NUR 206 - Exam 3 with 100% Correct
Solutions
Cardiomyopathy - ANSWER-•disease that affects heart muscle's ability to pump
effectively
•primary abnormality of heart muscle that affects it's structural or functional
characteristics
Dilated Cardiomyopathy - ANSWER-•most common
•inherited (1/3)
•chemical exposure
•common occurrence in 20-60 yo
•men > women
•muscle becomes thinner and weaker as it dilates
•SOB, fatigue, LE edema, JVD
Hypertrophic Cardiomyopathy (HCM) - ANSWER-•↓ compliance of LV and hypertrophy
•usually inherited
•also sec to HTN
•muscle mass enlarges, leading to small LV volume
•septal hypertrophy may inhibit outflow
Restrictive Cardiomyopathy (RCM) - ANSWER-•rigid ventricular walls that restrict
heart's ability to stretch and fill w/ blood
•usually acquired as result of amyloidosis (build up of protein)
•↓ compliance (expansion)
•diastolic dysfunction and HF
Arrythmogenic Right Ventricular Dysplasia (ARVD) - ANSWER-•↑ risk of ventricular
dysrhythmias sec to thickening of cardiac muscle
•usually hereditary
•can cause sudden cardiac death in young adults and athletes
Unclassified Cardiomyopathy - ANSWER-•peripartum cardiomyopathy (PPCM)
•rare but serious
•usually seen in last months of pregnancy or up to 5 months PP
•risk factors = multiple pregnancies, obesity, poor nutrition, HTN, some meds
Stenosis vs. Regurgitation - ANSWER-*Stenosis*
•narrowing of valve or artery
*Regurgitation*
,•backflow of blood into atria during ventricular systole
Conditions that Lead to Valvular Heart Disease - ANSWER-•congenital
•valvular stenosis
•valvular insufficiency
•HTN
•age
•atherosclerosis
•infection
•MI
Clinical Manifestations of Valvular Heart Disease - ANSWER-•SOB (mitral/aortic)
•weakness/lightheadedness (mitral/aortic)
•chest discomfort (any?)
•edema of LE (tricuspid/pulmonic)
•palpitations (any?)
•rapid weight gain (tricuspid/pulmonic)
Valvular Heart Disease Treatment and Interventions - ANSWER-*Medication*
•BB
•ACE inhibitors
•nitrates
•diuretics
•calcium channel blockers
•statins
•hydrazeline
*Interventions*
•low Na+ diet
•weight management
•↓ stress
•↑ physical activity
•stop smoking
Left Sided Heart Failure - ANSWER-•forward effects
•fatigue
•activity intolerance
•dizziness/syncope
•pulmonary congestion/edema
•orthopnea/PND
•S3,S4 heart sounds
Right Sided Heart Failure - ANSWER-•backward effects
•edema
•JVD
•liver engorgement
•GI issues
, •nocturia
•Cor Pulmonale (RV failure d/t pulmonary HTN, edema, etc.)
•anasarca (generalized edema)
Cardiac Output - ANSWER-•CO (ml/min) = HR (beats/min) x SV (ml/beat)
•normal = 4-6 L/min
*↑HR*
•SNS stimulation
•hypercapnea
•hypercalcemia
•drugs (atropine)
*↓ HR*
•PNS stimulation (acetylcholine)
•hypoxia
•hypocalcemia
•drugs (BB)
Preload & Afterload - ANSWER-*Preload*
•volume of blood in ventricles just before contraction
*Frank-Sterling Law*
•↑ in preload = ↑ contractility = ↑SV & CO
•temporary compensation, tires out heart
*Afterload*
•force needed to eject blood into circulation
•↑ in resistance = ↑ in afterload = heart tires out
•↓ in resistance = ↓ CO d/t ↓ in force of contraction
Heart Failure Labs and Diagnostics - ANSWER-*Labs*
•BNP (specific to ventricular stretch, ↑ = ↑ in size of LV)
•electrolytes
•BUN
•creatinine
*Diagnostics*
•CXR
•ECG
•echocardiogram
•cardiac catheterization
•hemodynamic monitoring
•MAP = 70-90 mmHg
•CVP measures right sided pressures = 2-6 mmHg
Systemic Inflammatory Response Syndrome (SIRS) - ANSWER-•whole body
inflammatory process resulting in acute critical illness
•can result from infections or noninfectious cause (burns, trauma, etc.)
Solutions
Cardiomyopathy - ANSWER-•disease that affects heart muscle's ability to pump
effectively
•primary abnormality of heart muscle that affects it's structural or functional
characteristics
Dilated Cardiomyopathy - ANSWER-•most common
•inherited (1/3)
•chemical exposure
•common occurrence in 20-60 yo
•men > women
•muscle becomes thinner and weaker as it dilates
•SOB, fatigue, LE edema, JVD
Hypertrophic Cardiomyopathy (HCM) - ANSWER-•↓ compliance of LV and hypertrophy
•usually inherited
•also sec to HTN
•muscle mass enlarges, leading to small LV volume
•septal hypertrophy may inhibit outflow
Restrictive Cardiomyopathy (RCM) - ANSWER-•rigid ventricular walls that restrict
heart's ability to stretch and fill w/ blood
•usually acquired as result of amyloidosis (build up of protein)
•↓ compliance (expansion)
•diastolic dysfunction and HF
Arrythmogenic Right Ventricular Dysplasia (ARVD) - ANSWER-•↑ risk of ventricular
dysrhythmias sec to thickening of cardiac muscle
•usually hereditary
•can cause sudden cardiac death in young adults and athletes
Unclassified Cardiomyopathy - ANSWER-•peripartum cardiomyopathy (PPCM)
•rare but serious
•usually seen in last months of pregnancy or up to 5 months PP
•risk factors = multiple pregnancies, obesity, poor nutrition, HTN, some meds
Stenosis vs. Regurgitation - ANSWER-*Stenosis*
•narrowing of valve or artery
*Regurgitation*
,•backflow of blood into atria during ventricular systole
Conditions that Lead to Valvular Heart Disease - ANSWER-•congenital
•valvular stenosis
•valvular insufficiency
•HTN
•age
•atherosclerosis
•infection
•MI
Clinical Manifestations of Valvular Heart Disease - ANSWER-•SOB (mitral/aortic)
•weakness/lightheadedness (mitral/aortic)
•chest discomfort (any?)
•edema of LE (tricuspid/pulmonic)
•palpitations (any?)
•rapid weight gain (tricuspid/pulmonic)
Valvular Heart Disease Treatment and Interventions - ANSWER-*Medication*
•BB
•ACE inhibitors
•nitrates
•diuretics
•calcium channel blockers
•statins
•hydrazeline
*Interventions*
•low Na+ diet
•weight management
•↓ stress
•↑ physical activity
•stop smoking
Left Sided Heart Failure - ANSWER-•forward effects
•fatigue
•activity intolerance
•dizziness/syncope
•pulmonary congestion/edema
•orthopnea/PND
•S3,S4 heart sounds
Right Sided Heart Failure - ANSWER-•backward effects
•edema
•JVD
•liver engorgement
•GI issues
, •nocturia
•Cor Pulmonale (RV failure d/t pulmonary HTN, edema, etc.)
•anasarca (generalized edema)
Cardiac Output - ANSWER-•CO (ml/min) = HR (beats/min) x SV (ml/beat)
•normal = 4-6 L/min
*↑HR*
•SNS stimulation
•hypercapnea
•hypercalcemia
•drugs (atropine)
*↓ HR*
•PNS stimulation (acetylcholine)
•hypoxia
•hypocalcemia
•drugs (BB)
Preload & Afterload - ANSWER-*Preload*
•volume of blood in ventricles just before contraction
*Frank-Sterling Law*
•↑ in preload = ↑ contractility = ↑SV & CO
•temporary compensation, tires out heart
*Afterload*
•force needed to eject blood into circulation
•↑ in resistance = ↑ in afterload = heart tires out
•↓ in resistance = ↓ CO d/t ↓ in force of contraction
Heart Failure Labs and Diagnostics - ANSWER-*Labs*
•BNP (specific to ventricular stretch, ↑ = ↑ in size of LV)
•electrolytes
•BUN
•creatinine
*Diagnostics*
•CXR
•ECG
•echocardiogram
•cardiac catheterization
•hemodynamic monitoring
•MAP = 70-90 mmHg
•CVP measures right sided pressures = 2-6 mmHg
Systemic Inflammatory Response Syndrome (SIRS) - ANSWER-•whole body
inflammatory process resulting in acute critical illness
•can result from infections or noninfectious cause (burns, trauma, etc.)
