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NURS 642 (Hepatology) EXAM 3 STUDY GUIDE COMPLETE AND ACCURATE WITH DIAGRAMS RATED A.
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NURS 642 (Hepatology) EXAM 3 STUDY GUIDE COMPLETE AND ACCURATE WITH DIAGRAMS RATED A.
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NURS 642 (Hepatology) EXAM 3 STUDY GUIDE COMPLETE ANDACCURATE RATED A.
1. Cardiomyopathy Heart muscle structurally/functionally abnormal
without CAD, HTN, or congenital heart disease.
2. Restrictive Cardiomy- Muscle unable to dilate. Impaired filling.
opathy Decreased CO from diastole = Diastolic HF. Pre-
sentation: exertional intolerance and fluid restric-
tion
CXR - pulm congestion, normal heart size.
*Echo - moderate EF (25-50%). normal to Thick
ventricle walls. Valvular: Endocardial involvement
involvement
Biopsy to find cause. Most common is Amyloido-
sis. Arrthymias: Ventricular tachy are uncommon
except in sacrodosis blocks. Mainly Atrial fib
3. Amyloidosis Protein deposited into heart muscle.
PE: : thickened tongue, peri-orbital purpura, he-
patomegaly
4. Dilated Cardiomyopathy Muscle is over dilated (LV or LV&RV). Impaired
contraction. Presenting symptoms: exertional in-
tolerance
Decreased CO from systole = Systolic HF.
Pansystolic (MR) murmur @ apex.
Labs - elevated BNP.
EKG - will be abnormal, nonspecific.
CXR - Cardiomegaly.
*Echo - Thin (dilated) ventricle walls (>60mm).
Decreased EF < 30%. Valvular: Annular dilata-
tion-Mitral regurgitation is seen first then tricus-
pid
, NURS 642 (Hepatology) EXAM 3 STUDY GUIDE COMPLETE AND
ACCURATE RATED A.
Cause: idiopathic, genetic, pregnancy, myocardi-
tis. Arrhythmias: ventricular tachy or connection
blocks
5. Hypertrophic Cardiomy- Muscle cell protein *genetic abnormality.
opathy Impaired filling (small ventricles due to hypertro-
phy).
Muscle does not contract properly.
Decreased CO from diastole = Diastolic HF.
S/SX: asymptomatic; syncope, palpitations,
DOE, sudden death! SYSTOLIC EJECTION
MURMUR / S4.
CXR - normal. EKG - normal.
*Echo - Thick ventricle walls & septum is thickest!
EF Normal >60% Valvular: related to valve sep-
tum.
Genetic testing or Biopsy for confirmation.
TX: temporary = BB, CCB, diuretics. Later, EP
interventions - ablation, PPM, AICD.
Avoid: sudden position changes, bearing down,
lifting weights, sudden activity.
6. Tako-Tsubo Cardiomy- Stressful event, postmenopausal
opathy or "broken heart Presents similar to ACS: ST elevation & troponin
syndrome" elevated.
Echo - LV ballooning at apex.
TX: BB, ASA, and ACE-I until LV function normal-
izes (weeks to months).
,7. Arrhythmogenic RV Car- Muscle replaced by fibrous fatty tissue. RV=1st.
diomyopathy (ARVC) Genetic.
S/SX: syncope, presyncope, sustained palpita-
tions, sudden cardiac death (youth, athletes).
EKG: LBBB, arrhythmias.
Echo w/ unique RV findings.
8. AHA Indications for Car- AHA Class 1: Cardiac monitoring indicated due
diac Monitoring to risk for life threatening arrhythmia.
§ EX: Cardiac arrest, unstable ACS, acute HF,
Long QT, Complicated PCI.
AHA Class 2: Cardiac monitoring may be indicat-
ed but not essential.
§ EX: Nonurgent PCI, chest pain syndrome,
chronic arrhythmias.
AHA Class 3: Cardiac monitoring may be indicat-
ed but not expected to save lives.
§ EX: Permanent Afib rate controlled, OB pa-
tients without heart disease.
9. Pulmonary valve Steno- valve does not open all the way. (Fibrosis/calcifi-
sis cation).
Genetic.
S/SX: *Crescendo-decrescendo murmur, ede-
ma, JVD, SOB, fatigue.
DX: ECHO.
TX: Balloon valvuloplasty.
, 10. Endocarditis Infection of the endocardium. Innermost layer of
the heart.
High risk: IV drug use.
S/SX: *Fever, *new heart murmur, septic emboli,
splinter hemorrhages in the nails, Roth spots in
the eyes, and glomerulonephritis.
**FUO + new murmur = assess for endocarditis.
DX: *Multiple positive blood cultures, ECHO, TEE
TX: underlying pathogen (culture) - Usually staph
aureus.
11. Dukes Criteria (2 major Major = +BC or +echo vegitation
or 1 major + 3 minor or 5 Minor = Predisposing factor (IV drug use), Fever
minor) >38C, evidence of emboli, immunological prob-
lems, +BC (not as specific as major).
12. Myocarditis Inflammation of the myocardium. "Muscle of the
heart". Middle layer of the heart.
Often associated with URI.
S/SX: Positional CP, Pleural CP, tachycardia,
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