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Class notes

WSCC MEDSURG 2 EXAM 2

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detailed class notes to prepare you for the exam

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Index
One
02
EXAM 2




Two
Three
TOPICS



Four
Five
cardiac V11




Six
endol


Seven
endo
Eight
11

endo 111 Nine
Ten




hematology
Eleven Twelve




©Jena W Designs | jenawdesigns.com

, CARDIAC V11
layers ofthe
endocardium innerlayer bloodsloshing
pericardium outerlayer sac holdsinplace v friction
myocardium muscle


PERICARDITIS acute vs chronic
inflammation of pericardium usually acute
50 Mls of fluid to cushion when it beats
too much pericardialeffusion
piasnic

CLINICAL MANIFESTATIONS jen
etipers.si

I
sharpstabbingpx w radiationtoback respiratory
usually
neck L shoulder or arm

DX that may w coughing swallowing
or LAYING FLAT anxiety relieved whyTayoBoughtreturns
transient interm F nf:P ftp.cannearw stetnoin85 resoivesincuweeksresoimhnths

EYE STelevation EMERGENCY ischemia necrosis may see AFIB
TX NURSING CARE
YrB marker ofinflammation art of event addressunderlyingcause
bedrestant
DIAGNOSTICS ppporm NOTMORPHINE
plfilati.fi nestpain CT is best pain management NSAIDSduetoinflammati
if no relief use corticosteriods
19 9 EE Pion if no relief in 29hrs colchine0.5mgBID
goesonformorethan 3 months
sided HF may occur position pt sitting upright leaning
8 989s slightlytoward
CARDIAC TAMPONADE IÑ 1 pericardiumfillsw fluid
monitorforpericardial effusion CP pressure
syncope palpitations cough dyspnea
11595 Ma'd Train restricts
hoarseness anxiety confusion
pumping a backflows pain laying flat
muffled sounds
edema
VALVES
paradoxicalpulse
bradycardia ENDOCARDITIS
hypotension
beck's triad JVD BP muffled sounds it
Ym ainted
cardiacdevices
Ian of care may include bodypiercings platelets'SÉg'atation
increasedfluids tomaintainBP hemodialysis
cardiacecho IV drugabuseinyyy.gg
affectsvalve
pericardiocentesis
ACUTE death in weeks
X breaks Yff
survivabilitydepends SUBACUTE gradualonset
pericardial window upon underlying systemitembo

pericardiectomy removeswholesac mitral valve is most common rxstoneskidneyissues

, ENDOCARDITIS PARTTWO DIAGNOSIS
t blood cultures mostreliable
anifestationsofinfective endocarditis echocardiography showsevidence
commonly SOB fatigue chestpain
fever chills PREVENTION
anorexia wtloss ABXprophylaxis is recommened inhighRX pts before after
heart murmer 85 dental work is done
rx of failure
neurologicalchanges emboli good oral hygiene rx ofbacteria drugabuse rehab
painfulfffts avoidtoothpicks
avoid nail biting
avoid bodypiercings tattoos
Memmushes minimize acne breakouts psoriasis
too
NONSURGICAL MANAGEMENT
IV ABX 2 6 weeks startrightawaywhile waitingforculture
antiinflammorydrugs NSAIDS
mail.nonpainful bedrestisrecommended until symptomssubside
anticoagulants are ofNOVALUE inpreventingemboli makesoutcomeswors
NURSING INTERVENTIONS cluster care soptcan rest
monitorforfever
administerABX PT TEACHING
restperiods PICC line care longtermABXtherapy
handhygiene hxdrugabuse hospitalization or homehealthw line lock
giveNSAIDS
importanceof antibiotics how toadminister
URGICAL INTERVENTIONS ABX will fix mostcases as scheduled
removinginfectedvalve usesofttoothbrush oralhygienex2daily
repairingvalvesorchordaetendinea NOwaterpicksorflossing
drainabscesses cleananyopenwoundsw ABXointment bacitracin
for veryseverecases
valueleafletsbecomerigid
cute inflammatory reaction
mayinvolve RHEUMATIC HEART deformed NOT GOOD
lining valves endocarditis resultsinstenosisorregurgitation
muscle myocardium
thepericardium pericarditis
DISEASE of the valve


nematicfevermaygoundxed until VALVE DYSFUNCTION OVERVIEW
RHDdevelops unTX strepthroat variesin severity
survivabilitydependson
GENERAL SIES valveaffected
fatigue depends ofdysfunction howfast it developed mitral artial
SOB degreeofimpairment valves are most
irregularheartbeat murmer affected
edemain feet ankles what cangowrong
CP syncope bloodcan leak back thru valveinopposite
direction which is called regurgitation
DIAGNOSTICTESTS
the mitral valvesometimeshas floppy flaps
IE o TEE
doesn'tclosetightly this iscalled mjturd.dkatvaesyPfQd2P e

Cathia whenthe valvedoesn'topenenough whichblocksblood
MRI flow it iscalled stenosis

stress test

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