med surg

Aortic Valve and Rheumatic Fever

  • Rheumatic Fever: Condition often associated with individuals from certain countries, presenting as:

    • Aortic Valve Issues

    • Mitral Valve Complications

    • Common presentations include symptoms like Osler's nodes.

Aortic Stenosis

  • Aortic Stenosis:

    • Typically occurs in individuals around age 60.

    • Common symptoms include:

    • Dyspnea: Difficulty in breathing.

    • Syncope: Fainting episode; notable presentation of this condition.

Cardiomyopathy

  • Definition: Condition in which the heart muscles become enlarged, also known as Hypertrophy.

  • Monitoring for Cardiomyopathy:

    • Priority is assessing for Fluid Overload.

    • Fluid overload can be observed in:

    • Left-sided Heart Failure

    • Right-sided Heart Failure

Troponin and Heart Attack

  • Troponin: A lab value used to confirm a myocardial infarction (MI) or heart attack.

  • Other significant lab tests include:

    • BNP (B-type Natriuretic Peptide): Assesses for heart failure with a normal value of less than 100.

    • Lactate Levels: Sometimes checked in contexts related to myocardial infarctions.

Peripheral Artery Disease (PAD)

  • PAD: Condition characterized by

    • Intermittent Claudication: Pain in the calf during physical activities.

Myocardial Infarction (MI) Presentation

  • ECG Findings for MI: Specific markers include elevated T-waves and characteristic patterns associated with a STEMI (ST-Elevation Myocardial Infarction).

Electrical Impulse Pathway in the Heart

  • Sequence of electrical impulse travel is imperative for understanding cardiac function.

Atrial Fibrillation (A-Fib) and Atrial Flutter (A-Flutter)

  • A-Flutter: Recognizable pattern on ECG resembling “sawtooth” waves.

  • Treatment for A-Fib: Patients typically require Anticoagulants due to the risk of Stroke from potential blood clots.

Heart Failure Symptoms

  • Left-Sided Heart Failure:

    • Common symptom is Dyspnea upon exertion due to pulmonary congestion.

  • Right-Sided Heart Failure:

    • Symptoms can include Jugular Venous Distension (JVD), Ascites, and peripheral edema.

Fluid Overload in Heart Failure

  • Symptoms of Fluid Overload: Can include weight gain and decreased urine output.

Heart Transplant Considerations

  • Post-heart transplant care includes:

    • Lifelong Immunosuppressive Therapy to prevent rejection.

    • Awareness that acute and chronic rejection can occur.

Renal Function Assessment

  • Creatinine Clearance: The primary test to evaluate kidney function.

  • Blood Urea Nitrogen (BUN): An elevated BUN level may suggest kidney impairment.

  • Urinalysis: An abnormal finding indicating protein in urine suggests potential kidney issues.

Renal Angiography Preparations

  • Before renal angiography:

    • Assess for allergies to iodine or contrast dye.

Monitoring After Renal Angiography

  • Post-procedure monitoring should focus on:

    • Bleeding at the insertion site.

Urinary Tract Infection (UTI) Diagnostics

  • Confirming UTI typically involves a Urine Culture.

Classic Triad of Kidney Cancer

  • Symptoms may include:

    • Mass in kidney

    • Flank Pain

    • Hematuria (blood in urine)

Diabetic Nephropathy

  • Identified primarily in the glomerulus of the kidneys.