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TL Infectious Heart

Nursing of the adult with Infectious or Inflammatory Heart Disease

QuestionAnswer
Define inflammatory and infectious heart disease. inflammatory and infectious process involving the endocardium and pericardium
Define endocarditis and its pathology. inflammatory disease involving the inner surface of the heart, including the valves. Organisms travels through the blood to the heart; adhere to valves or endocardium; potential to break off and become emboli
Give 7 causes of endocarditis(RCCDIII). Rheumatic fever, Congenital heart disease, Cardiac surgery, Dental procedures, Immunosuppression, Invasive procedures, IV drug abuse
Define pericarditis. inflammation of the outer lining of the heart
Name 7 causes of pericarditis (TMN CHII). Trauma, MI, Neoplasm, Connective tissue disease, Heart surgery, Idiopathic, Infections
What symptoms might the nurse find on assessment of a patient with endocarditis (8)? Fever, chills, malaise, night sweats, fatigue, symptoms of heart failure, atrial embolization, murmurs
What symptoms might the nurse find on assessment of a patient with Pericarditis(3)? Pain, Pericardial friction rub, fever
Describe the quality, location, and aggravating and alleviating factors associated with pain from Pericarditis. Sudden, Sharp, Severe; Substernal radiating to the back or arm; Aggravated by coughing, inhalation, and deep breathing; Relieved by leaning forward
Explain how the heart valves are damaged with endocarditis. by the growth of vegetative lesions
What risks are posed by vegetative lesions on valve leaflets? embolization; erosion or perforation of the valve leaflets; abscesses within adjacent myocardial tissues; valvular stenosis, requrgitation, insufficiency (most commonly of mitral valve – can lead to symptoms of left-or right-sided heart failure)
What is a defining symptom of pericarditis? Friction rub
What changes might be seen on a ECG if the patient has pericarditis? ST segment elevations and T wave inversion
Give a couple of applicable nursing diagnoses for inflammatory/infectious heart disease patients. Decreased cardiac output; Risk for injury: emboli
What do we need to monitor for our patient with endocarditis? Hemodynamic status including vital signs, level of consciousness, urinary output
Discuss the use of antibiotics as it relates to the patient with endocarditis. Administer antibiotics for 4-6 wks. AHA recommends erythromycin before dental or genitourinary procedures. Clients may be instructed in IV therapy for home health care.
What do we need to discuss with our client with endocarditis? Teach about anticoagulant therapy if prescribed. Encourage maintenance of good hygiene. Teach to alert dentist and other health care providers of history of endocarditis
How does the nurse care for the patient with pericarditis? Provide rest and position of comfort. Administer analgesics and anti-inflammatory drugs.
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