Inflammatory Heart Disorders Flashcards
ineffective endocarditis
disease of the endocardial layer of the heart, including the heart valves
which valves do ineffective carditis mostly affect
aortic and mitral
classification by cause for ineffective endocarditis
IV drug use (IV drug abuse), fungal
classification by involvement for ineffective endocarditis
prosthetic valve endocarditis (PVE)
causative organisms for ineffective endocarditis
bacterial, virus, fungi
which bacteria are the most common for ineffective endocarditis
s. aureus; streptococcus viridians; coagulase negative staphylococci
risk factors for IE
categories of high, moderate, and low risk of developing ineffective endocarditis
principal risk factors for ineffective endocarditis
prosthetic valves; hemodialysis; IV drug abuse
etiology and physiology for ineffective endocarditis
there are 3 stages: bacteremia, adhesion, and vegetation
vegetation
fibrin, leukocytes, platelets, and microbes; stick to the valve or endocardium; parts break off and enter circulation
left sided vegetation moves to
brain, kidneys, spleen
right sided vegetation moves to
lungs
clinical manifestations of IE
nonspecific, fever, chills, weakness, malaise, fatigue, anorexia
subacute forms of IE
arthralgias, myalgias, back pain, abdominal discomfort, weight loss, headache, clubbing of fingers
vascular manifestations
splinter hemorrhages in nail beds; petechiae; osler’s nodes on fingertips/toes; janeway’s leisons on pads of the fingers and toes; roth’s spots; new or worsening systolic murmur in most patients; heart failure
manifestations secondary to septic embolism
CNS, extremities, spleen, and kidneys
diagnostic studies
history, lab tests (blood cultures, CBC with differential, ESR, c-reactive protein); echocardiography; chest x-ray; ECG; duke criteria
interprofessional care
prophylactic antibiotic treatment; acute identification of organism; IV antibiotics; repeat blood cultures; valve replacement if needed; antipyretics; fluids; rest
prophylactic antibiotic treatment is given to patients who are experiencing…
certain dental procedures; respiratory tract incisions; tonsillectomy and adenoidectomy; surgical procedures involving infected skin, skin structures, or musculoskeletal tissue
nursing assessment
health history (valvular, congenital, or syphilitic heart disease; previous endocarditis; staph/strep infection); dugs (immunosuppressive therapy); recent surgeries and procedures; subjective and objective data
nursing diagnoses/problems
impaired CO; activity intolerance
overall goals for nursing
normal baseline function; ability to perform ADLs without fatigue; understanding of treatment plan to prevent recurrence
health promotion (implementation)
identify those at risk; assess history and understanding of disease process; teach importance of adherence to treatment regimen
patient teaching (implementation)
stress need to avoid infectious people; avoidance of stress and fatigue; plan rest periods; good oral hygiene; prophylactic antibiotics; drug rehab; monitor body temp; s/s of complications; nature of disease and how to reduce risk of reinfection; stress follow-up care, good nutrition, prompt treatment of common infection; need for prophylactic antibiotic therapy
ambulatory care (implementation)
antibiotic therapy for 4-6 weeks; assess home setting; monitor lab data, including blood cultures; assess IV lines; coping strategies; adequate rest; moderate activity; compression stockings; ROM exercises; deep breath and cough Q2 hrs
acute pericarditis
inflammation of pericardial sac (pericardium)
common causes of acute pericarditis
infectious agents (coxsackle B virus: most common); noninfectious; hypersensitive; or autoimmune
clinical manifestations of acute pericarditis
left/center chest pain; SOB when reclining; heart palpitations
complications of acute percarditis
pericardial effusion, cardiac tamponade, chronic constructive pericarditis
myocarditis
inflammation of myocardium; linked to dilated cardiomyopathy
causes of myocarditis
infectious agents (coxsackle A&B virus: most common); radiation therapy; chemical; drugs; autoimmune disorders
rheumatic heart disease
scarring and deformity of heart valves, resulting from rheumatic fever; complication of strep A pharyngitis affects heart, also skin, joints, and CNS
which audience does rheumatic heart disease affect
young adults
pathophysiology of rheumatic heart disease
cardiac lesion and valve deformities- thickening of valve leaflets, causing regurgitation (mitral and aortic valves are most affected)
complication of rheumatic heart disease
chronic rheumatic carditis
treatment of rheumatic heart disease
anti-inflammatory agents
cardiomyopathy
lead to cardiomegaly and heart failure; primary reason for heart transplant
what are the three major types of cardiomyopathy
dilated, hypertrophic, and restrictive
dilated cardiomyopathy
heart’s ability to pump blood decreases because the heart’s main pumping chamber; left ventricle is enlarged and weakened
hypertrophic cardiomyopathy
heart muscle cells enlarge and cause the walls of the ventricles to thicken; without ventricular dilations; symmetric left ventricular hypertrophy occurs less common than dilated CMP
restrictive cardiomyopathy
rare form of heart muscle disease that is characterized by RESTRICTIVE filling of the ventricles; myocardium diseased and impaired diastolic filling and stretch
evaulation
maintain adequate tissue and organ perfusion; maintain normal body temperature; report an increased in physical and emotional comfort
