Perfusion: Valves/Infective Heart

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Miranda Smith

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Perfusion: Valves/Infective Heart

Labelling

Label the parts of the heart.

Drag labels to their correct position on the image

Left Ventricle

Right Ventricle

Pulmonic Valve

Aorta

Pulmonary Veins

Sup/Inf Vena Cava

Aortic Valve

Pulmonary Artery

Mitral valve

Tricuspid Valve

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?

Presence of a pericardial friction rub on auscultation.

Elevated troponin levels in the blood.

ST-segment elevation on the EKG.

Severe shortness of breath with exertion.

Multiple Choice

Which diagnostic tool is the MOST VALUABLE to diagnosing endocarditis?

Chest X-ray

Blood culture

CT scan

Echocardiography

Multiple Choice

What is a priority goal of treatment for a client who has endocarditis or pericarditis?

Administer anticoagulants to prevent clots.

Increase heart rate and blood pressure.

Promote bed rest and limit fluid intake.

Eliminate infection and reduce inflammation.

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

Multiple Choice

For a patient diagnosed with infective endocarditis, which would be an important part of their treatment plan?

Intravenous antibiotics

Antiviral medication

Surgical intervention

Oral antibiotics

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?

Rash caused by an allergic reaction.

Blisters from a viral infection.

Burns from chemical exposure.

Petechiae caused by bleeding under the skin.

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

Drag and Drop

(Recognize Cues) 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.

Which findings are the most concerning on this client?

Drag these tiles and drop them in the correct blank above

murmur

cyanosis

Platelets 147,000

Temperature

INR

bruising

poor dental hygeine

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

Labelling

(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.

Drag labels to their correct position on the image

Temperature

Endocarditis

Pericarditis

Lactate

Administer 1/2 NS

Sodium

SpO2

Apply oxygen

INR

Administer antibiotics

Drag and Drop

(Generate Solutions) 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.

Which interventions would the nurse question if ordered by the provider?

Drag these tiles and drop them in the correct blank above

Ambulate

Strict intake and output

Apply a warm blanket

Lactate q3 hr x 3

Apply telemetry

Administer 80 mg enoxaparin IV q8 hr

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

Drag and Drop

(Evaluate Outcomes) 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.

Which assessment findings would indicate FURTHER DETERIORATION of this client?

Drag these tiles and drop them in the correct blank above

INR 3.6

Hgb 6.1

WBC 15,000, Hgb 10.5

Platelets 200,000, Na 140

Temp 98.6 F, HR 80 bpm

Lactate 5.6

Lactate 1.9

RR 36

GCS 9

Multiple Choice

Which is a common symptom of infective endocarditis that requires immediate medical attention?

Headache

Chest pain during exercise

Petechial rash

Sudden weight loss

Multiple Choice

When assessing a patient with pericarditis, what symptoms would you expect to find?

Shortness of breath and wheezing

Persistent cough and fatigue

Chest pain, fever, pericardial friction rub, and signs of inflammation.

Nausea and vomiting

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 assess treatment effectiveness and detect complications.

To evaluate for anemia

To monitor the patient's blood pressure regularly.

Multiple Choice

What is the advantage of prosthetic valves over mechanical heart valves?

Easier to implant than prosthetic valves.

Prosthetic valves require more frequent maintenance

Prosthetic valves do not require long-term blood thinning medication.

Higher durability compared to prosthetic valves.

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

Perfusion: Valves/Infective Heart

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