PERICARDITIS Flashcards

1
Q

It refers to an inflammation of the pericardium (outer layer) – is the membranous sac enveloping the heart.

A

PERICARDITIS

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2
Q

acts as a lubricant to
prevent friction between the parietal and
visceral pericardium because it may lead to
chest pain.

A

Pericardial Fluid

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3
Q

EXPLAIN

pericardial effusion

cardiac tamponade

A

Due to inflammation of the pericardium, the body compensates by releasing chemical mediators, and one of its effects is increased capillary permeability. This causes plasma (albumin) to move from the intravascular to the interstitial space, and water follows, resulting in the accumulation of fluid in the pericardial space. This condition is known as pericardial effusion.

pleural effusion is <300 cc
– there is increase fluid in pericardial sac and compress the heart

If this fluid increases by more than 300cc, it is then referred to as cardiac tamponade.

Excessive fluid compresses the heart, preventing it from expanding to receive blood, resulting in reduced cardiac output.

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4
Q

If accumulation is rapid, as little as 100 to 150 mL of blood in the pericardial space can adversely affect cardiac output.

A

❖ CARDIAC TAMPONADE

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5
Q

S/Sx of cardiac tamponade

A

▪ Confused, anxious, and restless
▪ Tachypnea and Tachycardia
▪ Distended Neck Veins
▪ Muffled Heart Sounds – due to the
presence of fluid (blood)

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6
Q

2 types of Infectious

A

viral and bacterial

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7
Q

Viral examples

A

Echo virus, mumps, HIV, Hepatitis

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8
Q

Bacterial examples

A

Pneumococci, Streptococci

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9
Q

5 types of non-infectious

A

Uremia

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10
Q

the kidneys can’t remove the
toxins leading to accumulation of urea in
the body and this can reach the heart
leading to inflammation of pericardium

A

Uremia

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11
Q

the flow of blood into the heart
is blocked due to excess fluid and may
lead to necrosis

A

Acute MI

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12
Q

❖ CLASSIC TRIAD OF SYMPTOMS

A

→ Chest Pain – sharp, stabbing
→ Fever
→ Pericardial Friction Rub

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13
Q

EXPLAIN

chest pain classic triad sx

A

Plenty of fluids in the pericardial sac because of inflammation -> there is compression of the heart -> less space for the heart -> less blood going to the ventricle -> less blood going to heart -> cardiac ischemia ! aerobic respiration – anaerobic respiration ! lactic acid ! stimulate nerve endings ! CHEST PAIN

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14
Q

cause of fever - classic triad sx

A

due to inflammation

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14
Q

assessment of doctor to know if patient have pericarditis

A

Place patient in a Left Lateral Decubitus Position to palpate if there is enlargement of the left ventricle: (+) if there is a strong beat.

▪ This position puts the heart near the chest.

▪ The heartbeat can be felt at the Left Anterior Axillary Line if the heart is enlarged.

++ fluid in pericardial causes increase pressure
- putting plenty fluid in pericarial sac that increase pressure in heart that is
- it prevent heart from expanding to receive blood

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15
Q

The most characteristics clinical manifestation is:

A

creaky, scratchy, grating in quality of friction rub

16
Q

The pain is generally worse with

A

deep inspiration and when lying supine or turning

17
Q

EXPLAIN

Dyspnea

A

Sitting up and leaning forward stretches pericardium away from the pleura which relieves discomfort.

17
Q

chest is relieved

A

▪ Sitting – leaning forward over 2 to 3 pillows.

17
Q

how can Sitting – leaning forward over 2 to 3 pillows relieved chest pain

A

It relieves chest pain because the fluid goes down by gravity and it pushes the parietal layer (has many nerve endings) forwards and away from the fluid which lessens the friction and reduces chest pain.

18
Q

in pericardial effusion, what happen if there is less cardiac output is the brain

A

drowsy, confused

less blood going to brain

compensate: tachycardia

breath sound: not clear

presence of water in pericardial space

18
Q

common symptoms of pericarditis

A

sharp, stabbing chest pain

19
Q

It is performed with the guidance of ultrasound.

During this procedure, a 16–18- gauge needle or catheter is carefully inserted into the pericardial space to aspirate or remove excess fluid.

This minimally invasive technique is used to relieve pressure on the heart

A

Pericardiocentesis

20
Q

may be prescribed for pain relief during the acute phase in pericarditis

A

Analgesic Medications and NSAIDs such as
aspirin, indomethacin, or ibuprofen

21
Q

drugs can be used as an alternative when NSAIDs are contraindicated

A

Corticosteroids (e.g., prednisone)

21
Q

drug that may be prescribed if the pericarditis is severe as an additive therapy to NSAIDs

A

Colchicine

22
Q

what does colchicine do for pericarditis

A

It prevents the WBCs to migrate in the inflamed site, because if WBCs migrates, it further enlarges the heart which increases the pressures; that is why it is only given if it is severe.

➢ It prevents WBCs to go to the inflamed site to lessen pain and swelling

22
Q

health teaching of colchine

A

➢ Advise patient to increase fluid intake while taking antigout drugs to promote uric acid excretion and to prevent renal calculi.

➢ Advise patient to avoid foods high in purine such as sardines, salmons, alcohol drinks, Organ meats (liver and kidneys), anchovies, scallops.

➢ Advise patient to take this drug with food to avoid GI irritation.

➢ To reduce acidity, acetaminophen should be taken for discomfort instead of aspirin.

23
Q

❖ NURSING CARE for Pericarditis

A

→ Monitor vital signs regularly, paying close attention to heart rate, blood pressure, and signs of cardiac tamponade (e.g., decreased blood pressure, increased heart rate).

→ Monitor and document intake and output, as well as electrolyte levels, especially if diuretics or colchicine are prescribed.

→ Advise the patient to rest and limit physical activity, especially during the acute phase. This helps reduce cardiac strain and discomfort.

→ Instruct the patient to report any worsening of symptoms promptly, such as increasing pain, shortness of breath, or signs of cardiac tamponade.

→ Implement safety measures to prevent falls, as some medications or pain can cause dizziness or weakness

+ Bed rest until fever, chest pain subsides
+ Pain maybe relieved in sitting and leaning forward
+ Reassure the patient that the pericardial pain does not indicate MI
+ Six small meals a day
+ Avoid gas forming foods, will distent abdomen -> diaphragm higher -> not give good cardiac output