NUR 529 EXAM 2 QUESTIONS WITH
PROVEN SOLUTIONS
Viral infections (e.g., with coxsackieviruses and echoviruses) ✅✅ANSW-are the most common
cause of pericarditis
Pericarditis ✅✅ANSW-Other causes include bacterial or mycobacterial infections, connective
tissue diseases (e.g., systemic lupus erythematosus, rheumatoid arthritis), uremia, postcardiac
surgery, neoplastic invasion of the pericardium, radiation, trauma, drug toxicity, and contiguous
inflammatory processes of the myocardium or lung
Acute pericarditis ✅✅ANSW-manifestations include a triad of chest pain, pericardial friction rub,
and electrocardiographic (ECG) changes. Nearly all people have chest pain, which is usually abrupt in
onset and sharp, occurring in the precordial area, and may radiate to the neck, back, abdomen, or
side. The pain is typically worse with deep breathing, coughing, swallowing, and positional changes
because of changes in venous return and cardiac filling. The person often finds relief by sitting up
and leaning forward. It is important to differentiate the chest pain from acute myocardial infarction
(MI) or pulmonary embolism (PE).
Acute pericarditis ✅✅ANSW-diagnosis is based on clinical manifestations.
ECG, chest radiography, and echocardiography
Friction rub
Rheumatic fever and rheumatic heart failure ✅✅ANSW-complications of the immune-mediated
response to group A (beta-hemolytic) streptococcal (GAS) throat infection
Rheumatic heart failure ✅✅ANSW-can lead to the development of chronic valvular disorders that
produce permanent cardiac dysfunction and sometimes fatal HF years later
Stenosis, regurgitation ✅✅ANSW-two mechanical disruptions that occur with valve disorders
Stenosis ✅✅ANSW-narrowing and thickening of the valve opening and distortion so it doesn't
open properly
o increases the resistance to blood flow, increases volume and work of the chamber emptying
through the narrowed valve; L atrium if mitral & LV if aortic
,Retracted fibrosed valve leaflets - incompetent or regurgitant valve ✅✅ANSW-valve that is
unable to close completely - permits backflow; flowing back into the LV during diastole if aortic valve
& flowing back into L atrium during systole if mitral valve
o Heart murmur
Right side HF ✅✅ANSW-impairs the ability to move deoxygenated blood from the systemic
circulation into the pulmonary circulation (body to lungs)
Right side HF ✅✅ANSW-o S&S: dependent peripheral edema because the R ventricle can't move
blood forward blood accumulates in the systemic venous system (body) - body areas affected!
o Hepatomegaly, splenomegaly, ascites, RUQ pain - engorged liver because of venous distension and
blood backing into the hepatic veins that drain into the inferior vena cava
o If extreme, jugular veins become distended and can be seen when pt is sitting or standing
Right side HF ✅✅ANSW-Causes include conditions that impede blood flow into the lungs or
compromise the pumping of the right ventricle. LV failure is the most common cause, Sustained
pulmonary hypertension, stenosis or regurgitation of tricuspid or pulmonic valves, right ventricular
infarction, and cardiomyopathy, also caused by congenital heart defects, such as tetralogy of Fallot
and ventricular septal defect (VSD).
Cor pulmonale ✅✅ANSW-is when right-sided heart failure occurs due to chronic pulmonary
disease
Left side HF ✅✅ANSW-impairs the movement of blood from the low-pressure pulmonary
circulation into the high-pressure arterial side of the systemic circulation (lungs to body) - lungs
affected!
Left side HF ✅✅ANSW-Decrease in CO to system circulation (body), blood accumulates in the LV,
left atrium, & pulmonary circulation (lungs) which increases the pressure there o S&S: pulmonary
edema due to changes in pressure, often occurs at night
Left side HF ✅✅ANSW-Common causes- hypertension and acute MI (can develop rapidly with
acute MI.) Stenosis or regurgitation of the valves also creates left-sided backflow, resulting in
pulmonary congestion. As pulmonary pressure rises, it may progress to produce right-sided heart
failure.
, Conditions that precipitate overt HF ✅✅ANSW-Infection, emotional stress, uncontrolled
hypertension, fluid overload
Tx for Acute heart failure syndrome (AHFS) ✅✅ANSW-requires stabilizing & and correcting the
cause for exacerbation, Includes mechanical support devices such as the intra-aortic balloon pump
and ventricular assist device (VAD), Oxygen therapy, CPAP which increases intrathoracic pressure
which can help decrease venous return and left ventricular preload, BiPAP - also delivers higher
pressure during inspiration can also decrease RR & HR
Nonpharmacologic tx of HF ✅✅ANSW-exercise, sodium & fluid restrictions, improving symptoms,
quality of life, and reducing risk factors (HTN)
Pharmacologic Tx of HF ✅✅ANSW-decided by pts symptomology
Cardiac Cachexia ✅✅ANSW-A condition of severe malnutrition that develops in heart failure
patients; characterized by weight loss and tissue wasting.
hypertrophic cardiomyopathy ✅✅ANSW-usually asymptomatic but may include dyspnea, chest
pain during exertion, exercise intolerance, syncope, and arrhythmias
hypertrophic cardiomyopathy ✅✅ANSW-inherited, it may present anywhere from early
childhood to late adulthood
ductus arteriosus ✅✅ANSW-For 90% of full-term infants, functionally closed by 48 hours of age
patent ductus arteriosus ✅✅ANSW-passageway between the aorta and the pulmonary artery
remains open after birth, A murmur is typically detected within days or weeks of birth
Atrial septal defect ✅✅ANSW-flaw in the septum that divides the two atria of the heart
Atrial septal defect ✅✅ANSW-Intracardiac shunting is usually from left to right and may increase
with age as the right ventricle becomes more compliant. In most cases, there is a moderate shunt,
resulting in dilation of the right heart chambers
PROVEN SOLUTIONS
Viral infections (e.g., with coxsackieviruses and echoviruses) ✅✅ANSW-are the most common
cause of pericarditis
Pericarditis ✅✅ANSW-Other causes include bacterial or mycobacterial infections, connective
tissue diseases (e.g., systemic lupus erythematosus, rheumatoid arthritis), uremia, postcardiac
surgery, neoplastic invasion of the pericardium, radiation, trauma, drug toxicity, and contiguous
inflammatory processes of the myocardium or lung
Acute pericarditis ✅✅ANSW-manifestations include a triad of chest pain, pericardial friction rub,
and electrocardiographic (ECG) changes. Nearly all people have chest pain, which is usually abrupt in
onset and sharp, occurring in the precordial area, and may radiate to the neck, back, abdomen, or
side. The pain is typically worse with deep breathing, coughing, swallowing, and positional changes
because of changes in venous return and cardiac filling. The person often finds relief by sitting up
and leaning forward. It is important to differentiate the chest pain from acute myocardial infarction
(MI) or pulmonary embolism (PE).
Acute pericarditis ✅✅ANSW-diagnosis is based on clinical manifestations.
ECG, chest radiography, and echocardiography
Friction rub
Rheumatic fever and rheumatic heart failure ✅✅ANSW-complications of the immune-mediated
response to group A (beta-hemolytic) streptococcal (GAS) throat infection
Rheumatic heart failure ✅✅ANSW-can lead to the development of chronic valvular disorders that
produce permanent cardiac dysfunction and sometimes fatal HF years later
Stenosis, regurgitation ✅✅ANSW-two mechanical disruptions that occur with valve disorders
Stenosis ✅✅ANSW-narrowing and thickening of the valve opening and distortion so it doesn't
open properly
o increases the resistance to blood flow, increases volume and work of the chamber emptying
through the narrowed valve; L atrium if mitral & LV if aortic
,Retracted fibrosed valve leaflets - incompetent or regurgitant valve ✅✅ANSW-valve that is
unable to close completely - permits backflow; flowing back into the LV during diastole if aortic valve
& flowing back into L atrium during systole if mitral valve
o Heart murmur
Right side HF ✅✅ANSW-impairs the ability to move deoxygenated blood from the systemic
circulation into the pulmonary circulation (body to lungs)
Right side HF ✅✅ANSW-o S&S: dependent peripheral edema because the R ventricle can't move
blood forward blood accumulates in the systemic venous system (body) - body areas affected!
o Hepatomegaly, splenomegaly, ascites, RUQ pain - engorged liver because of venous distension and
blood backing into the hepatic veins that drain into the inferior vena cava
o If extreme, jugular veins become distended and can be seen when pt is sitting or standing
Right side HF ✅✅ANSW-Causes include conditions that impede blood flow into the lungs or
compromise the pumping of the right ventricle. LV failure is the most common cause, Sustained
pulmonary hypertension, stenosis or regurgitation of tricuspid or pulmonic valves, right ventricular
infarction, and cardiomyopathy, also caused by congenital heart defects, such as tetralogy of Fallot
and ventricular septal defect (VSD).
Cor pulmonale ✅✅ANSW-is when right-sided heart failure occurs due to chronic pulmonary
disease
Left side HF ✅✅ANSW-impairs the movement of blood from the low-pressure pulmonary
circulation into the high-pressure arterial side of the systemic circulation (lungs to body) - lungs
affected!
Left side HF ✅✅ANSW-Decrease in CO to system circulation (body), blood accumulates in the LV,
left atrium, & pulmonary circulation (lungs) which increases the pressure there o S&S: pulmonary
edema due to changes in pressure, often occurs at night
Left side HF ✅✅ANSW-Common causes- hypertension and acute MI (can develop rapidly with
acute MI.) Stenosis or regurgitation of the valves also creates left-sided backflow, resulting in
pulmonary congestion. As pulmonary pressure rises, it may progress to produce right-sided heart
failure.
, Conditions that precipitate overt HF ✅✅ANSW-Infection, emotional stress, uncontrolled
hypertension, fluid overload
Tx for Acute heart failure syndrome (AHFS) ✅✅ANSW-requires stabilizing & and correcting the
cause for exacerbation, Includes mechanical support devices such as the intra-aortic balloon pump
and ventricular assist device (VAD), Oxygen therapy, CPAP which increases intrathoracic pressure
which can help decrease venous return and left ventricular preload, BiPAP - also delivers higher
pressure during inspiration can also decrease RR & HR
Nonpharmacologic tx of HF ✅✅ANSW-exercise, sodium & fluid restrictions, improving symptoms,
quality of life, and reducing risk factors (HTN)
Pharmacologic Tx of HF ✅✅ANSW-decided by pts symptomology
Cardiac Cachexia ✅✅ANSW-A condition of severe malnutrition that develops in heart failure
patients; characterized by weight loss and tissue wasting.
hypertrophic cardiomyopathy ✅✅ANSW-usually asymptomatic but may include dyspnea, chest
pain during exertion, exercise intolerance, syncope, and arrhythmias
hypertrophic cardiomyopathy ✅✅ANSW-inherited, it may present anywhere from early
childhood to late adulthood
ductus arteriosus ✅✅ANSW-For 90% of full-term infants, functionally closed by 48 hours of age
patent ductus arteriosus ✅✅ANSW-passageway between the aorta and the pulmonary artery
remains open after birth, A murmur is typically detected within days or weeks of birth
Atrial septal defect ✅✅ANSW-flaw in the septum that divides the two atria of the heart
Atrial septal defect ✅✅ANSW-Intracardiac shunting is usually from left to right and may increase
with age as the right ventricle becomes more compliant. In most cases, there is a moderate shunt,
resulting in dilation of the right heart chambers
