| Quick trip to VALVE-oline | Tough Love (cardiomyopathy) | Attack Attack! | "The greatest teacher failure is" | You don't want surgery? Su-ture self |
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What is C. Aortic stenosis
he murmur is low pitched, crescendo–decrescendo, rough, rasping, and vibrating. An S4 sound may be heard. If the examiner rests a hand over the base of the heart (second intercostal space next to the sternum and above the suprasternal notch) and up along the carotid arteries, a vibration may be felt. (p.796)
With which valve disorder can an S4 heart sound be heard?
A. Mitral stenosis B. Mitral regurgitation C. Aortic stenosis D. Aortic regurgitation |
What is C. Heart failure
Sodium is the major electrolyte involved with cardiomyopathy. Cardiomyopathy often leads to heart failure, which develops, in part, from fluid overload. Fluid overload is often associated with elevated sodium levels (p.801)
Which of the following disorders can be caused by cardiomyopathy
A. Ischemic stroke B. End-stage renal disease C. Heart failure D. COPD |
What is B. Streptococcus
Acute rheumatic fever, which occurs most often in school-age children, may develop after an episode of group A beta-hemolytic streptococcal pharyngitis (p.809)
What type of bacteria are known to cause rheumatic endocarditis?
A. E.coli B. Streptococcus C. N.gonorrhoeae D. H.pylori |
What is C. A dental procedure
Antibiotic prophylaxis is necessary before dental procedures involving manipulation of gingival tissue, the periapical area of the teeth, or perforation of the oral mucosa (not including routine anesthetic injections, placement of orthodontic brackets, or loss of deciduous teeth) (p.801)
Antibiotic prophylaxis is important before which of the following?
A. A cardiac stress test B. A colonoscopy C. A dental procedure D. Travel outside the country |
What is D. A human cadaver
Homografts, or allografts (human valves), are obtained from cadaver tissue donations and are used for aortic and pulmonic valve replacement (p.800)
Where is a homograft obtained from?
A. A 3D printer B. Another part of the patient's heart C. A pig cadaver D. A human cadaver |
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What is D. Aortic regurgitation
One characteristic sign is the water hammer (Corrigan’s) pulse, in which the pulse strikes a palpating finger with a quick, sharp stroke and then suddenly collapses.(p.794)
With which valve disorder can the nurse palpate Corrigan's pulse?
A. Mitral stenosis B. Mitral regurgitation C. Aortic stenosis D. Aortic regurgitation |
What is D. African Americans
Regardless of type and cause, cardiomyopathy may lead to severe heart failure, lethal dysrhythmias, and death. The mortality rate is highest for African Americans and older adults (p.803)
In which population is the mortality rate of cardiomyopathy the highest?
A. Caucasians B. Hispanics C. Asians D. African Americans |
What is C. Penicillin
The objective of treatment is to eradicate invading organisms through adequate doses of an appropriate antimicrobial agent. Antibiotic therapy usually is given for 2 to 6 weeks every 4 hours or continuously by IV infusion (p.811)
Which of the following medications would be used to treat someone with infective endocarditis?
A. Cardizem B. Nitroglycerin C. Penicillin D. Naloxone |
What is D. Take antibiotics as prescribed
-Antibiotic prophylaxis is necessary before dental procedures involving manipulation of gingival tissue, the periapical area of the teeth, or perforation of the oral mucosa (p.801) -The nurse administers antibiotic, antifungal, or antiviral medication as prescribed or educates the patient to take them as prescribed (p.812)
Which of the following is most important to educate a patient about when taking antibiotic prophylaxis?
A. Take antibiotics on an empty stomach B. Do not take antibiotics prior to dental or surgical procedures C. Take antibiotics only when experiencing symptoms of infective endocarditis D. Take antibiotics as prescribed |
What is A,B,C
-Thought to be more durable than tissue prosthetic valves therefore, they often are used for younger patients (p.800) -mechanical valves do not deteriorate or become infected as easily as tissue valves. -Significant complications associated with mechanical valves are thromboemboli and long-term use of required anticoagulants
Which of the following are true about mechanical valves? (Select all that apply)
A. More durable than tissue valves B. Bileaflet, tilting disk, and "ball and cage" are types of mechanical valves C. Often used in younger patients D. They are more likely to become infected than tissue valves E. Less likely to develop thromboemboli than tissue valves |
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What is A. Mitral stenosis
As a result of increased blood volume and pressure, the atrium dilates, hypertrophies, and becomes electrically unstable (patients experience atrial dysrhythmias such as atrial fibrillation).(p.794)
Atrial fibrillation is most commonly seen with which valve disorder?
A. Mitral stenosis B. Mitral regurgitation C. Aortic stenosis D. Aortic regurgitation |
What is C. Hypertrophic cardiomyopathy
HCM is an autosomal dominant condition, occurring in men, women, and children (often detected after puberty) with an estimated prevalence rate of 0.2% of the population in the United States (p.802)
Which type of cardiomyopathy is autosomal dominant?
A.Dilated cardiomyopathy B.Restrictive cardiomyopathy C.Hypertrophic cardiomyopathy D.Arrhythmogenic right ventricular cardiomyopathy |
What is B. History of heart attack
Chart 28-4 (p.810)
Which of the following is NOT a risk factor for infective endocarditis?
A. Implanted cardiac device (pacemaker, LVAD) B. History of heart attack C. IV drug abuse D. Prosthetic cardiac valve |
What is A. Prevention of infective endocarditis
Patients with a mechanical valve prosthesis (including annuloplasty rings and other prosthetic materials used in valvuloplasty) require education to prevent infective endocarditis. Patients may be at risk for infective endocarditis that results from bacteria entering the bloodstream and adhering to abnormal valve structures or prosthetic devices (p.801)
S.T. is a patient who just had a mechanical valve placed. What is important for the nurse to educate this patient on?
A. Prevention of infective endocarditis B. Importance on becoming active the day after surgery C. Monitoring intake and output D. Lying supine a majority of the day for the next 2 weeks |
What is C. They last 15-20 years
Viability is 7 to 15 years (p.800)
Which of the following is false about bioprosthesis?
A. Patients do not need to be on long-term anticoagulation therapy B. They come from animals such as pigs, cows, and horses C. They last 15-20 years D. Can be used for aortic, mitral, or tricuspid valve replacement |
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What is B. blood flowing back from the left ventricle into the left atrium during systole
A. Mitral stenosis C. Aortic regurgitation D. Aortic stenosis
Which of the following describes mitral regurgitation?
A. Obstruction of blood flow from left atrium to left ventricle B. Blood flowing back from the left ventricle into the left atrium during systole C. Blood flowing back into the left ventricle from the aorta during diastole. D. Narrowing of the orifice between the left ventricle and aorta. |
What is A
A. Restrictive cardiomyopathy B. Hypertrophic cardiomyopathy C. Dilated cardiomyopathy D. N/A
Which of the following describes restrictive cardiomyopathy?
A.diastolic dysfunction caused by rigid ventricular walls that impair diastolic filling and ventricular stretch B.increased thickness of the heart muscle reduces the size of the ventricular cavities and causes the ventricles to take a longer time to relax after systole. C.significant dilation of the ventricles without simultaneous hypertrophy and systolic dysfunction D.bacterial accumulation within ventricles |
What is A. Heart murmur and fever
Primary presenting symptoms of infective endocarditis are fever and a heart murmur (p.810)
What are the primary presenting factors of someone with infective endocarditis?
A. Heart murmur and fever B. Chest pain and shortness of breath C. Back pain and hematuria D. Abdominal pain and hypotension |
What is B. Nitroglycerin
Specific precautions are emphasized, such as the risk to patients with aortic stenosis who experience angina pectoris and take nitroglycerin. The venous dilation that results from nitroglycerin use decreases blood return to the heart, thus decreasing cardiac output and increasing the risk of syncope and decreased coronary artery blood flow. The nurse instructs the patient about the importance of attempting to relieve the symptoms of angina with rest and relaxation before taking nitroglycerin and to anticipate the potential adverse effects. (p.796)
Patients with valvular diseases are cautioned about taking which medication?
A. Aspirin B. Nitroglycerin C. Furosemide D. Ibuprofen |
What is C. Valve replacement
Repair, rather than replacement, of a cardiac valve is referred to as valvuloplasty (p.796) A. repair of chordae tendineae (often involved with mitral valve) B. A commissurotomy is the procedure performed to separate the fused leaflets. D. repair of the valve annulus (junction of valve leaflets and muscular heart wall)
Which of the following is NOT a type of valvuloplasty?
A. Chordoplasty B. Comissurotomy C. Valve replacement D. Annuloplasty |
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What is A,E
-Prevention of aortic regurgitation is primarily based on prevention of and treatment for bacterial infections (p.795) -Prevention of mitral stenosis primarily is minimizing risk of and treatment for bacterial infections (p.794)
Which of the following valve disorders are a complication of rheumatic endocarditis? (Select all that apply)
A. Mitral stenosis B. Mitral regurgitation C. Mitral valve prolapse D. Aortic stenosis E. Aortic regurgitation |
What is A,B,C
-DCM is the most common cordiomyopathy. -The ventricles have elevated systolic and diastolic volumes but a decreased ejection fraction. (p.802)
Which of the following is true about dilated cardiomyopathy? (Select all that apply)
A. Diminished contractility of actin and myosin filaments B. Dilation of ventricles without hypertrophy or systolic dysfunction C. Genetic factors may be involved D. The least common cardiomyopathy E. The ventricles have decreased systolic and diastolic volumes but a elevated ejection fraction. |
What is D. Colchicine
Colchicine (Colcrys) or corticosteroids (e.g., prednisone) may be prescribed if the pericarditis is severe or if the patient does not respond to NSAIDs. Colchicine also may be used instead of NSAIDs during the acute phase (p.814) What is the main sign of pericarditis? -Pericardial friction rub
Patient presents to her doctor with an exacerbation of her pericarditis. Patient states the chest pain will not go away when using aspirin. Which of the following medications can be used?
A. Indomethacin B. Ibuprofen C. Amoxicillin D. Colchicine |
What is C. Reduce activity level
As the patient’s condition improves, the nurse encourages gradual increases of activity. However, if pain, fever, or friction rub recurs, activity restrictions must be resumed (p.814)
A patient is walking around the med surg unit, and when they return, the nurse hears a friction rub upon heart auscultation. What does the nurse instruct the patient to do?
A. Eat smaller meals throughout the day B. Increase activity level C. Reduce activity level D. Drink more fluids each day |
What is B,D,E
A. Performed in a cardiac catheterization lab C: Used in a closed commisurotomy (p.797)
Which of the following is involved in a balloon valvuloplasty? (Select all that apply)
A. It is performed bedside B. Balloons are inflated with a dilute angiographic solution C. It is a tool used in an open commisurotomy D. Used for patients with stenosis E. Regurgitation is a common side effect |
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