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Questions and Answers
What are the early signs of bacterial endocarditis?
Which type of bacterial endocarditis mainly occurs after surgical valve replacement?
What causes Janeway lesions in patients with bacterial endocarditis?
Which organism is most commonly associated with early-onset prosthetic valve endocarditis?
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What are Osler nodes characterized by?
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Which age group is most at risk for developing Rheumatic Heart Disease?
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Which of the following is NOT a manifestation of prolonged bacterial endocarditis?
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What is one of the major criteria for diagnosing Rheumatic Fever according to the Revised Jones criteria?
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What is the primary aim of blood culture in the management of bacterial endocarditis?
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What potential complication is associated with renal emboli in bacterial endocarditis?
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Which laboratory test is most useful for diagnosing heart valve problems in suspected cases of Rheumatic Heart Disease?
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What symptom is associated with the involvement of cardiac tissues in Rheumatic Heart Disease?
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What is a common treatment option for a patient with Rheumatic Heart Disease who is allergic to penicillin?
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Which finding would likely be indicative of inflammation in a patient with suspected Rheumatic Fever?
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What is considered a minor criterion for the diagnosis of Rheumatic Fever?
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What indicator suggests a child presents with a high pretest probability of streptococcal pharyngitis?
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What is a critical nursing intervention for patients with endocarditis to detect hemodynamic instability?
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Which measure is essential for maintaining oxygenation in patients with endocarditis?
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What teaching point is important for patients with congestive heart failure?
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Which type of myocarditis is linked to an autoimmune mechanism and characterized by multinucleated giant cells?
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What symptom is commonly associated with infectious myocarditis?
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Which of the following is a recognized non-infectious cause of myocarditis?
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What is an appropriate comfort measure for patients with endocarditis who are experiencing fever?
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What is a potential consequence of giant cell myocarditis if left untreated?
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Which symptom is commonly assessed for the diagnosis of cardiac tamponade?
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What is the purpose of performing a pericardiocentesis?
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Which imaging technique is NOT typically used in the diagnosis of cardiac tamponade?
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What nursing action is essential for a patient with cardiac tamponade?
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Which medication is commonly used to increase blood pressure in cardiac tamponade management?
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What is the primary goal of performing thoracotomy in patients with cardiac tamponade?
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What condition often leads to the development of aortic aneurysms relevant to cardiac tamponade?
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Which lab test is essential for evaluating heart function in a patient suspected of cardiac tamponade?
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Which method is NOT commonly used to diagnose Aortic Regurgitation?
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What is one of the initial nursing actions for patients with valvular disorders?
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Which medication is typically used to alleviate symptoms of heart failure due to valvular disorders?
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When monitoring for complications in patients with valvular disorders, which sign would indicate potential thromboembolism?
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What lifestyle modification is essential for patients with valvular disorders to prevent further complications?
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What does monitoring for new onset murmurs indicate in patients with valvular disorders?
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Which of the following interventions is part of the management of patients undergoing surgery for valvular disorders?
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What symptom indicates pulmonary congestion in patients with valvular disorders?
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Study Notes
Rheumatic Heart Disease
- Rheumatic heart disease (RHD) is a condition that affects the heart valves due to an untreated strep throat infection.
- RHD typically affects children between the ages of 5 and 15.
- It is more common in crowded living conditions and lower socioeconomic groups.
- Factors contributing to RHD include poor oral hygiene and untreated throat infections.
- RHD is diagnosed based on the Jones criteria, which includes major and minor criteria.
RHD Major Criteria:
- Carditis (inflammation of the heart)
- Arthritis (inflammation of the joints)
- Chorea (jerky, involuntary movements)
- Erythema marginatum (a rash)
- Subcutaneous nodules
RHD Minor Criteria:
- Fever (over 38.5°C)
- Elevated ESR (erythrocyte sedimentation rate)
- Elevated CRP (C-reactive protein)
- Prolonged PR interval on ECG (electrocardiogram)
RHD Treatment:
- Antibiotics such as penicillin are used to treat the underlying infection.
- Anti-inflammatory drugs like aspirin may be prescribed.
Bacterial Endocarditis
- Bacterial endocarditis (BE) is an infection of the inner lining of the heart, typically affecting the heart valves.
- BE is primarily caused by bacteria, commonly streptococci.
- BE can occur after valve replacement, known as prosthetic valvular endocarditis.
- BE can also occur as a result of other infections, such as those of the mouth or skin.
BE Symptoms:
- Fever (often mild)
- Night sweats
- Fatigue
- Weight loss
- Chills
- Joint pain
BE Diagnosis:
- Blood cultures are used to identify the bacteria causing the infection.
- Echocardiogram is used to assess the damage to the heart valves.
BE Management:
- Antibiotics are used to treat the infection.
- Other treatments may include:
- Cardiac stabilization
- Oxygenation
- Hemodialysis (for renal failure)
- Salt restriction (for congestive heart failure)
- Activity limitation (for heart failure)
Myocarditis
- Myocarditis is inflammation of the heart muscle caused by various factors, including infections and drugs.
Myocarditis Types:
- Infectious myocarditis is caused by viruses (HIV, Coxsackie), bacteria (streptococci, staphylococci), fungi, and parasites.
-
Non-infectious myocarditis is caused by:
- Cardiotoxins (ethanol, heavy metals, radiation therapy)
- Inflammatory diseases (Kawasaki disease, Takayasu’s disease, sarcoidosis)
- Certain drugs (doxorubicin, daunorubicin, cyclophosphamide)
- Giant cell myocarditis is a rare form of myocarditis with an unclear etiology but possibly linked to an autoimmune mechanism.
Myocarditis Symptoms:
- Fatigue
- Dyspnea (shortness of breath)
- Edema (swelling)
- Fever
- Muscle aches (myalgias)
- Crackles in lungs
- Third (S3) or fourth (S4) heart sound
Cardiac Tamponade
- Cardiac tamponade occurs when fluid builds up in the space between the heart and the sac surrounding it (pericardium).
- The fluid buildup compresses the heart, making it difficult to pump blood.
Cardiac Tamponade Symptoms:
- Chest pain
- Shortness of breath
- Dizziness
- Fainting
- Neck vein distention
Cardiac Tamponade Diagnosis:
- Echocardiogram
- Chest X-ray
- Electrocardiogram
- Computerized tomography (CT) scan
- Cardiac enzymes
Cardiac Tamponade Management:
- Oxygen
- IV fluids
- Medications (inotropics)
- Pericardiocentesis (removal of fluid from the pericardium)
- Pericardiectomy (removal of part of the pericardium)
- Thoracotomy (opening of the chest for drainage)
Valvular Disorders
- Valvular disorders involve damage or defects in the heart valves (mitral, aortic, tricuspid, or pulmonary valves).
- Valvular disorders can cause narrowing (stenosis) or leaking (regurgitation) of the valve.
Valvular Disorders Diagnosis:
- Echocardiogram
- Exercise testing
- Cardiac magnetic resonance imaging
- Cardiac catheterization
Valvular Disorders Management:
- Medication (vasodilators, diuretics, nitrates, digoxin, calcium blockers)
- Low sodium diet
- Avoiding strenuous activity
- Surgery (including percutaneous balloon valvuloplasty, valve replacement, or repair)
Nursing Care for Cardiac Conditions:
- Monitor vital signs (heart rate, blood pressure, respiratory rate, oxygen saturation)
- Auscultate heart sounds for murmurs
- Monitor for signs of pulmonary congestion (shortness of breath, crackles, pink frothy sputum)
- Monitor intake and output
- Administer prescribed medications
- Prepare patients for surgery
- Teach patients about their condition and treatment
- Provide emotional support
- Encourage healthy lifestyle changes (smoking cessation, diet modification, exercise)
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Description
This quiz provides an overview of Rheumatic Heart Disease (RHD), including its causes, symptoms, and diagnostic criteria based on the Jones criteria. Understand the major and minor criteria for diagnosis, as well as treatment options available for this condition. Perfect for students studying cardiology or related health fields.
