NUR 257 Exam 3 Study Guide Graded A 2024

symptoms and criteria used to diagnose rheumatic fever? - -Jones criteria (2 major, or 1 major & 2 minor) -Carditis, Polyarthritis( arthritis in multiple joints), chorea (uncontrolled muscle spasms), subcutaneous nodules, rash, fever, arthralgia, etc, etc -+ Serum strep antibodies (antistreptolysin O titer) -Assess cardiac function -Post-group A B-hemolytic streptococcus infection (2-6 weeks prior); un or undertreated (Strep throat, impetigo, etc) reliable and best standardized test for rheumatic fever? - antistreptolysin O (ASO) Treatment of rheumatic fever? - -ATB: PCN/erythromycin; encourage drug compliance -ASA/salicylates: for inflammation, fever, pain -Bed rest during acute phase w/ good alignment of joints High percentage of recurrence of rheumatic fever so its important to complete ______therapy - -Antibiotic major complication of rheumatic fever? - -rheumatic heart disease which can result in cardiac valve damage Risk factors of CHD for infant? - -other anatomic defects -chromosomal abnormalities (down syndrome) Risk factors of CHD for mother? - -chronic health conditions ie- DM, poorly controlled PKU -maternal alcohol/illicit drug use -teratogenic medications taken by mother during pregnancy -exposure to infections ie-rebulla -exposure to environmental toxins -low birth weight d/t intrauterine growth restrictions -high birth weight infants What are the 3 Congenital heart defects that that cause a LEFT to RIGHT shunting of blood and increased pulmonary blood flow? - Atrial septal defect ventricular septal defect patent ductus arteriosus What is atrial septal defect? - -increased pulmonary blood flow: L-R shunt -Loud, harsh murmur -may be asymptomatic -may have enlarged R atrium with increased O2 saturation in R atrium -extra blood flow: too much pressure (crackles) What is ventricular septal defect? - -increased pulmonary blood flow: L-R shunt -Most common -hole in heart -loud, harsh murmur -may be asymptomatic if small -increased O2 sat RV -often closed during 1st year -repair: often wait to repair if asymptomatic What is patent ductus arteriosus? - -increased pulmonary blood flow: L-R shunt -Failure of fetal circulation to close "persistent fetal circulation" -murmur (machine like) -wide pulse pressure -bounding pulses -may be asymptomatic at rest -Treatment: ¡Indocin [indomethacin] (prostaglandin inhibitor); promotes closure of PDA; may require surgery What is coarctation of aorta? - -obstruction of blood flow from ventricles -Narrowing of lumen of aorta -increased BP in upper extremities --nosebleeds -weak or absent lower extremity pulses -cool lower extremities What is tetralogy of fallot? - -decreased pulmonary blood flow: R-L shunt -Murmur -cyanosis -dyspnea -digital clubbing -polycythemia -FTT -hypercyanotic/blue/tet spell -"squat" position to slow pulmonary blood flow -multiple surgeries -Tetralogy: pulmonic stenosis, VSD, overriding aorta, R ventricular hypertrophy Digoxin? - -used to treat heart failure -toxicity symptoms: Bradycardia, anoxeria, N/V, confusion, colored vision changes (cant tell the difference between green, yellow, purple), halo vision, flickering lights -Teach the parents to take the drug the same time and not giving to much