Pericarditis

Question 1

. Assessment of a patient with pericarditis may reveal which of the following signs and symptoms?

a. Ventricular gallop and substernal chest pain
b. Narrowed pulse pressure and shortness of breath
c. Pericardial friction rub and pain
d. Pericardial tamponade and widened pulse pressure

Answer 1

ANS: C
Pain is the most common symptom of pericarditis, and a pericardial friction rub is the most common initial sign. A friction rub is best auscultated with a stethoscope at the sternal border and is described as a grating, scraping, or leathery scratching. Pericarditis frequently produces a pericardial effusion.

Question 2

A patient has been admitted with acute pericarditis. How should the nurse care for this patient? Select all that apply.
1 Provide an overbed table.
2 Ask the patient to avoid alcohol.
3 Keep the patient in a Trendelenberg position.
4 Allow the patient to be as active as possible.
5 Administer antiinflammatory medications.

Answer 2

ANS: 1, 2, 5
A sitting position with an overbed table helps in reducing the pain associated with acute pericarditis. The patient should be instructed to avoid alcohol to prevent gastrointestinal bleeding. Antiinflammatory medicines should be administered for pain relief. The patient should not be placed in a Trendelenberg position; instead, the head of the bed should be elevated to 45 degrees. The physical activities of the patient should be restricted, and he or she should be on complete bed rest to decrease cardiac workload.