Unit 2 and 3 Chapter 32 Pericarditis, Cardiac Tamponade Flashcards
What is Pericarditis?
is an inflammation or alteration of the pericardium (the membranous sac that encloses the heart). The problem may be fibrous,serous, hemorrhagic, purulent, or neoplastic. Acute pericarditis is most commonly associated with:
What can cause Pericarditis?
- Infective organisms (bacteria, viruses, or fungi) (usually respiratory)
- Post–myocardial infarction (MI) syndrome (Dressler syndrome)
- Postpericardiotomy syndrome
- Acute exacerbations of systemic connective tissue disease (Marfan Syndrome)
What are the s/s of Pericarditis
-pericardial friction rub; This scratchy, high- pitched sound is produced when the inflamed, roughened pericardial
-pain in supine position
-pain in include substernal precordial pain that radiates to the left side of the neck, the shoulder, or the back
-wbc elevation
-fever
-a fibrillation
-st elevation on EKG on ALL 12 leads
What is the medical tx for afib
-Warfarin
normal w/o use;0.9-1.2
with use -2-3
What is the medication of use to reverse the effect of warfarin if the PT 65
Vitamin K
What does the treatment plan consist of for a person dx with Pericarditis
-NSAIDs-to reduce inflammation , pai mngmt works in 48 hours
-assist the client position to provide comfort
-DO NOT administer aspirin or anticoags can induce tamponade
-corticorsteroids
What should you monitor for when taking steroids
A. hyperglycemia
B.hypoglycemia
C. WBC 7,000
D. hypertention
A. hyperglycemia
Which of the following positions relieves the pericardial pain that is associated pericarditis
A.supine
B.prone.
C.trensdelenburg
D.leaning forward or tripod
D.leaning forward or tripod
The pain is worse when the patient is in the supine position and may be relieved by sitting up and leaning forward.
What are the different types of Pericarditis?
-Bacterial pericarditis
-Chronic pericarditis
-Uremic pericarditis
-Chronic constrictive pericarditis
Tx for bacterial pericarditis?
bacterial pericarditis (acute) usually requires antibiotics and pericardial drainage. The usual clinical course of acute pericarditis is short term (2 to 6 weeks), but episodes may recur.
Tx for Chronic Pericarditis
Chronic pericarditis caused by malignant disease may be treated with radiation or chemotherapy,
Tx for Uremic Pericarditis
uremic pericarditis is treated by hemodialysis
Tx for Chronic constrictive pericarditis i
surgical excision of the pericardium (pericardiectomy)
What are the two complications that can occur with Pericarditis
- Pericardial effusion
-Cardiac tamponde
^MEDICAL EMERGENCY
What is Pericardial Effusion?
Pericardial effusion occurs when the space between the parietal and visceral layers of the pericardium fills with fluid.
What does Pericardial Effusion put your patient at risk for?
A. crackles in the lungs
B. splinter hemmroges
C. pink frothy sputum
D. Cardiac Tamponde
D. Cardiac Tamponde
This complication puts the patient at risk for cardiac tamponade, or excessive fluid within the pericardial cavity.
What is Cardiac Tampnde
Excessive fluid in the pericardium space or cavity
Is Cardiac Tamponde a medical emergency?
A. Yes
B. No
A. Yes
What are the S/s of Cardiac Tamponde?
Jugular vein distention
Clear lungs
Muffles heart tones
pulses paradoxes
-decreased cardiac output
(4-8ML per min is normal)
-Tachycardia
-Hypotention
-decrease O2 sat
-Decrease CO
What is Pulsus paradoxes
Pulsus paradoxus ( BP more than 10 mm HG higher on expiration
than inspiration
Example you Bp is 120/80 on expiration
on Inspiartion your BP in 99/59
What is the tx for Cardiac tamonde
Oxygen
*Volume expansion with fluid admin
* Bed rest with leg elevation
* Dobutamine (increase pump without increasing
SVR)
* Avoid using PEEP with MV (decreases venous
return)
Pericardiocentisis
Percutaneous Surgical window
What is the medical intervention for Decreased CO for a patient with Cardiac Tamponde ?
The health care provider may initially manage the decreased CO with increased fluid volume administration while awaiting an echocardiogram or x-ray to confirm the diagnosis.
What is Pericardiocentis used to treeat? and what is it?
To treat Cardiac Tamponde**
The health care provider may elect to perform a pericardiocentesis to remove fluid and relieve the pressure on the heart
Which of the following is expected outcome after Pericardiocentesis?
A. Negative Jugular vein distention
B. decreased CO
C. present muffled heart tones
D. systolic bp more 20mm on expiration
A. Negative Jugular vein distention
After Pericardiocentesis:
The pressures should return to normal as the fluid compressing the heart is removed, and the signs and symptoms of tamponade should resolve.
