ADH3: Heart Disorders

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Last updated 9:42 PM on 10/10/26

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17 Terms

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infective endocarditis key assessment findings: (4)

oslers nodes

red, painful nodes in pads of fingers and toes

janeway lesions

red, painless spots on palms and soles

splinter hemorrhages

tiny blood clots that run vertically under nails

murmur

turbulent blood flow across a heart valve

<ol><li><p><span style="color: rgb(226, 118, 118);"><strong>oslers nodes</strong></span></p></li></ol><ul><li><p>red, <strong>painful </strong>nodes in pads of fingers and toes</p></li></ul><ol start="2"><li><p><span style="color: rgb(166, 143, 27);"><strong>janeway</strong></span> lesions</p></li></ol><ul><li><p>red, <strong>painless </strong>spots on palms and soles</p></li></ul><ol start="3"><li><p><span style="color: rgb(74, 191, 198);"><strong>splinter hemorrhages</strong></span></p></li></ol><ul><li><p>tiny blood clots that run vertically under <strong>nails</strong></p></li></ul><ol start="4"><li><p><span style="color: rgb(174, 66, 219);"><strong>murmur</strong></span></p></li></ol><ul><li><p>turbulent blood flow across a heart valve</p></li></ul><p></p>

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dx test for infective endocarditis: (4)

TTE (transthoracic echo)

regular echo

TEE (transesophageal echo)

more invasive; goes through esophagus to see backside of heart

blood cultures

⬆WBCs

<ol><li><p><span style="color: rgb(89, 55, 229);"><strong>TTE </strong></span>(transthoracic echo)</p></li></ol><ul><li><p>regular echo</p></li></ul><ol start="2"><li><p><span style="color: rgb(44, 187, 20);"><strong>TEE </strong></span>(transesophageal echo)</p></li></ol><ul><li><p>more invasive; goes through esophagus to see backside of heart</p></li></ul><ol start="3"><li><p><span style="color: rgb(192, 172, 43);"><strong>blood cultures</strong></span></p></li></ol><ol start="4"><li><p><span style="color: rgb(248, 129, 129);"><strong><span data-name="arrow_up" data-type="emoji">⬆</span>WBCs</strong></span></p></li></ol><p></p><p></p><p></p>

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infective endocarditis main tx:

for how long?

IV abx therapy (PICC line)

standard tx 4-6 weeks but may be longer for prosthetic valves

<p>IV <span style="color: rgb(16, 154, 17);"><strong>abx</strong></span> therapy (PICC line)</p><ul><li><p>standard tx <span style="color: rgb(21, 164, 60);"><strong>4-6 weeks</strong></span> but may be longer for prosthetic valves</p></li></ul><p></p>

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major complications of endocarditis:

embolic events!!

left side: TIA, stroke, kidney, spleen, liver
right (lungs): pulmonary embolism

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nursing actions endocarditis (4)

PICC line for long term abx

standard 4-6 weeks

good oral hygiene

bleeding gums = bacteria entry into blood

inform of previous dental/invasive procedures

prophylactic abx may be prescribed

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myocarditis assessment findings:

cardiogenic shock
CP
SOB
palpitations

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myocarditis dx tests: (2)

whats definitive?

labs:

C-reactive proteins (inflammatory marker)
troponins
BNP (fluid volume overload)

myocardial biopsy: definitive test—reserved for actue cases!

<ol><li><p><span style="color: rgb(95, 151, 23);"><strong>labs</strong></span>:</p></li></ol><ul><li><p>C-reactive proteins (inflammatory marker)</p></li><li><p>troponins</p></li><li><p>BNP (fluid volume overload)</p></li></ul><p></p><ol start="2"><li><p><span style="color: rgb(233, 96, 96);"><strong>myocardial biopsy</strong></span>: definitive test—reserved for actue cases!</p></li></ol><p></p>

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main nursing education for myocarditis:

avoid strenuous activities!!
- athletes no competitive sports while inflammation present
- re-evaluate 3-6 months before continuing sport

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complications for myocarditis: (2)

dilated cardiomyopathy

heart chamber enlarges and lose contractility

sudden cardiac death in young athletes

<ol><li><p><span style="color: rgb(67, 115, 218);"><strong>dilated cardiomyopathy</strong></span></p></li></ol><ul><li><p>heart chamber enlarges and lose contractility</p></li></ul><p></p><ol start="2"><li><p>sudden <span style="color: rgb(231, 81, 81);"><strong>cardiac death</strong></span> in young athletes</p></li></ol><p></p>

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pericarditis key findings: (6)

pleuritic CP
pericardial friction rubs: scratchy sounds that occur w/ each heart beat

muffled heart sounds

pericardial effusion
EKG changes: widespread ST Elevation / PR Depression
pulses paradoxus
cardiac tamponade

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how is pleuritic CP different from MI?

Pleuritic CP relieved by sitting up and leaning forward compared to MI

<p>Pleuritic CP <span style="color: rgb(49, 151, 135);"><strong>relieved by sitting up and leaning forward</strong></span> compared to MI</p>

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Dx testing in Pericarditis? (2)

EKG: widespread ST elevation / PR depression

CXR:

cardiomegaly + clear lung fields = pericardial effusion (fluid build-up in pericardial sac)

<ol><li><p><strong>EKG</strong>: widespread <span style="color: rgb(45, 69, 201);">ST elevation / PR depression</span></p></li></ol><p></p><ol start="2"><li><p><strong>CXR</strong>:</p></li></ol><ul><li><p>cardiomegaly + clear lung fields = <span style="color: rgb(100, 136, 29);"><strong>pericardial effusion</strong></span> (fluid build-up in pericardial sac)</p></li></ul><p></p>

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Complications of pericarditis? (2)

pericardial effusion

fluid build up >20-60 mL in pericardial space
- tx: pericardiocentesis

pericardial tamponade

Becks Triad
- JVD, muffled heart sounds, hypotension

<ol><li><p><span style="color: rgb(62, 110, 204);"><strong>pericardial effusion</strong></span></p></li></ol><ul><li><p>fluid build up <strong>>20-60 mL</strong> in pericardial space</p><ul><li><p>tx: pericardiocentesis</p></li></ul></li></ul><p></p><ol start="2"><li><p><span style="color: rgb(216, 138, 240);"><strong>pericardial tamponade</strong></span></p></li></ol><ul><li><p>Becks Triad</p><ul><li><p>JVD, muffled heart sounds, hypotension</p></li></ul></li></ul><p></p>

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Nursing interventions for Pericarditis: (3)

sit up and lean forward

ASA, NSAIDs

raise HOB relieves SOB

<ol><li><p><span style="color: rgb(22, 179, 126);"><strong>sit up and lean forward</strong></span></p></li></ol><ol start="2"><li><p><span style="color: rgb(140, 104, 210);"><strong>ASA, NSAIDs</strong></span></p></li></ol><ol start="3"><li><p><span style="color: rgb(190, 118, 30);"><strong>raise HOB</strong></span> relieves SOB</p></li></ol><p></p>

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Stenosis definition

result

narrowed valve opening = ⬇blood flow
- ventricular hypertrophy: occurs to generate adequate force to open valve
  - over time the ventricle will fail and progress to HF

<ul><li><p><span style="color: rgb(77, 111, 183);"><strong>narrowed valve opening</strong></span> = <span data-name="arrow_down" data-type="emoji">⬇</span>blood flow</p><ul><li><p><span style="color: rgb(166, 66, 172);"><strong>ventricular hypertrophy</strong></span>: occurs to generate adequate force to open valve</p><ul><li><p>over time the ventricle will fail and progress to HF</p></li></ul></li></ul></li></ul><p></p>

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Regurgitation definition

valve leaflets dont properly close = backflow of blood into atrium
- signs of L/R sided HF develop

<ul><li><p>valve leaflets <span style="color: rgb(208, 168, 32);"><strong>dont properly close = backflow</strong></span> of blood into atrium</p><ul><li><p>signs of L/R sided HF develop</p></li></ul></li></ul><p></p><p></p>

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Prolapse definition

valve flaps dont close smoothly (they balloon upward as ventricles contract)
- progress to regurgitation