Infectious and Inflammatory Heart Disorders
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Questions and Answers

What is a common complication of untreated rheumatic fever?

  • Acute kidney injury
  • Pneumonia
  • Rheumatic carditis (correct)
  • Sepsis

    • Which assessment finding is least likely to be present in rheumatic carditis?

  • Fever
  • Heart murmur
  • Splinter hemorrhages (correct)
  • Rapid heart rate

    • Which diagnostic finding would most directly indicate inflammation in a patient suspected of having rheumatic fever?

  • Decreased C-reactive protein
  • Normal white blood cell count
  • ECG abnormalities
  • Elevated ESR (correct)

    • What is the primary medical management for a client diagnosed with infective endocarditis?

    <p>Intravenous antibiotics</p> Signup and view all the answers

    Which of the following factors is a significant risk for developing infective endocarditis?

    <p>Prolonged intravenous therapy</p> Signup and view all the answers

    Which symptoms are characteristic of infective endocarditis?

    <p>Petechiae and Osler nodes</p> Signup and view all the answers

    When managing a client with rheumatic fever, which nursing intervention is essential?

    <p>Administer prescribed drug therapy</p> Signup and view all the answers

    What potential outcome is linked to prolonged pericarditis if left untreated?

    <p>Constrictive pericarditis</p> Signup and view all the answers

    What is a key characteristic of myocarditis that differs from myocardial infarction?

    <p>Pain relief when sitting up</p> Signup and view all the answers

    Which diagnostic finding is essential in diagnosing pericarditis?

    <p>Elevated ST segment on ECG</p> Signup and view all the answers

    What is a primary medical management intervention for cardiomyopathy?

    <p>Cardiotonic drugs</p> Signup and view all the answers

    In which scenario is pericardiocentesis indicated?

    <p>Acute cardiac tamponade</p> Signup and view all the answers

    What type of cardiomyopathy is characterized by leg swelling and dyspnea on exertion when lying down?

    <p>Dilated cardiomyopathy</p> Signup and view all the answers

    Which assessment finding in pericarditis is commonly associated with altered blood pressure?

    <p>Pulsus paradoxus</p> Signup and view all the answers

    What symptom is typically reported in patients with restrictive cardiomyopathy?

    <p>Cyanotic skin</p> Signup and view all the answers

    Which laboratory test is crucial for evaluating the inflammatory process associated with myocarditis?

    <p>C-reactive protein levels</p> Signup and view all the answers

    What is a common side effect of aggressive IV antibiotic therapy in management of heart infections?

    <p>Dysrhythmias</p> Signup and view all the answers

    What lifestyle change is often recommended for patients with cardiomyopathy?

    <p>Sodium-restricted diet</p> Signup and view all the answers

    What is the primary rationale for covering the site of pericardiocentesis with a sterile dressing?

    <p>To protect compromised skin from microorganisms</p> Signup and view all the answers

    Which of the following assessment findings is most commonly associated with pericarditis?

    <p>Friction rubs</p> Signup and view all the answers

    Which set of symptoms is least likely to be associated with thrombophlebitis?

    <p>Cold and numb extremities</p> Signup and view all the answers

    What is the significance of Virchow's triad in relation to thrombus formation?

    <p>It identifies three major factors contributing to clot formation</p> Signup and view all the answers

    Which of the following is NOT a common management strategy for thromboangiitis obliterans?

    <p>Caloric supplementation</p> Signup and view all the answers

    Which symptom pair best describes intermittent claudication as it relates to Buerger disease?

    <p>Cramps after exercise and pain at rest</p> Signup and view all the answers

    In assessing a patient with signs of venous thromboembolism, which diagnostic tool is most appropriate for evaluating venous structures?

    <p>Doppler ultrasound</p> Signup and view all the answers

    Which symptom is characteristic of a significant complication associated with untreated pericarditis?

    <p>Arrhythmias</p> Signup and view all the answers

    When providing care for a patient with pericarditis, which of the following findings suggests a management strategy has been successful?

    <p>Stabilization of vital signs</p> Signup and view all the answers

    What is a key characteristic of rheumatic fever that distinguishes it from rheumatic carditis?

    <p>It occurs after group A streptococcal infection.</p> Signup and view all the answers

    Which assessment finding would likely indicate rheumatic carditis in a patient?

    <p>Rapid heart rate and abnormal rhythm.</p> Signup and view all the answers

    What is the primary infectious risk factor associated with the development of infective endocarditis?

    <p>Prolonged use of catheters.</p> Signup and view all the answers

    Which symptom is least likely to be associated with infective endocarditis?

    <p>Streptococcal sore throat.</p> Signup and view all the answers

    Which of the following nursing interventions is essential for a patient diagnosed with rheumatic fever?

    <p>Administering prophylactic antibiotics as prescribed.</p> Signup and view all the answers

    Which laboratory finding is most directly related to active inflammation in patients with rheumatic fever?

    <p>Elevated C-reactive protein levels.</p> Signup and view all the answers

    What primary risk factor for infective endocarditis involves the use of medical devices?

    <p>Insertion of cardiac pacemakers.</p> Signup and view all the answers

    What finding on a patient with rheumatic fever might suggest the presence of a heart murmur?

    <p>Irregular heart rhythm.</p> Signup and view all the answers

    What are some common assessment findings in a patient with thrombophlebitis?

    <p>Calf pain with dorsiflexion</p> Signup and view all the answers

    What is the primary non-surgical management approach for a patient diagnosed with thromboangiitis obliterans?

    <p>Buerger-Allen exercises</p> Signup and view all the answers

    Which clinical sign is most characteristic of pericarditis?

    <p>Friction rub</p> Signup and view all the answers

    In assessing a patient with potential Buerger disease, what symptom would be least likely to be present?

    <p>Increased hair growth on extremities</p> Signup and view all the answers

    Which combination of symptoms is commonly associated with acute pericarditis?

    <p>Fever and tachycardia</p> Signup and view all the answers

    What underlying factors contribute to the development of thrombophlebitis as described by Virchow's triad?

    <p>Altered blood coagulation, trauma, and venous stasis</p> Signup and view all the answers

    When managing a client with pericarditis, which symptom would indicate that the condition has worsened?

    <p>Sudden onset of dyspnea</p> Signup and view all the answers

    Which of the following findings must be monitored closely in a patient receiving anticoagulant therapy for thrombophlebitis?

    <p>Signs of bleeding</p> Signup and view all the answers

    What is a common indicator for the necessity of Doppler ultrasound in a patient suspected of having venous thromboembolism?

    <p>Calf swelling or pain</p> Signup and view all the answers

    What complication should be considered for a patient with untreated pericarditis?

    <p>Cardiac tamponade</p> Signup and view all the answers

    What is a key symptom of myocarditis that distinguishes it from myocardial infarction?

    <p>Chest pain alleviated by sitting up</p> Signup and view all the answers

    Which diagnostic test is essential for assessing cardiomyopathy?

    <p>Cardiac MRI</p> Signup and view all the answers

    Which of the following is a hallmark finding of pericarditis during auscultation?

    <p>Pericardial friction rub</p> Signup and view all the answers

    What surgical intervention is often required for severe cases of cardiomyopathy?

    <p>Ventriculomyomectomy</p> Signup and view all the answers

    Which medication class is NOT typically used in the management of myocarditis?

    <p>Antipsychotics</p> Signup and view all the answers

    What finding would be suggestive of cardiac tamponade?

    <p>Increased heart rate with hypotension</p> Signup and view all the answers

    In cases of suspected myocarditis, which viral agents are commonly associated?

    <p>Coxsackie virus A and B</p> Signup and view all the answers

    What is a significant dietary recommendation for patients with heart inflammatory disorders?

    <p>Sodium restriction</p> Signup and view all the answers

    Which assessment finding is crucial in diagnosing pericarditis?

    <p>Elevation of ST segments on ECG</p> Signup and view all the answers

    What is typically the primary management for a patient diagnosed with pericarditis?

    <p>Administration of NSAIDs and corticosteroids</p> Signup and view all the answers

    What is the pathophysiological basis for rheumatic carditis?

    <p>Infection following group A streptococcal infection</p> Signup and view all the answers

    Which assessment finding is characteristic of infective endocarditis?

    <p>Enlarged spleen</p> Signup and view all the answers

    Which laboratory test is crucial for diagnosing inflammation associated with rheumatic fever?

    <p>C-reactive protein test</p> Signup and view all the answers

    What is the primary treatment approach for rheumatic fever to prevent complications?

    <p>Intravenous antibiotics and prophylactic measures</p> Signup and view all the answers

    Which microorganism is commonly associated with causing infective endocarditis?

    <p>Staphylococcus aureus</p> Signup and view all the answers

    Which clinical manifestation would be consistent with rheumatic fever?

    <p>Spotty rash that quickly disappears</p> Signup and view all the answers

    Which of the following risks is most associated with the development of infective endocarditis?

    <p>Invasive procedures like cardiac catheterization</p> Signup and view all the answers

    Which of the following nursing interventions is critical for a patient diagnosed with infective endocarditis?

    <p>Monitoring vital signs, especially for signs of systemic infection</p> Signup and view all the answers

    Which of the following symptoms is NOT typically associated with acute pericarditis?

    <p>Cold extremities</p> Signup and view all the answers

    What is the primary rationale for immediate intervention in a patient with thrombophlebitis?

    <p>To prevent potential embolism</p> Signup and view all the answers

    Which finding is commonly associated with myocarditis and is characterized by sharp chest pain that is relieved by sitting up?

    <p>Sharp stabbing or squeezing chest discomfort</p> Signup and view all the answers

    When assessing a patient for Buerger disease, which finding would be least expected?

    <p>Thickened nails</p> Signup and view all the answers

    What is the primary pathological change in cardiomyopathy?

    <p>Loss of ability to pump blood efficiently</p> Signup and view all the answers

    Which treatment strategy is generally recommended for managing thromboangiitis obliterans?

    <p>Tobacco cessation</p> Signup and view all the answers

    In assessing a client with potential pericarditis, which combination of assessment findings is crucial?

    <p>Chest pain and friction rubs</p> Signup and view all the answers

    Which finding is indicative of pericarditis during auscultation?

    <p>Pericardial friction rub</p> Signup and view all the answers

    What is a common non-surgical management strategy used in both myocarditis and pericarditis?

    <p>Rest and analgesics</p> Signup and view all the answers

    What is a critical nursing management concern for a client with thrombophlebitis?

    <p>Monitoring for signs of infection</p> Signup and view all the answers

    Which of the following is a specific symptom of restrictive cardiomyopathy?

    <p>Exertional dyspnea</p> Signup and view all the answers

    Which assessment finding typically indicates worsening severity in patients with thrombophlebitis?

    <p>Increased calf size</p> Signup and view all the answers

    What is the role of echocardiography in diagnosing infectious and inflammatory disorders of the heart?

    <p>Detecting structural abnormalities</p> Signup and view all the answers

    In the context of diagnosing Buerger disease, which symptom signifies chronic ischemia?

    <p>Intermittent claudication</p> Signup and view all the answers

    Which diagnostic method is least commonly utilized for detecting thromboangiitis obliterans?

    <p>Anticoagulant therapy response</p> Signup and view all the answers

    Which symptom may suggest advanced cardiac tamponade linked to pericarditis?

    <p>Neck vein distention</p> Signup and view all the answers

    What would be a significant nursing intervention for managing a patient with acute pericarditis?

    <p>Implementing a sterile dressing on the pericardiocentesis site</p> Signup and view all the answers

    During nursing management of a patient with myocarditis, which intervention is priority?

    <p>Limiting activity and monitoring vital signs</p> Signup and view all the answers

    Which laboratory marker is typically elevated in cases of pericarditis due to inflammation?

    <p>C-reactive protein</p> Signup and view all the answers

    What's an accurate assessment finding linked to hypertrophic cardiomyopathy?

    <p>Syncope and chest pain</p> Signup and view all the answers

    Study Notes

    Infectious and Inflammatory Disorders of the Heart

    • Rheumatic Fever and Rheumatic Carditis

      • Pathophysiology: follows group A streptococcal infection
      • Rheumatic carditis: inflammatory cardiac manifestations of rheumatic fever
      • Assessment Findings: mild fever, rapid heart rate, abnormal rhythm, rash (red, spotty), swollen warm, red, and painful joints, heart murmur, pericardial friction rub

    • Infective Endocarditis

      • Pathology: inflammation of inner heart tissue (autoimmune response)
      • Microorganisms: bacteria, streptococci, staphylococci, fungi (see Table 23-1)
      • Causes: prolonged IV therapy, cardiac pacemaker/catheterization, Foley
      • Assessment Findings: fever, chills, muscle aches, joint pain, Osler nodes, splinter hemorrhages, Janeway lesions, Roth spots, petechiae, enlarged spleen, heart murmur

    • Myocarditis

      • Pathophysiology: inflammation of heart muscle layer
      • Causes: viral, bacterial, fungal, or parasitic infection (e.g. Coxsackie viruses A and B, influenza A and B, measles, mumps, Epstein-Barr virus, COVID-19)
      • Assessment Findings: sharp stabbing or squeezing chest discomfort (resembles MI), low-grade fever, tachycardia, dysrhythmias, dyspnea, fatigue, cyanotic skin, crackles, S3 galloping rhythm

    • Pericarditis

      • Pathophysiology: inflammation of pericardium, primary or secondary (with or without effusion)
      • Secondary to: endocarditis, myocarditis, chest trauma, MI, post-cardiac surgery
      • Cardiac tamponade: acute compression of the heart, pulsus paradoxus (see Nursing Guidelines 23-1)
      • Assessment Findings: fever, malaise, heaviness in chest, precordial pain, worsening pain with movement/breathing, relief with upright posture, pericardial friction rub, severe hypotension

    Diagnostic Findings, Medical and Surgical, and Nursing Management (Infectious and Inflammatory Disorders of the Heart)

    • Diagnostic Findings: anemia, leukocytosis, blood cultures, transesophageal echocardiography, ECG
    • Medical and Surgical Management: high doses of IV antibiotic therapy, bed rest, valve replacement (see Drug Therapy Table 23-1)
    • Nursing Management: limit activity, assess for changes in weight, pulse rate, and rhythm, administer antibiotics, monitor cardiopulmonary status, VS, I&O, daily weights, LS, SpO2, maintain BR, O2

    Inflammatory Disorders of the Peripheral Blood Vessels

    • Thrombophlebitis

      • Pathophysiology: inflammation of a vein with clot/thrombus formation (DVT, PE)
      • Inner vein is irritated or injured; platelets clump together
      • Virchow triad: venous stasis, altered blood coagulation, trauma to the vein (causes)
      • Assessment Findings: calf pain that increases with dorsiflexion (Homans sign), heat, redness, and swelling, capillary refill < 2 seconds, fever, malaise, fatigue, anorexia

    • Thromboangiitis Obliterans (Buerger Disease)

      • Pathophysiology: inflammation of blood vessels with clot formation and fibrosis of the blood vessel wall
      • Assessment Findings: cold, numbness, burning, and tingling in feet, intermittent claudication (leg cramps after exercise), pain at rest, cyanosis and redness of feet and legs, skin: mottled purplish-red, thin and shiny, sparse hair growth, black gangrenous areas on toes and heels
      • Medical Management: tobacco restriction, Buerger-Allen exercises, analgesics, sympathectomy
      • Nursing Management: history of pain (increased or decreased), examine extremities, nails, skin, temperature, peripheral pulses, capillary refill. See client and family teaching 23-4

    Additional Information

    • Medical and Surgical Management (Inflammatory Disorders of Peripheral Blood Vessels): Doppler ultrasound, venography, impedance plethysmography (IPG), ambulation, compression bandaging, anticoagulant therapy
    • Medical and Surgical Management (Additional): diuretics, digitalis, antihypertensives, antidysrhythmic, anticoagulants, corticosteroids, dietary sodium restriction, pacemaker, defibrillator, ventriculomyomectomy, transplant
    • Nursing Management (Infectious and Inflammatory Disorders of the Heart): administer prescribed drug therapy, diversion activities, bed rest, prophylactic antibiotics. Limit activity, assess for changes in weight, pulse rate, and rhythm; administer antibiotics. Monitor cardiopulmonary status, VS, I&O, daily weights, SpO2, maintains BR, O2

    Question #1

    • Correct Answer: B) Strep throat 4 weeks earlier
    • Rationale: Bacterial endocarditis is associated with upper respiratory infection caused by the Streptococcus bacteria.

    Question #2

    • Correct Answer: E) All of the above
    • Rationale: The signs and symptoms of inflammatory disorders of the heart include diaphoresis, chest pain, friction rubs, and elevated cardiac enzymes.

    Question #3

    • Correct Answer: C) The condition is associated with smoking.
    • Rationale: Buerger's disease is an inflammatory process affecting medium-sized arteries/veins of the legs, leading to occlusion of circulation. Smoking exacerbates the process.

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    Related Documents

    Chapter 23: Caring for Clients With Infectious and Inflammatory Disorders of the Heart and Blood Vessels PDF

    Description

    Test your knowledge on infectious and inflammatory disorders of the heart, including rheumatic fever, infective endocarditis, and myocarditis. This quiz covers pathophysiology, assessment findings, and key microorganisms involved in these conditions. Dive deep into heart diseases and enhance your understanding of cardiovascular health.

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