Infective endocarditis

-the body try to get rid of it so it use macrophage lymphocyte it leaves

a sticky film the sticky film its called vegetation it makes harder for
the values to open and close
-acute ( healthy) it takes less time to heal
-usually cause is staph and strep , MRSA and also the virus and
candida , rheumatic heart disease ( the organism that cause it its
streph)
-it can affect any of the valves but most likely the mitral vavle ,
-this leads to heart failure and you will have mur mur
-it it gets to the heart it cause pulmonary emobili or it cause dvt
-what stands out of the sx is the slinter hemmorage f the nail and
janeway lesion , osler node +flu like symptoms
-you have to asks about the last 6 month hx such as skin infection,
denture, were you in the hospital etc , gyn procedure
-they will order blood culture they are 30 minutesr apart and two
different site they dont want to do it in the central or pic line bc that
line might be infective
-echo is going to show the overgrowth
-cxr how big the heart is
-ecg show 1st and second and degree heart block
-cardiac cath to see the vegetated growth
-all the treatment are iv bc you want them to work on the infection
asap
-treatment its usually six weeks , people who are high risk needs to be
treated piror to the invasive dental procedure
-people dont take the medication as prescribe
-if the infection is due to fungus or proseptic vavluve they have to have
a vavle replacement after the new vavle they need to be on antibiotic
for more than 6 weeks
-identify the high risk patients , educate the pts family member about
givening the medication on the right time
-checking for mur mur and dysrhythmia, check skin
-monitor blood culture, calcium magnesium and potassium and cbc
-ecg= heart block 1st and second degree heart block
-vanco causes tinnitus , you get a traf before the 3rd dose and 10-20 is
ok
acute pericarditis
-infection that cause inflammation of the pericarido sac they dont
know what causes it it could be staph strep tb
-toxoplasmosis ( cat litter, or uncooked lamb) lyme (ticks)
-neoplasma( cacner)
-they have severe chest pain its really painful it prevents them from
taking a deep breath , theyw ill have shallow breath
-everytime you have it you are going to have scar tissue

-esr is erythrocyte segmentation rate it indicate infllmation

-serosanguineous its usually tb or cancerous or radiation therapy ,
frank blood its usually trauma,
-cardic tamponade extra fluid bulid up on the right side of the ventricle
everytime the right ventricle contracts it goes up and then to the
atrium and bc there is no circulation in the systemic circulation you
could die, if they have juglar vein distendtino too
chronic constricutive pericarditis
- scarring of the tissue bc it kept on happening the layer of
pericardio sac is going to be stuck together
- onset is gradual
- periocardio knock super loud diastolic sound
thuetmatic heart disease
-casue by the fever which is cause by strep
-always remember to give iv antibiotic on time , prevent cardiac
complex
-heating pads for joint pain
-educate them to
valvular heart disease
-a problem when its 1/3 open or more bc blood can drip to the ventricle
and become a clot
-mitral vavlve prolapse is a genetic disorder if the vavle isnt open that
much they are asytompmatic
-xapalto its an anticoagulant
-digoxing and amioterian is for a fib
-if you take your vavles from pigs , cadaver, you dont need anticog,
but if its mechanical you need the anticoag for life, mechanical is
usually not recommended for ppl 65 or older
cardiomyopathy(dengeration of heart muscle)
-primary they dont know what happen
-secondary they do know its usually the co morbitities
-3 types to secondary
-most common is dilated a cause of it could bt HTN
it doesnt have much strength to contract blood , it would be systolic
failure because it has pumping problems .
it affects mostly men
left sided heart failure sx and then going to turn into right side
unless they are copd pt they will have left and right
only thing different in lab is bnp
-there is no treatment but the only one is heart transplant
aortic valve

-if its in the left ventricle its going to cause sob , crackle alter level of
contcitions
-anytime valvues are involve echo and card cath
hypertrophic cardiomyopathy
-its a genetic disorder parents are asytomatic , happens to atletes a
lot
dysryhtymia are usually vtac and v fib
no vasodilartor blood is not going back up and elevate the fee
restrictive cardiomyopathy
start with left sided failure end up with right sided
preload its atrium down to ventricle
preoload after load affect stroke volume
know formula for mean atrial pressure 60 to sustain vital organs
know what plus pressure is
what can decrease preoload and high pulse pressure
ecg rhytym know what p wave send for , electrical pathway sa node to
peerkunji
know cardiac diet dash diet
know cardiac marker and normal valvue
stemi and no setmie
know what to do when pt comes in with chest pt( 12 lead ecg)
hyperkalemia peak t wave treated with insulin with d 5 if its due to
acidosis you would give bicarb, and then calclium gluconate to
increase the threasal
prep for cardiac cath and post care
trendmil tee and tte
holter monitors ( diabetic use it)
know onset for chronist stable angia( princmetal st is elevated and its
usually depressed)
ppl who have st elevation is an acute mi they dont have a lot of blood
in the coronary artery its total occulasion if tis nonsetmi its usually a
partial and not totally occuled
pqrsti pain , know what to do with onset what can you do 12 hurs
first 12 hours pci within the first 90 minutes when you enter the
emergency , only time not to do is 3 or more occuluded of coronary
artery or left asending artery, if they cant do that they will do the
fibrinolytic ( 6 hr of onset). If they cant do it anymore they will do a
caggabe
which one you can take nitro and it will work
systolic and dilastoic failure
right sided vs left sided

3 compensatory mechanism sympathetic , neurohormal, dilation know

the difference
nursing action in certain suitation what poisiton would you put them in
HTN the different stages and the medications stage 1 diuruetic stage 2
2 diuretic hypertension crisis you dont want to lower the bp too fast
more tha 25 % except for atoritic distention or stroke are the one you
can decrease fast
Organ transplant who qualifies and who doesnt
Samples question of seniarios
1 math problem every test has one
focus on infective endocarditis has all the symptoms of everything
else rheumatic heart disease ends up with , actue pericarditis , caridio
myopathy which one can be treated and which one cant only the
hypertrophic can be treated
valve treatment