Perfusion: Valves/Infective Heart
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Education
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Miranda Smith
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1 Slide • 19 Questions
1
2
Labeling
Label the parts of the heart.
Pulmonary Artery
Left Ventricle
Mitral valve
Aorta
Aortic Valve
Right Ventricle
Pulmonary Veins
Pulmonic Valve
Sup/Inf Vena Cava
Tricuspid Valve
3
Multiple Choice
A present presents to the emergency room complaining of severe chest pain. The EKG is presented. VS: HR 132 bpm, RR 24 BP 189/99 (129) mmHg. Which finding would indicate this client is having pericarditis and NOT a myocardial infarction?
4
Multiple Choice
Which diagnostic tool is the MOST VALUABLE to diagnosing endocarditis?
5
Multiple Choice
What is a priority goal of treatment for a client who has endocarditis or pericarditis?
6
Multiple Choice
Who is at the highest risk of developing endocarditis?
Someone who has chronic UTIs
Someone who has high blood pressure
IV drug user
Someone who receives chemotherapy
7
Multiple Choice
For a patient diagnosed with infective endocarditis, which would be an important part of their treatment plan?
8
Multiple Choice
You are caring for a client on the med-surg floor who presented with fever of unknown origin. During your assessment, you notice this spots on the hands. What are these spots and what is the cause?
9
Match
This is the beginning of a case study, please answer the questions appropriately.
A homeless client is brought into the ED. Upon assessment you notice poor dental hygeine, loose teeth, a murmur at the right sternal border, and the skin is warm to touch. VS HR 112 bpm, RR 25 min, BP 94/64 (74) mmHg, Sat 92% on room air, Temp 102.3 F. GCS 12 Fingers are cyanotic with a delayed capillary refill. There is bruising to the right flank and scabbed areas to the right and left antecubital areas.
In the spots below, match the assessment findings with the primary survey
Match the assessment findings that correspond to the ABCs.
Airway
Breathing
Circulation
Disability
Exposure
loose teeth
RR 25, SpO2 92%
Delay capillary refill
GCS 12
Scabbed areas to ACs, bruising
loose teeth
RR 25, SpO2 92%
Delay capillary refill
GCS 12
Scabbed areas to ACs, bruising
10
Drag and Drop
Labs have been obtained: WBC 22,000, Hgb 8.2, Platelets 147,000, Na 132, K 3.5, INR 1.2, Lactate 2.6.
Which findings are the most concerning on this client?
11
Reorder
(Analyze Cues) A homeless client is brought into the ED. Upon assessment, you notice poor dental hygiene, loose teeth, a murmur at the right sternal border, and the skin is warm to touch. VS HR 112 bpm, RR 25 min, BP 94/64 (74) mmHg, Sat 92% on room air, Temp 102.3 F. GCS 12 Fingers are cyanotic with a delayed capillary refill. There is bruising to the right flank and scabbed areas to the right and left antecubital areas.
Labs have been obtained: WBC 22,000, Hgb 8.2, Platelets 147,000, Na 132, K 3.5, INR 1.2, Lactate 2.6.
Based on your suspicion of what is happening to the client. Reorder the following based on how they should be completed.
Obtain blood cultures
Begin antibiotics
Call for ECHO
Obtain type and screen
Administer acetaminophen
12
Labeling
(Prioritize Hypothesis) A client is brought in upon assessment you notice poor dental hygiene, loose teeth, a murmur at the right sternal border, and the skin is warm to touch. VS HR 112 bpm, RR 25 min, BP 94/64 (74) mmHg, Sat 92% on room air, Temp 102.3 F. GCS 12 Fingers are cyanotic with a delayed capillary refill. There is bruising to the right flank and scabbed areas to the right and left antecubital areas.
Labs have been obtained: WBC 22,000, Hgb 8.2, Platelets 147,000, Na 132, K 3.5, INR 1.2, Lactate 2.6.
Complete the bow tie. by filling in the priority actions and priority things to monitor.
Administer antibiotics
Pericarditis
Administer 1/2 NS
Temperature
SpO2
Lactate
Sodium
INR
Apply oxygen
Endocarditis
13
Drag and Drop
Labs have been obtained: WBC 22,000, Hgb 8.2, Platelets 147,000, Na 132, K 3.5, INR 1.2, Lactate 2.6.
Which interventions would the nurse question if ordered by the provider?
14
Multiple Select
(Take Action) A homeless client is brought into the ED. Upon assessment you notice poor dental hygeine, loose teeth, a murmur at the right sternal border, and the skin is warm to touch. VS HR 112 bpm, RR 25 min, BP 94/64 (74) mmHg, Sat 92% on room air, Temp 102.3 F. GCS 12 Fingers are cyanotic with a delayed capillary refill. There is bruising to the right flank and scabbed areas to the right and left antecubital areas.
Labs have been obtained: WBC 22,000, Hgb 8.2, Platelets 147,000, Na 132, K 3.5, INR 1.2, Lactate 2.6.
The provider has placed order in the EMR, which order(s) would be appropriate for the nurse to implement?
CT of head
CT of abdomen
Start IV fluids, obtain blood cultures, administer broad-spectrum antibiotics, and obtain a chest x-ray.
Administer a sedative to calm the patient
Administer 3% NS over 3 hours
15
Drag and Drop
Labs have been obtained: WBC 22,000, Hgb 8.2, Platelets 147,000, Na 132, K 3.5, INR 1.2, Lactate 2.6.
Which assessment findings would indicate FURTHER DETERIORATION of this client?
16
Multiple Choice
Which is a common symptom of infective endocarditis that requires immediate medical attention?
Headache
Petechial rash
17
Multiple Choice
When assessing a patient with pericarditis, what symptoms would you expect to find?
18
Multiple Choice
In the management of a patient with endocarditis, why is it crucial to monitor blood cultures regularly?
To assess for signs of heart failure
To evaluate for anemia
19
Multiple Choice
What is the advantage of prosthetic valves over mechanical heart valves?
Prosthetic valves require more frequent maintenance
Prosthetic valves do not require long-term blood thinning medication.
20
Multiple Choice
A client who has a mechanical heart valve has been taking warfarin for years. Which laboratory finding would be the most concerning for the client?
Platelets 125,000
INR 5.3
RBC 3.6
Hgb 8.6
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