Marfan Syndrome

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Ashley Powell
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Marfan Syndrome Pathochart (Cheatsheet)
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Outline

Overview

  1. Autosomal Dominant Genetic disorder
  2. Causes abnormalities in connective tissue, including musculoskeletal, cardiovascular, and integumentary  system.

Nursing Points

General

  1. Defect in body’s production of fibrillin, a protein found in connective tissue

Assessment

  1. MSK
    1. Tall, thin body
    2. Disproportionately long arms, legs,  fingers, and toes
    3. Chest deformities
    4. Joint hypermobility
    5. Scoliosis
    6. Positive wrist sign
  2. Cardiovascular system
    1. Mitral Valve Prolapse
    2. Aortic Enlargement
    3. Aortic aneurysm
  3. Vision problems
    1. Myopia
    2. Glaucoma
  4. Stretch marks  (shoulders, hips, lower back)

Therapeutic Management

  1. No cure
  2. Monitor cardiovascular status closely
    1. May need surgery
      1. Valve  replacements
      2. Prophylactic antibiotics should be taken prior to dental work or invasive procedures
    2. Medications
      1. Beta Blockers
        1. Reduce cardiac afterload to to reduce stress on aorta
  3. Monitor scoliosis
    1. Surgical intervention likely

Nursing Concepts

  1. Mobility
  2. Human Development

Patient Education

  1. Avoid sports that put a lot of stress on the heart and joints
    1. Long-distance running, football, scuba diving
  2. Preventative measures for endocarditis
  3. Physical or occupational therapy may be required
  4. Educational topics for scoliosis

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Transcript

Hey guys, In this lesson we are going to go over the basics about Marfan Syndrome.

Marfan Syndrome is a genetic disorder that causes abnormalities in connective tissue. Essentially there is a mutation on something called the fibrillin gene. This gene plays a really important role in forming connective tissue. Without it patients have problems with their musculoskeletal system, their cardiac system the eyes, and skin.

I made this table so you can quickly look at the various symptoms. Probably the most noticeable symptom is a tall, thin body with very long arms, legs and fingers. A positive wrist sign, which you can see in the photo here demonstrates how long their limbs and fingers are. Chest deformities are common and their joints are hypermobile. They are also very prone to having severe scoliosis.

In the cardiac system the major issues are the valves and in the aorta. Mitral valve prolapse, aortic enlargement and aortic aneurysm. The problems with the aorta increase their risk for having an aortic dissection, which is a tear in the aorta that is often fatal.

Stretch marks are common on the skin and in the eyes the lens can be dislocated. Nearsightedness is common and so is glaucoma.
The top priority for management is to keep a very close eye on the child’s cardiac status. They may need a valve replacement and they need to be aware of signs of an aortic dissection (the most distinct symptom is sudden severe chest pain that feels like tearing or ripping).

To reduce the risk of damage to the aorta these patients are often prescribed a beta blocker. This helps by reducing cardiac after load so there is less pressure on the aorta.

Another important part of their management is to treat the scoliosis. Again, they usually have severe scoliosis so surgery is usually needed.

Most people with Marfan Syndrome can life a full life with a normal life expectancy so long as their cardiac function is very carefully monitored and efforts are put in place to minimize stress on the aorta. One big part of this prevention is making sure that these kids avoid activities that will strain their heart and joints.

Your priority nursing concepts for a patient with Marfan Syndrome are mobility and human development.
Okay, lets to over your key points for this lesson. Marfan syndrome is a genetic disorder that affects connective tissue. It primarily causes problems with the musculoskeletal system, cardiac system, eyes and skin.

For the cardiac system it can cause mitral valve prolapse and there’s an increased risk for aortic aneurysm and aortic dissection. Beta blockers are commonly prescribed to reduce stress on the aorta.

They will likely need surgical treatment for scoliosis.

Patient education is super important so they know to avoid activities that will put stress on the heart and joints.

That’s it for our lesson on Marfan Syndrome. Make sure you check out all the resources attached to this lesson. Now, go out and be your best self today. Happy Nursing!

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My Study Plan

Concepts Covered:

  • Prenatal Concepts
  • Musculoskeletal Disorders
  • Respiratory Disorders
  • Childhood Growth and Development
  • Prenatal and Neonatal Growth and Development
  • Adulthood Growth and Development
  • Integumentary Disorders
  • Hematologic Disorders
  • Pregnancy Risks
  • Oncologic Disorders
  • Postpartum Complications
  • Fetal Development
  • Endocrine and Metabolic Disorders
  • Labor and Delivery
  • Gastrointestinal Disorders
  • Labor Complications
  • EENT Disorders
  • EENT Disorders
  • Postpartum Care
  • Cardiovascular Disorders
  • Newborn Care
  • Renal and Urinary Disorders
  • Newborn Complications
  • Neurologic and Cognitive Disorders
  • Liver & Gallbladder Disorders
  • Microbiology
  • Infectious Disease Disorders

Study Plan Lessons

OB Course Introduction
Pediatrics Course Introduction
Care of the Pediatric Patient
Care of the Pediatric Patient
Care of the Pediatric Patient
Vitals (VS) and Assessment
Vitals (VS) and Assessment
Overview of Childhood Growth & Development
Developmental Stages and Milestones
Growth & Development – Infants
Growth & Development – Infants
Growth & Development – Toddlers
Growth & Development – Preschoolers
Growth & Development – Preschoolers
Growth & Development – School Age- Adolescent
Growth & Development – School Age- Adolescent
Eczema
Gestation & Nägele’s Rule: Estimating Due Dates
Impetigo
Pediculosis Capitis
Burn Injuries
Burn Injuries
Fundal Height Assessment for Nurses
Physiological Changes
Sickle Cell Anemia
Sickle Cell Anemia
Discomforts of Pregnancy
Iron Deficiency Anemia
Hemophilia
Nutrition in Pregnancy
Abortion in Nursing: Spontaneous, Induced, and Missed
Pediatric Oncology Basics
Anemia in Pregnancy
Leukemia
Cardiac (Heart) Disease in Pregnancy
Nephroblastoma
Nephroblastoma
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
HELLP Syndrome
Fertilization and Implantation
Fever
Dehydration
Dehydration
Fetal Development
Fetal Environment
Fetal Circulation
Process of Labor
Vomiting
Vomiting
Pediatric Gastrointestinal Dysfunction – Diarrhea
Mechanisms of Labor
Leopold Maneuvers
Celiac Disease
Celiac Disease
Fetal Heart Monitoring (FHM)
Appendicitis
Appendicitis
Obstetrical Procedures
Intussusception
Umbilical Hernia
Constipation and Encopresis (Incontinence)
Constipation and Encopresis (Incontinence)
Strabismus
Conjunctivitis
Prolapsed Umbilical Cord
Acute Otitis Media (AOM)
Placenta Previa
Abruptio Placentae (Placental abruption)
Tonsillitis
Precipitous Labor
Dystocia
Postpartum Physiological Maternal Changes
Acute Bronchitis
Postpartum Interventions
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Postpartum Discomforts
Breastfeeding
Pneumonia
Asthma
Asthma
Cystic Fibrosis (CF)
Sudden Infant Death Syndrome (SIDS)
Congenital Heart Defects (CHD)
Congenital Heart Defects (CHD)
Postpartum Hematoma
Defects of Increased Pulmonary Blood Flow
Defects of Increased Pulmonary Blood Flow
Defects of Decreased Pulmonary Blood Flow
Defects of Decreased Pulmonary Blood Flow
Obstructive Heart (Cardiac) Defects
Obstructive Heart (Cardiac) Defects
Subinvolution
Mixed (Cardiac) Heart Defects
Mixed (Cardiac) Heart Defects
Postpartum Thrombophlebitis
Initial Care of the Newborn (APGAR)
Nephrotic Syndrome
Nephrotic Syndrome
Enuresis
Newborn Physical Exam
Body System Assessments
Epispadias and Hypospadias
Newborn Reflexes
Babies by Term
Cerebral Palsy (CP)
Meningitis
Transient Tachypnea of Newborn
Retinopathy of Prematurity (ROP)
Spina Bifida – Neural Tube Defect (NTD)
Autism Spectrum Disorders
Autism Spectrum Disorders
Erythroblastosis Fetalis
Addicted Newborn
Attention Deficit Hyperactivity Disorder (ADHD)
Attention Deficit Hyperactivity Disorder (ADHD)
Newborn of HIV+ Mother
Tocolytics
Betamethasone and Dexamethasone
Scoliosis
Magnesium Sulfate
Opioid Analgesics
Prostaglandins
Uterine Stimulants (Oxytocin, Pitocin)
Meds for PPH (postpartum hemorrhage)
Rh Immune Globulin (Rhogam)
Lung Surfactant
Eye Prophylaxis for Newborn (Erythromycin)
Phytonadione (Vitamin K)
Hb (Hepatitis) Vaccine
Rubeola – Measles
Rubeola – Measles
Mumps
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
Influenza – Flu
Acute Otitis Media (AOM)
Antepartum Testing
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Cerebral Palsy (CP)
Chorioamnionitis
Cleft Lip and Palate
Clubfoot
Conjunctivitis
Cystic Fibrosis (CF)
Pediatric Gastrointestinal Dysfunction – Diarrhea
Disseminated Intravascular Coagulation (DIC)
Ectopic Pregnancy
Eczema
Enuresis
Epiglottitis
Family Planning & Contraception
Fetal Alcohol Syndrome (FAS)
Fever
Gestational Diabetes (GDM)
Gravidity and Parity (G&Ps, GTPAL)
Hemophilia
Hydrocephalus
Hyperbilirubinemia (Jaundice)
Hyperemesis Gravidarum
Imperforate Anus
Impetigo
Incompetent Cervix
Intussusception
Marfan Syndrome
Mastitis
Maternal Risk Factors
Meconium Aspiration
Meningitis
Menstrual Cycle
Omphalocele
Pediculosis Capitis
Pertussis – Whooping Cough
Phenylketonuria
Postpartum Hemorrhage (PPH)
Premature Rupture of the Membranes (PROM)
Preterm Labor
Reye’s Syndrome
Rheumatic Fever
Scoliosis
Signs of Pregnancy (Presumptive, Probable, Positive)
Spina Bifida – Neural Tube Defect (NTD)
Tonsillitis
Varicella – Chickenpox