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Infective endocarditis Answer: infection on intermost layer of the heart, including heart valves
Patho of infective endocarditis Answer: blood turbulence --> organisms infect valves --> fragile
vegetations form (can break off an become emboli) --> damage to valves and supporting
structures --> can spread to myocardium --> heart blocks, dysrythmias, HF, embolization
Effects of embolization from the left side of the heart Answer: - spleen (LUQ pain)
- kidneys (flank pain)
- limbs (ischemia, gangrene)
- brain (altered LOC)
Effects of embolization from the right side of the heart Answer: - Lungs (acute dyspnea)
Risk factors for infective endocarditis Answer: - Invasive procedures (intravascular devices,
dental work, tonsillectomies, wound infections)
- IV drug use
- Prior cardiac history
Clinical manifestations of infective endocarditis Answer: - non-specific
- fever, flu-like symptoms
- new onset murmurs/changes in existing murmurs
Vascular manifestations of infective endocarditis Answer: - splinter hemorrhages
- osler's nodes
- janeway's lesions
- roths spots
Left ventricular heart failure Answer: - more common than being isolated at right
- exertional dyspnea
- crackles
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, - wheezes
- angina, syncope, systolic murmur w/ absent S2
Right ventricular heart failure Answer: - rarely isolated, signifies early catch
- edema
Infective endocarditis diagnostics Answer: - procedure within six months
- blood cultures
- echocardiography
- ECG (heart block)
Infective endocarditis treatment Answer: - IV antibiotics (not often effective with prosthetics)
- valve replacement
Nursing care infective endocarditis Answer: - monitor for fever
- maintain perfusion, body temp, increase activity tolerance
Acute pericarditis Answer: - inflammatory response from injury or infection in the pericardium
(2 layers that anchor heart, lubricate, and prevent stretching)
- fibrin deposits
Acute pericarditis causes Answer: - may occur 48-72 hours post MI
Clinical manifestations of acute pericarditis Answer: - progressive, sharp chest pain (increases
with inspiration or lying supine)
- dyspnea
- relieved by leaning forwards
- pericarditis friction rub (high pitched grading sound best heard at lower left sternal border)
Complications of pericarditis Answer: - pericardial effusion
- cardiac tamponade (decreased cardiac output and Beck's triad)
Becks triad Answer: - hypotension
- distended neck veins
- muffled heart sounds
Acute pericarditis diagnostics Answer: - ECG (widespread ST elevation)
- echocardiogram
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