomyopathy diagnostic tests – answer Chest x-ray (cardiomegaly)
Echocardiography
ECG
Cardiac catheterization
Endomyocardial biopsy
Cardiomyopathy pharmacological mgt - answer beta blockers; potassium channel
blockers, angiotensin-converting enzyme (ACE) inhibitors; digoxin, diuretics, and
dysrhythmic agents.
Aortic or mitral valve débridement, excision, or replacement is required in what kind of
patients? - Answer- Develop congestive heart failure despite adequate medical
treatment
- Have more than one serious systemic embolic episode
- Develop a valve obstruction
- Develop a periannular (heart valve), myocardial, or aortic abscess
- Have uncontrolled infection, persistent or recurrent infection, or fungal endocarditis
Surgical valve replacement
- Have prosthetic valve endocarditis
Endocarditis primary symptoms - answerfever & heart murmur
Additional are petechiae, Olsner nodes, Janeway lesions, Roth spots, headache, stroke,
HF, tachycardia, cardio/splenomegaly
Endocarditis medical mgt - answer- NSAIDs as antipyretics
- Long-term IV microbial therapy
Endocarditis Pathophysiology - answer- Deformity or injury leads to clot formation
- Bacterial infections (Staph & Strep)
- Infection most frequently occurs from clustering vegetations
- Vegetations > 10mm = Left-sided heart endocarditis
- Pulmonary emboli = Right-sided heart endocarditis
Meds for Myocarditis - answerPenicillins, Amphotericin B
Myocarditis pathology - answerViral infections or immune related (rheumatic fever,
Crohn's, Lupus)
, Pericarditis - nursing mgt - answerAnalgesics, forward-leaning or sitting position to
relieve pain, gradual increases in acivity
Pericarditis assessment - answer- Evaluate patient in various positions
- presence of pericardial friction rub (hallmark sign) (creaky/scratch, louder at
exhalation)
- pt has to sit, lean forward, and hold their breath for rub to be heard
Pericardial effusion - answerabnormal accumulation of fluid b/w pericardial linings
- can accumulate and choke the heart (i.e., cardiac tamponade, impair v-filling &
pumping)
Cardiac tamponade - answer- acute compression of the heart
- SOB, chest tightness, dizziness
- Beck triad is hallmark (hypotension, muffled heart sounds, elevated jugular venous
pressure)
- heart sounds go from distant to imperceptible
Angina pectoris pathophysiology - answer- Atheroslerosis
- Associated w/angina pain: physical exertion, exposure to cold, eating a heavy meal, or
stressful situation
Types of Angina - answerstable, unstable, intractable/refractory, variant, silent ischemia
Intractable or refractory angina - answersevere incapacitating chest pain
Variant angina - answerpain at rest with reversible ST-segment elevation; thought to be
caused by coronary artery vasospasm
Silent ischemia - answerObjective evidence of ischemia (ECG changes w/stress test)
but no pain
Angina nursing mgt - answer- Treat it: stop activities, semi-Fowler's, 12-lead ECG, nitro,
oxygen
- Reduce anxiety: guided imagery, music therapy, spiritual needs
- Promote care: education, symptoms, prevention
Angina pharmacological mgt - answer
Atherosclerosis pathology - answer- Narrowing (stenosis) of lumen, obstruction by
thrombosis, aneurysm, ulceration, and rupture
- cells die due to lack of blood flow
- vulnerable where arteries bifurcate/branch
- males have more below-the-knee pathology
