Infectious Cardiac Disorders Flashcards
What are the systemic clinical manifestations of Rheumatic Fever?
Sore throat can occur quickly
Fever
Red and swollen tonsils
-may have white patches or pus
Petechiae on roof of the mouth
Swollen lymph nodes on front of neck
What are the more specific clinical signs of Rheumatic Fever?
Erythema marginatum is a temporary nonpruritic skin rash
Subcutaneous Nodules: round firm painless nodules
beneath the skin. (disappear 1-2 weeks)
Sydenham’s chorea: Irritability, inability to concentrate, sudden jerky involuntary muscle movements. (weeks to months)
What labs and diagnostic tests are used to diagnosis Rheumatic Fever and Rheumatic Heart Disease?
Rapid strep test
Throat culture
-positive Group A Beta hemolytic streptococci
What medications are used to treat Rheumatic Fever? What are the challenges in treatment?
Antibiotics for 10 days
-Penicillin G or amoxicillin
What are some causes of endocarditis?
Body piercings, tattoos
Poor dental health
IV drug use
Infections
Administering drugs intravenously
Long Term placement of central line catheters
Hemodynamic monitoring
Catheters
Dialysis Shunts
Pacemakers, ICD
Foley catheters
Prosthetic valves
Recent heart surgery
What are the clinical manifestations of endocarditis? What clinical signs are unique for endocarditis?
Systemic: anorexia, malaise, fatigue, fever, chills, arthralgias
Heart: murmur from valve involvement, heart failure, tachycardia
Hematological: often strokes
Eyes: Roth Spots
Skin: petechiae, splinter hemorrhages, Osler’s nodes,
Janeway lesions
Unique for endocarditis:
Osler’s Nodes: Small, red, painful nodules on finger and toes pads
Janeway Lesions: small, non-tender, purplish red macular lesions on the palms of hands and soles of the feet
Roth Spots: small, whitish, spots “*cotton wool spots” surrounded by hemorrhages seen on the retina.
Splinter Hemorrhages: hemorrhagic streaks under the fingernails or toenails
How are vegetations formed on cardiac valves and what serious complications can vegetations cause?
Micro-organism introduced into systemic circulation adheres to the lesion. Platelets and fibrin cover the microorganism
Vegetations then cause thinning and destroy heart valves causing valve dysfunction.
Friable vegetation’s can break off causing emboli resulting in hemorrhages, infarcts, or abscesses.
What diagnostic tests are used to evaluate the effects of endocarditis on function and structure of cardiac valves?
Echocardiography
Chest X-ray
Electrocardiogram
What lab tests could be used to evaluate the effectiveness of therapy
for infective endocarditis?
Labs
*CBC, WBC
*ESR
*C-Reactive Protein
*Blood Cultures
What nursing interventions would be appropriate for nursing management of Endocarditis
What are the risk factors for myocarditis?
Altered immune response
Malnutrition
Alcoholics
Immunosuppressive drugs
Exposure to radiation
Stress
Elderly
What are the clinical manifestations of myocarditis?
Asymptomatic
Symptomatic is “flu-like”
-Fever
* Fatigue
* General malaise
* Myalgias
* Arthralgias
What are some tests used to diagnosis myocarditis? What test confirms the diagnosis?
WBC & CRP elevated
* Erythrocyte Sedimentation Rate (ESR) ↑
* Chest X-ray: Cardiomegaly
* Electrocardiography (ECG)
ST Segment and T wave changes
* Cardiac Markers (enzymes)
* Creatinine kinase (CPK-MB)
* Troponin I
Endomyocardial Biopsy: Confirms diagnosis
What are some medications used to treat myocarditis and why would they be prescribed?
Antibiotics
* Antiviral: interferon
* Immunosuppressive therapy
* Steroids
* Heart Failure: ACE inhibitors, ARBS, BB, Diuretics
*Anti-dysrhthmics: for dysrhythmias
Anticoagulants to prevent emboli.
What are some interventions for myocarditis nursing diagnoses?
Activity intolerance: balance rest and activity
Decreased cardiac output: monitor cardiopulmonary signs, administer oxygen
