Cardiology Quiz: Pericarditis Assessment

Medical-Surgical Nursing II (Herzing University) Exam 1 Blueprint Answers

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Cardiomyopathy

• Assessment (NSG223 03.02.03): Detailed history of presenting symptoms, identifying possible causes (heavy alcohol intake, recent illness, family history). Chest pain review, orthopnea, PND, syncope, dyspnea with exertion. Pillows needed to sleep, weight changes, limitations on ADLs. Usual diet assessment for sodium intake and nutrition optimization. Physical assessment focusing on heart failure signs and symptoms, including vital signs.
• Diagnostics (NSG223 03.02.01): Diagnosis is usually made through patient history and ruling out other heart failure causes like MI. Echocardiogram is a helpful diagnostic tool.
• Management (NSG223 03.02.04): Pharmacological management focused on controlling symptoms

Valvular Disorders - Mitral Valve Prolapse

• Manifestations (NSG223 03.01.01): Most patients are asymptomatic. Symptoms may include fatigue, shortness of breath, and lightheadedness (not correlated with activity level or pulmonary function).
• Information NOT included in provided text. Detailed information on specific valvular disorder pathologies and their management techniques are NOT provided in the text.

Valvular Disorders - Mitral Regurgitation

• Manifestations: Develops without symptoms initially, and may later include shortness of breath on exertion (DOE), pulmonary venous hypertension, and fatigue. Symptoms often develop after the valve opening decreases from one-half to one-third its usual size.
• Ocular symptoms: Reduced blood flow to the brain may cause dizziness and syncope. Angina pectoris is a frequent symptom.

Valvular Disorders - Aortic Regurgitation

• Manifestations: May develop without symptoms. Marked arterial pulsations may be visible or palpable. Exertional dyspnea and fatigue often follow as a symptom.

Valvular Disorders - Aortic Stenosis

• Manifestations: A common presenting symptom is exertional dyspnea. Other potential symptoms are: orthopnea and paroxysmal nocturnal dyspnea (PND), caused by increased pulmonary venous pressure.

Valvular Disorders - Medical mgt (NSG223 03.03.01):

• Mitral Valve Prolapse: Treatment is primarily focused on symptom management, including pain, anxiety reduction, and appropriate activity restrictions.
• Other Valvular Disorders: Management usually mirrors that for heart failure. Treatment may include anticoagulants to prevent thrombus formation, medications for arrhythmias, and possibly surgical repair or replacement.

Infective Endocarditis

• Assessment (NSG223 03.03.01): Definitive diagnosis is made when a microorganism is found in two separate blood cultures, vegetation, abscess, or new prosthetic valve dehiscence. At least two or more sets of blood cultures are drawn from different venipuncture sites, at least 12 hours apart. Symptoms may include fever and a heart murmur (which may be intermittent or absent).
• Manifestations: Heart murmur, petechiae, Osler nodes, Janeway lesions, and splinter hemorrhages. Cardiomegaly, heart failure, tachycardia, or splenomegaly may occur. Cerebral ischemia leading to headache and temporary strokes can also happen.

Pericarditis

• Assessment (NSG223 03.03.03): Pain is the primary concern and is evaluated in different patient positions. The severity is often assessed by how the patients' pain is affected by respiratory movements, and the movement of shoulders, rotation/flexion of the spine, coughing, and swallowing. Nurses look for a pericardial friction rub (a creaky or scratchy sound that is louder at the end of exhalation)

Angina Pectoris

• Pathophysiology (NSG223 02.01.01): Angina is often caused by atherosclerotic disease, resulting in insufficient coronary blood flow, producing the pain or pressure.
• Types: Stable angina is predictable, onset from exertion, and relieved by rest and/or nitroglycerin. Unstable angina is characterized by increased pain frequency and severity that is not relieved.
• Assessment: Critical evaluation of pain; The patient's descriptions of the pain, location, and related events. Questions are also included.

Atherosclerosis

• Pathophysiology (NSG223 02.02.01): Abnormal buildup of plaque in the arterial lining, including lipids, fibrous tissue, and other substances. This can obstruct the artery.
• Prevention (NSG223 02.02.02): Lifestyle modifications are recommended, including dietary changes (reduce saturated fats and cholesterol). Medications can also reduce blood lipids.

Acute Coronary Syndrome (NSG223 02.03.01):

• Pathophysiology: Characterized by an acute onset of myocardial ischemia. Includes unstable angina, NSTEMI, and STEMI. Disruption of blood flow in one or more coronary blood vessels, either due to thrombus formation (clot) or vasospasm (constriction). Can lead to myocardial death if treatment isn't immediate.
• Assessment and Medical Management: Important to assess for symptoms (chest pain, shortness of breath) and to implement medical therapies. Treatment includes pain management, oxygen administration, and ECG monitoring.

Cardiac Monitoring (NSG223 01.01.01):

• Purpose: Continuous ECG monitoring is a critical aspect of patient care for assessing heart rhythms and detecting abnormalities or indications of heart problems.
• Procedure: Involves placing electrodes on specific body areas. Methods for skin-electrode contact are important for proper signal transmission and minimizing artifacts.

Rhythm Strip Analysis (NSG223 01.02.02):

• Assessment: Involves systematic analysis of the ECG rhythm strip, including ventricular rate, rhythm, QRS duration, P waves, PR intervals, and the P:QRS ratio.

Arrhythmias (PAC, A-fib, A-flutter) (NSG223 01.03.02):

• PACs: Premature atrial complexes, are often caused by caffeine, stress, alcohol, and other factors. Usually not treated unless frequent.
• Atrial fibrillation: An irregular and rapid atrial rhythm; treatment is based on the cause, clinical presentation, and duration.
• Atrial Flutter: A regular but rapid atrial rhythm (250-400 bpm), with a characteristic sawtooth pattern on the EKG; rate control and rhythm conversion may be implemented.

Additional Information (not organized by topic):

• Medications: Each section discusses specific medications used to treat cardiac conditions, with specific indications, side effects, and potential adverse outcomes. Nurses should be aware of particular cautionary measures related to each medication.
• Important Considerations in all Cardiac Cases: A multitude of factors across categories need to be addressed: assessing patients (and their families), pain control and education, and monitoring for and preventing complications.

Test your knowledge on the assessment of pericarditis in patients. This quiz covers methods for evaluating pain, identifying sounds like pericardial friction rub, and the best positions for auscultation. Challenge yourself and see how well you understand this important cardiovascular condition.