Inflammatory Heart Disease Flashcards
Causes of Infective Endocarditis
- IV drug use; 2. Prosthetic Valves; 3. Invasive Catheters;
- Aging; 5. Hemodialysis; 6. Cardiac Conditions
S/S Infective Endocarditis
Low-grade fever; Flu-like symptoms; Clubbing of fingers;
New or changing heart murmur; splinter hemorrhages; Petechiae;
Osler’s Nodes; Janesway’s Lesions; Roth’s Spots
Most common murmur found w/ infective endocarditis
Mitral valve
Microembolization of vegetation breakes off and settles in tissues. Seen in finger nails
Splinter hemorrhage’s
Microembolization of vegetation in trunk, ankles and feet
Petechiae
Painful lesions on finger tips/toes; Inflammatory response
Osler’s Nodes
Flat, painless red spots on palms/soles of feet; irregular shaped
Janesway’s Lesions
Small, whitish spots on retina seen w/ eye exams
Roth’s Spots
Complications of Infective Endocarditis
Heart failure; embolization of vegetation
Signs of embolization to spleen
Sharp LUQ pain
Decreased UOP, flank pain, increased BUN/Creatinine indicates embolism of vegetation to….
Kidneys
SOA, Chest pain, anxiety, decreased o2 saturation is indicative of embolization of vegetation to
Lungs (Pulmonary Embolism)
Level of consciousness changes, vision changes suggests embolization of vegetation to
Brain
Pain, altered sensation, shiny skin, cool, decreased pulse indicated embolization of vegetation to
Blood vessels (arterial)
Diagnostics for Infective endocarditis
Health history; Positive blood cultures; new or changing murmur; vegetation seen on echocardiogram; mild increase in WBCs; Increase in ESR
Collaborative Care for Infective Endocarditis
Antibiotics; Blood Cultures; Treat Fever; Valve Replacement
Nursing Care for Infective Endocarditis
Throrough H&P;
Antibiotic Administration;
Watch for Complications;
Provide teaching
What are some important things to look for with history and physical? (Infective Endocarditis)
Recreational drug use; Cardiac Conditions (Valve replacement); Recent Dental Work?; fever, chills, Petechiae
What are some things the nurse should watch out for related to complications with infective endocarditis?
Neuro - Decreased LOC
Renal - hematuria, decreased UOP, flank pain;
Pulmonary - SOA, decreased sats;
Others - LUQ pain, arterial occlusion
What are some things the nurse can teach to prevent patient from developing infective endocarditis again?
Stop drugs; clean needles; take antibiotics;
Inform provider before invasive dental procedure or any procedure
Nursing diagnoses for Infective Endocarditis
Decreased cardiac output;
Hyperthermia;
Activity Intolerance
Causes of pericarditis
Viral/bacterial;
Acute MI;
lupus; cancer/radiation; Drug reactions;
Trauma (pacemaker insertion, central catheter placement)
S/S Pericarditis
Chest pain; Dyspnea; Fever; Anxiety; Pericardial Friction Rub
Hallmark signs of pericarditis
Pericardial friction rub - scratchy/grating/high-pitched sound
What is the difference between MI chest pain and pericardial chest pain?
Chest pain w/ pericarditis is positional;
Worsens w/ inspiration or laying flat;
Relieved by sitting up and leaning forward
Diagnostic Studies for pericarditis
ECG; Echo; CXR; ESR and CRP (inflammatory markers)
Collaborative Care Pericarditis
ID and Treat cause;
Treat Pain and Inflammation
Complications of Pericarditis
Pericardial Effusion;
Cardiac Tamponade
Large collection of fluid that can compress the heart that can compress the heart structures.
Pericardial effusion
Where does pericardial effusion typically collect
At apex
Sign of chronic/progressive pericardial effusion
Distant heart sounds
Pressure in heart leading to inability to pump; result of increasing volume of pericardial effusion
Cardiac tamponade
S/S Cardiac Tamponade
Beck’s Triad: 1. Hypotension 2. Muffled Heart Sounds 3. JVD Also: increased HR, Narrow pulse pressure, pulses paradoxus
A decrease in systolic blood pressure greater than 10 mmHg during inspiration signifies…
Pulsus paradoxus
Nursing Care for Cardiac Tamponade
Gas Exchange
Perfusion
Cardiac Function
Collaborative care for cardiac tamponade
Pericardiocentesis;
Watch for pneumothorax and dysrhythmias;
Pericardial window for recurrent tamponade
Nursing care for pericarditis
Manage acute pain; Watch for ineffective breathing pattern; watch for complication (cardiac tamponade); provide education
What education can nurse provide to someone with pericarditis
Take NSAIDs as scheduled around the clock to reduce inflammation
Inflammatory disease in response to group A strep pharyngitis
Rheumatic Fever
S/S Rheumatic Fever
Fever; joint pain; erythema marginatum; carditis
Red, flat rash on trunk, upper arms and legs, painless
Erythema marginatum
How long after strep infection does rheumatic fever present?
2-3 weeks
Diagnostic Studies for Rheumatic Fever
Positive Throat Culture; ASO Tiger; Increased ESR & CRP; Echo; CXR
Nursing Care Rheumatic Fever
Prevention;
Penicillin/Cephalosporins;
Anti-inflammatories and Corticosteroids;
Prophylactic antibiotic treatments for medical procedures
