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NURS 642 Exam 4 newest 2024 study guide questions and correct answers
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NURS 642 Exam 4 newest 2024 study guide questions and correct answers
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NURS 642 Exam 4 newest 2024 study guidequestions and correct answers
myocarditis Correct Answer inflammation of the heart
muscle
endomyocardial biopsy (diagnostic of choice)
primary myocarditis Correct Answer Acute Viral Infection
(a/w URI)
tx for primary myocarditis Correct Answer •ACEi and BB if
LVEF < 40%
•NSAIDS for CP
•Colchicine for arrhythmias suppression
secondary myocarditis Correct Answer Fibrosis of Heart
muscle and/or inflammatory rxn
tx for secondary myocarditis Correct Answer • Treatment:
BB (stenosis), CCB & Nitrate (coronary spasms), HF
pericardial disorders include Correct Answer Acute
inflammatory, constrictive, effusion/tamponade
Acute Pericarditis (inflammatory) Correct Answer Days
after MI, progress to effusion/tamponade
•EKG: Diffuse ST elevation IN ALL LEADS EXCEPT aVR
•Admit: Fever, Effusion, Tamponade, AKI
,•Treatment: High Dose NSAIDs, Colchicine
•Avoid systemic steroids (if possible): Minimum 1 month
dosing
Constrictive Pericarditis: Correct Answer Cardiac
Surgery/idiopathic
•Easily misdiagnosed as liver disease due to right sided
congestion findings on initial presentation (Murmur: High
Pitch, Early Diastole)
•Treatment: Treat the HF (Diuresis/Surgery)
pericardial Effusion/Tamponade Correct Answer Pulsus
paradoxus is the hallmark (↓ BP > 10 mmHg with
inspiration)
•Tamponade: 100-200mL effusion
•Early Signs: anxious, ↑ HR, dyspnea, CP, orthopnea
•Late Signs: CV shock, Tension PNX, RV fx
•Treatment: Pericardial Window
(Surgery/Pericardiocentesis)
•Mild Effusion: NSAIDs
Endocarditis Correct Answer Valve Dz (including MVP),
Cardiac hardware, hemodialysis, CLABSI
•Suspicion: Fever of unknown origin with new/worsened
murmur
•Dx: TEE over TTE
,•Modified Duke: 2/0, 1/3, 0/5
•Major: Blood cx w/ typical organisms, Suggestive Echo,
blood cx w/ coxiella
•Minor: Heart Hx/IVDA, Fever (>38), emboli,
glomerulonephritis, + bc w/o major criteria
cardiomyopathy types Correct Answer dilated
hypertrophic
constrictive
dilated cardiomyopathy Correct Answer 50% idiopathic
•ECHO: Dilated Ventricles w/o hypertrophy (impaired
systolic function/reduced EF)
•Symptoms: LHF
•Treatment: Diuretics, BB, ACEi
hypertrophic cardiomyopathy Correct Answer FAMILY
HISTORY (50% have 1st degree relatives)
•ECHO: LV hypertrophy w/o dilatation, LA enlargement
(Increased risk of SCD)
•Symptoms: RHF
•Treatment: BB, CCB, Diuretics
•Closely monitor pregnant and HOCM (Obstructive)
Restrictive cardiomyopathy Correct Answer •ECHO (Stiff
Venticles): Impaired diastolic (low LVEF), but normal
systolic LV fxn (preserved contractile function)
, •Symptoms: RHF
•Tx: Cardiology Consult (all cases)
•Avoid Digoxin, BB, and ACEi
Tako-Tsubo cardiomyopathy Correct Answer Broken heart
syndrome: Occurs in postmenopausal women following an
- overwhelming, emotionally stressful event
chatecholamine release leads to: ballooning and left
venticular dyskinesias
Management: Beta-blockers and ACEi
ARVC (Arrhythmogenic right ventricular cardiomyopathy)
Correct Answer Genetic (extended)
•RV Fibrosis
•EKG: LBBB (Increased risk of SCD)
•Treatment: Must be on Cardiac Monitoring (May need
AICD)
Ischemic CM Correct Answer Not actual CM (LV dysfxn w/
CAD)
most common infection in the hospital setting Correct
Answer cauti
cauti Correct Answer •VRE: Remove catheter 1st
•Remove Device
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