Infectious Inflammatory Disorders Flashcards
Inflammatory and Infectious Heart Disease
Inflammatory and infectious process involving the endocardium and pericardium.
What is Endocarditis?
an inflammatory disease involving the inner surface of the heart, including the valves. Organisms travel through the blood to the heart, where vegetations adhere to the valve surface or endocardium and can break off and become emboli.
Causes of endocarditis
- Rheumatic heart disease
- Congenital heart disease
- IV drug abuse
- Cardiac surgery
- Immunosuppression
- Dental procedures
- Invasive procedures
Pericarditis
inflammation of the outer lining of the heart.
Causes of pericarditis
- MI
- Trauma
- Neoplasm
- Connective-tissue disease
- Heart surgery
- Idiopathic
- Infections
Endocarditis Assessment Findings
- Fever
- Chills, malaise, night sweats, fatigue
- Murmurs
- Symptoms of heart failure
- Atrial embolization
Pericarditis Assessment Findings
- Pain: sudden, sharp, severe:
- Substernal, radiating to the back or arm
- Aggravated by coughing, inhalation, deep breathing
- Relieved by leaning forward
- Pericardial friction rub heard best at left lower sternal border
- Fever
- ST-segment elevation and T-wave inversion are also signs of pericarditis.
HESI (2013-11-29). HESI Comprehensive Review for the NCLEX-RN® Examination (Kindle Locations 4383-4384). Elsevier Health Sciences. Kindle Edition.
Endocarditis nursing interventions
- Monitor hemodynamic status (vital signs, level of consciousness, urinary output).
- Administer antibiotics IV for 4 to 6 weeks. The American Heart Association recommends administration of antibiotics before dental or genitourinary procedures in high-risk patients. Clients may be instructed in IV therapy for home health care.
- Teach clients about anticoagulant therapy if prescribed.
- Encourage client to maintain good hygiene.
- Instruct client to inform dentist and other health care providers of history.
Pericarditis nursing interventions
- Provide rest and maintain position of comfort.
- Administer analgesics and antiinflammatory drugs.
Valvular Heart Disease
Heart valves that are unable to open fully (stenosis) or close fully (insufficiency or regurgitation)
A. Valve dysfunction most commonly occurs on the left side of the heart; the mitral valve is most commonly involved, followed by the aortic valve.
Mitral Valve Stenosis
In mitral valve stenosis, blood is regurgitated back into the left atrium from the left ventricle. In the early period, there may be no symptoms, but as the disease progresses, the client will exhibit excessive fatigue, dyspnea on exertion, orthopnea, dry cough, hemoptysis, or pulmonary edema. There will be a rumbling apical diastolic murmur, and atrial fibrillation is common.
Valvular Heart Disease - Nursing Diagnoses
A. Decreased cardiac output related to …
B. Impaired gas exchange related to …
C. Activity intolerance related to …
Common causes of valvular disease
- Rheumatic fever
- Congenital heart diseases
- Syphilis
- Endocarditis
- HTN
Prevention of rheumatic heart disease would reduce the incidence of valvular heart disease.
Valvular Heart Disease - Assessment Findings
A. Fatigue
B. Dyspnea, orthopnea
C. Hemoptysis and pulmonary edema
D. Murmurs
E. Irregular cardiac rhythm
F. Angina
Valvular Heart Disease - Interventions
A. See Heart Failure.
B. Monitor client for atrial fibrillation with thrombus formation.
C. Teach the necessity for prophylactic antibiotic therapy before any invasive procedure, such as dental procedures, that is likely to produce gingival or mucosal bleeding: bronchoscopy, esophageal dilation, upper endoscopy, colonoscopy, sigmoidoscopy, or cystoscopy.
D. Prepare the client for surgical repair or replacement of heart valves.
E. Instruct clients receiving valve replacement of the need for lifelong anticoagulant therapy to prevent thrombus formation. Tissue (biologic) valves and autografts do not require lifelong anticoagulant therapy.
