The primary cause of acquired valvular heart disease is:
-Heredity
-Smoking
-Drug abuse
-Rheumatic fever
Give this one a try later!
Rheumatic fever remains the most common cause of acquired valvular
disease. The valves are a perfect place for bacteria to colonize, and blood
is the perfect medium for bacterial growth. The causative organism is beta-
hemolytic Streptococcus.
You are caring for a 7 day opstoperative CABG patient. He remains severly
hypocalcemic despite calcium supplementation. Which of the following complications
is this patient at greatest risk for developing?
,-Bleeding
-Muscle tetany
-Flattened T waves
-Deep vein thrombosis
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Bleeding
Due to the decreased availibility of calcium essential to the coagulations
phase (used with intinsic, extrensic and common pathways), the patient will
not have formed permanent clots. The platelet plugs formed over
damaged vessels initially after surgery may be dislodged by blood flow,
leading to recurrent bleeding at postoperative days 7 to 10.
An anterior wall infarct may be seen in leads?
• V4, R
• V5, V6
• V7, V9
• V2, V4
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V2, V4 -anterior wall
V4, R -right ventricular damage
V5, V6 -apical injury
V7, V9 - posterior wall
Bernard was admitted for PNA. He is two years post heart transplant. When you place
EKG monitoring leads, you note sinus tachycardia with PVCs and a 2-mm ST elevation.
The patient denies pain. This finding is:
,-Impossible
-Normal
-Indicative of an RBBB
-Indicative of an inferior MI
Give this one a try later!
Normal
Patients with heart transplants do not feel cardiac pain because the heart
has been denervated.
The most common new-onset dysrhythmias seen is a patient with pulmonary edema
is:
-Supraventricular tachycardia
-RBBB
-Ventricular tachycardia
-Atrial fibrillation
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Atrial fibrillation
A Fib is the result of the constant stretching and disruption of normal
pathyways in the atrium due to inreased preload produced by the
pulmonary congestion.
A patient who is status post heart transplant may have significant bradycardia. The
drug of choice in such cases is:
-Atropine
-Isuproterenol
, -Apresoline
-Adenosine
Give this one a try later!
Isuproterenol
When the heart is denervated, it has no conduction to the autonomic
nervous system, so a reflexive response does not occur. A sympathetic
stimulant must be used to provide this response. If no other complications
occur, the ventricle will eventually adjust to not receiving autonomic input.
Mr. J underwent a CABG 4 days ago and was tx-ed to you yesterday. Today, he c/o
dull aching around the sternum. You note increased tenderness to touch along the
sternal edge and contracted intercostal muscles. You should?
• Call the doc for orders: EKG, cardiac enzymes, and morphine
• Culture the wound for infection
• Do nothing; his pain is normal
• Administer morphine and diazepam as ordered.
Give this one a try later!
ADMINISTER MORPHINE AND DIAZEPAM AS ORDERD.
The chest wall pain is most likely from his open-heart surgery. Pain must be
addressed. MS and diazepam will treat both pain and muscle spasms.
The pain the pt c/o is not indicative of another MI and EKG changes would
not be seen.
There is no indication of infections, so no culture is indicated.
Pain must ALWAYS be addressed.
Your patient will be having an LVAD placed this evening and will subsequently be
cared for in the PCU. Family members are quite anxious to learn more about the
-Heredity
-Smoking
-Drug abuse
-Rheumatic fever
Give this one a try later!
Rheumatic fever remains the most common cause of acquired valvular
disease. The valves are a perfect place for bacteria to colonize, and blood
is the perfect medium for bacterial growth. The causative organism is beta-
hemolytic Streptococcus.
You are caring for a 7 day opstoperative CABG patient. He remains severly
hypocalcemic despite calcium supplementation. Which of the following complications
is this patient at greatest risk for developing?
,-Bleeding
-Muscle tetany
-Flattened T waves
-Deep vein thrombosis
Give this one a try later!
Bleeding
Due to the decreased availibility of calcium essential to the coagulations
phase (used with intinsic, extrensic and common pathways), the patient will
not have formed permanent clots. The platelet plugs formed over
damaged vessels initially after surgery may be dislodged by blood flow,
leading to recurrent bleeding at postoperative days 7 to 10.
An anterior wall infarct may be seen in leads?
• V4, R
• V5, V6
• V7, V9
• V2, V4
Give this one a try later!
V2, V4 -anterior wall
V4, R -right ventricular damage
V5, V6 -apical injury
V7, V9 - posterior wall
Bernard was admitted for PNA. He is two years post heart transplant. When you place
EKG monitoring leads, you note sinus tachycardia with PVCs and a 2-mm ST elevation.
The patient denies pain. This finding is:
,-Impossible
-Normal
-Indicative of an RBBB
-Indicative of an inferior MI
Give this one a try later!
Normal
Patients with heart transplants do not feel cardiac pain because the heart
has been denervated.
The most common new-onset dysrhythmias seen is a patient with pulmonary edema
is:
-Supraventricular tachycardia
-RBBB
-Ventricular tachycardia
-Atrial fibrillation
Give this one a try later!
Atrial fibrillation
A Fib is the result of the constant stretching and disruption of normal
pathyways in the atrium due to inreased preload produced by the
pulmonary congestion.
A patient who is status post heart transplant may have significant bradycardia. The
drug of choice in such cases is:
-Atropine
-Isuproterenol
, -Apresoline
-Adenosine
Give this one a try later!
Isuproterenol
When the heart is denervated, it has no conduction to the autonomic
nervous system, so a reflexive response does not occur. A sympathetic
stimulant must be used to provide this response. If no other complications
occur, the ventricle will eventually adjust to not receiving autonomic input.
Mr. J underwent a CABG 4 days ago and was tx-ed to you yesterday. Today, he c/o
dull aching around the sternum. You note increased tenderness to touch along the
sternal edge and contracted intercostal muscles. You should?
• Call the doc for orders: EKG, cardiac enzymes, and morphine
• Culture the wound for infection
• Do nothing; his pain is normal
• Administer morphine and diazepam as ordered.
Give this one a try later!
ADMINISTER MORPHINE AND DIAZEPAM AS ORDERD.
The chest wall pain is most likely from his open-heart surgery. Pain must be
addressed. MS and diazepam will treat both pain and muscle spasms.
The pain the pt c/o is not indicative of another MI and EKG changes would
not be seen.
There is no indication of infections, so no culture is indicated.
Pain must ALWAYS be addressed.
Your patient will be having an LVAD placed this evening and will subsequently be
cared for in the PCU. Family members are quite anxious to learn more about the
