Endocarditis Flashcards
Non-Specific clinical manifestations of Endocarditis
- What to do first when patient walks in??
- Most patients present with?
- Other symptoms? 5
- What 2 other symptoms are common?
- Assess patient for?
ASSESS!!!
Fever, may be low grade or may be absent in immunocomrpimised older adults
Chills
Weakness
Malaise
Fatigue
Anorexia
Arthralgia (joint pain) and myalgias are common.
Assess for joint or muscle tenderness and decreased ROM
Acute Infective Endocarditis
Symptoms?
Abrupt onset
High Fever and chills
Heart related clinical manifestations of Endocarditis
- What is heard in 90% of patients with inefective endocarditis
- Why are the sounds heard?
- What if there is a preexisting murmer?
Murmur
Heart valve is affected, blood flow is affected, and the sound is affected
May worsen or new one may develop
Heart related clinical manifestations of Endocarditis
- What are the heart symptoms present?
- What is common if left untreated?
- What is impaired?
- What can also be present
Dysrhythmias: Rate of the rythym is off
Heart failure!
Cardiac Output (5-7 L per min)
Emboli
What are heart valve vegetations and why do they occur?
What is a complication that could occur?
Masses of bacteria and cell fragments that form on the heart valves.
Usually occurs on the heart valves and when there is pre-existing endocardial damage to the valves
They can break off and travel to other organs, potentially causing serious complications (strokes/organ damage)
Be able to describe the skin and eye changes that can occur with endocarditis.
2
Splinter hemorrhages (black longitudinal streaks) in the nail beds
Petechiae from microembolization of vegetative lesions can occur on eyes, mouth, feet, arm, and back of knee.
Other skin/eyes manifestations of endocarditis
3
Osler’s nodes: PAINFUL, tender, red or purple, pea-size lesions found on the fingertips or toes.
Janeway’s lesions: flat, PAINLESS, small, red spots seen on the palms of the hands and soles of the feet.
may have hemorrhagic retinal lesions called Roth’s spots (pale center)
how many blood cultures are drawn?
How often?
How many sites?
when a person has endocarditis
What does it mean if results come back negative? 2 things
3 blood cultures are drawn frequently from 3 different venipuncture sites
Antibiotic usage within the last 2 weeks
or
Pathogen not easily detected by standard cultures
How would you explain these tests to a patient?
Echcardiogram
Electrocardiogram (ECG/EKG)
One more test?
Echocardiogram: The machine uses high frequency sound to create picture of your heart
ECG/EKG: by attaching small sticky patches called electrodes to your chest, arms, and legs, which pick up the electrical signals produced by your heart each time it beats.
Chest X-RAY
What changes would you expect with labs, specifically WBC?
What is the normal range for WBC?
Elevated ESR, CRP, and WBC
Normal WBC: 5000-10,000
Explain why a patient would require a valve replacement when diagnosed with endocarditis.
3 reasons to perform surgery are?
Endo carditis directly affects the valve
Valve dysfunction causing heart failure
To prevent embolization
Uncontrolled infection
Fever that remains after is managed with?
Complete bed rest is usually not required unless?
Inflammatory endocarditis with heart failure
responds?
Aspirin, acetaminophen, fluids, and rest.
The fever continues or there are signs of heart failure
Inflammatory endocarditis with heart failure responds poorly to drug therapy and valve replacement, so it can be life-threatening.
Explain the nursing implications associated with providing care for a patient with endocarditis.
Tell the patient to avoid?
Tell the patient to inform?
What may be needed?
Patients are at risk for?
Teach patients and caregivers to recognize?
Tell the patient to avoid people with infections, especially upper respiratory tract infections, and to report cold, flu, and cough symptoms.
Tell the patient to inform providers scheduling invasive procedures about the history of IE.
Prophylactic antibiotic therapy may be needed.
Patients are at risk for life- threatening complications, such as stroke, pulmonary edema, and heart failure.
Teach patients and caregivers to recognize
signs and symptoms of these complications (e.g., change in mental status, dyspnea, chest pain, unexplained weight gain).
The patient needs?
Stress the importance of?
Bed rest may be needed?
Otherwise?
The patient needs adequate periods of physical and emotional rest.
Stress the importance of avoiding fatigue, and planning rest periods.
Bed rest may be needed when the patient has a fever or heart complications.
Otherwise, the patient may perform moderate activity.
To prevent problems related to decreased mobility: 3
Encourage elastic compression stockings
Perform ROM exercises
Deep breathing
Stress the importance of good?
Patient may have?
Tell the patient to inform HCP?
Stress the importance of good oral hygiene and regualr dental visits.
The patient may have anxiety and fear.
Recognize this and begin strategies to help the patient cope with the illness.
Tell the patient to inform HCPs scheduling invasive procedures about the history of IE
