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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maternity and pediatric nursing and med-surg 1

Concepts Covered:

  • Pregnancy Risks
  • Prenatal Concepts
  • Liver & Gallbladder Disorders
  • Microbiology
  • Newborn Care
  • Labor Complications
  • Postpartum Complications
  • Labor and Delivery
  • Integumentary Disorders
  • Newborn Complications
  • Postpartum Care
  • Fetal Development
  • Eating Disorders
  • Respiratory Disorders
  • Noninfectious Respiratory Disorder
  • Renal Disorders
  • Shock
  • Disorders of Pancreas
  • Disorders of the Adrenal Gland
  • Developmental Theories
  • Childhood Growth and Development
  • Prenatal and Neonatal Growth and Development
  • Hematologic Disorders
  • Endocrine and Metabolic Disorders
  • EENT Disorders
  • Gastrointestinal Disorders
  • EENT Disorders
  • Neurologic and Cognitive Disorders
  • Musculoskeletal Disorders
  • Infectious Disease Disorders
  • Note Taking
  • Test Taking Strategies
  • Basics of NCLEX
  • Studying

Study Plan Lessons

Nutrition in Pregnancy
Antepartum Testing
Discomforts of Pregnancy
Physiological Changes
Hb (Hepatitis) Vaccine
Phytonadione (Vitamin K)
Eye Prophylaxis for Newborn (Erythromycin)
Lung Surfactant
Rh Immune Globulin (Rhogam)
Meds for PPH (postpartum hemorrhage)
Uterine Stimulants (Oxytocin, Pitocin)
Prostaglandins
Opioid Analgesics
Meconium Aspiration
Newborn of HIV+ Mother
Fetal Alcohol Syndrome (FAS)
Addicted Newborn
Erythroblastosis Fetalis
Hyperbilirubinemia (Jaundice)
Retinopathy of Prematurity (ROP)
Transient Tachypnea of Newborn
Babies by Term
Postpartum Thrombophlebitis
Subinvolution
Mastitis
Postpartum Hemorrhage (PPH)
Postpartum Hematoma
Breastfeeding
Postpartum Discomforts
Postpartum Interventions
Postpartum Physiological Maternal Changes
Dystocia
Precipitous Labor
Preterm Labor
Placenta Previa
Prolapsed Umbilical Cord
Premature Rupture of the Membranes (PROM)
Obstetrical Procedures
Fetal Heart Monitoring (FHM)
Leopold Maneuvers
Mechanisms of Labor
Process of Labor
Fetal Environment
Fetal Development
Fertilization and Implantation
Infections in Pregnancy
Incompetent Cervix
Gestational HTN (Hypertension)
Hyperemesis Gravidarum
Hydatidiform Mole (Molar pregnancy)
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Ectopic Pregnancy
Chorioamnionitis
Cardiac (Heart) Disease in Pregnancy
Abortion in Nursing: Spontaneous, Induced, and Missed
Maternal Risk Factors
Fundal Height Assessment for Nurses
Signs of Pregnancy (Presumptive, Probable, Positive)
Gravidity and Parity (G&Ps, GTPAL)
Gestation & Nägele’s Rule: Estimating Due Dates
Family Planning & Contraception
Menstrual Cycle
Fluid Shifts (Ascites) (Pleural Effusion)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
ABGs Nursing Normal Lab Values
ABG (Arterial Blood Gas) Interpretation-The Basics
ROME – ABG (Arterial Blood Gas) Interpretation
ABGs Tic-Tac-Toe interpretation Method
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
ABG (Arterial Blood Gas) Oxygenation
Lactic Acid
Base Excess & Deficit
Metabolic & Endocrine Module Intro
Addisons Disease
Overview of Developmental Theories
Developmental Stages and Milestones
Sickle Cell Anemia
Iron Deficiency Anemia
Hemophilia
Fever
Dehydration
Phenylketonuria
Cleft Lip and Palate
Celiac Disease
Strabismus
Cerebral Palsy (CP)
Hydrocephalus
Meningitis
Reye’s Syndrome
Spina Bifida – Neural Tube Defect (NTD)
Autism Spectrum Disorders
Clubfoot
Scoliosis
Marfan Syndrome
Rubeola – Measles
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
Influenza – Flu
Drawing Pictures
Outline Question Method (Note taking)
NCLEX® Question Traps
Denying Feelings
Repeating Words
Duplicate Facts
What do you want me to know?
Acute vs Chronic
Nursing Process
Same
Opposites
Absolute Words
Anatomy of an NCLEX Question
What is the NCLEX?
Bloom’s Taxonomy
Critical Thinking
Goal Setting
Study Setting
Time Management