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29 Cards in this Set
- Front
- Back
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inflammations locations
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endocardium - inside lining (endocarditis)
pericardium - outside lining (pericarditis) myocardium - heart muscle (myocarditis/rheumatic carditis) |
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infective endocarditis acute
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acute - infection of normal valve by virulent organism = rapid valve destruction and death
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infective endocarditis subacute
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infection of exisiting valvular or cardiac defect by less virulent organism - mechanisum for endocardial bacterial vegetation
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predisposing conditions
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cardiac defects
IV drug abusers cardiac urgery/prosthetic valve intravenous foreign devices immunosuppresive states |
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ports of entry
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oral cavity, skin rashes, lesions, ascesses, GI, GU, skin infections, surgery/invasive procedures
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infective endocarditis pathophys
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cardiac defect - tissue erosion due to turbulent blood flow - sterile platelet fibrin thrombosis forms - bacteria trappe and vegetate - vegetations grows - destroys endocardium and valve
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clinical manifestations of infective endocarditis
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fever, chills, anorexia, fatigue
cardiac - murmur, heart failure, aterial embolization |
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peripheral clincal manifestations
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petichiae
splinter hemorrhage oslers nodes janeway's lesions slenomegaly clubbing roth's spots musculoskeletal - |
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infective endocarditis diagnostic testing
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lab values
cardiac cath/echocardiogram |
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infective endocarditis maangement
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antibiotics (4-6 weeks IV therapy)
anticougulants activity limited as tolerated surgery if indicated |
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infective endocarditis teaching
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discharge antibiotic regimen & site care
safety cares (oral hygiene, prophylactic antibiotic therapy) monitor and record temp |
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pericarditis
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acute or chronic
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acute pericarditis
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viruses, bactremia, parasitic, fungal
trauma uremia post-MI syndrome (dresslers) postpericardiotomy syndrome neoplasms |
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chronic constrictive pericarditis etiology
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tb
radiation trauma renal failure metastic cancer |
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acute pericarditis pathophys
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dry or exudative
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dry pericarditis
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adhesions form within pericardial space - obilterates pericardiacl sac and can penetrate heart muscle
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exudative pericarditis
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fluid acumulates in sac
slow vs rapid accumulation high risk for cardiac tamponade |
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clinical manifestations
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history of recent infection
pain (different from MI or pleural pain) pericardial friction rub fever, chills, malaise, anorexia, nausea, weight loss |
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pericarditis diagnostic testing
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ekg changes (ST segment elevatiion, t wave changes)
elevated WBCs adn positive cultures |
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pericarditis effusion development
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friction rub disappears, heart sounds muffles, pulsus paradoxus, diagnosis with echocardiogram
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acute pericarditis dry form
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treat cause if unknown - otherwise treat symptoms
antiobiotics if bacterial aspirin and NSAIDS for fever/pain |
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acute pericarditis exudative form
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pericardiocentesis
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chronic constrictive pericarditis
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medical - like HF
surgical - pericardiectomy |
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myocarditis
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acute or chronic
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myocarditis etiology
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viral infections
bacterial infections toxins and chemicals radiation parasitic infections |
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myocarditis pathophys
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damage begins at cardiac myocytes - cellular damage - damage to cardiac muscle
impaired contractililty in both ventricles HF, aneurysm, dilated cardiomyopathy lethal dysrhythmias |
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clincal manifestations myocarditis
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recent URI, viral pharyngitis, tonsilitis
fatigue, dyspnea, palpitations mild chest pain tachycardia/dysrhythmias pericardial friction rub cardiac failure |
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myocarditis dx
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chest x-ray, echocardiogram
endomayocardial biopsy ekg changes lab values |
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myocarditis management nursing care
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antibiotic therapy and antipyretics for fever
cardiac monitoring immunosuppressive therapy under investigation teaching |
