Infective Endocarditis

Question 1

Most common and most virulent

Answer 1

Staphylcocci

Question 2

Risk Factors of Infective Endocarditis

Answer 2

-Prosthetic cardiac valves or prosthetic material used for cardiac valve repair
-Implanted cardiac devices (pacemaker, implanted cardioverter defibrillator)
-History of bacterial endocarditis
-Congenital Heart Disease
-Cardiac transplant recipients with valvulopathy
-IV drug abuse
-Body piercing
-Hemodialysis

Question 3

Is a microbial infection of the endothelial surface of the heart

Answer 3

Infective Endocarditis

Question 4

Clinical Manifestations of Infective Endocarditis

Answer 4

-Fever
-Heart murmur
-Petechial rash
-Osler Nodes
-Janeway lesions
-Roth Spots
-Splinter Hemorrhage

Question 5

small, painful nodules in pads of fingers or toes

Answer 5

Osler Nodes

Question 6

irregular, red or purple, painless flat macules on pals, fingers, hands, soles, and toes

Answer 6

Janeway Lesions

Question 7

Hemorrhages with pale centers in eye fundus

Answer 7

Roth Spots

Question 8

reddish- brown lines and streaks seen under the proximal half of fingernails and toenails

Answer 8

Splinter Hemorrhage

Question 9

Alternative medication if allergic to penicillin

Answer 9

Clindamycin or cefalexin

Question 10

Preventive Management of Infective Endocarditis

Answer 10

-Antibiotic prophylaxis for at risk patients undergoing dental procedure
(Amoxicillin 1 gm 1 hour before procedure)
- Good oral hygiene
-IV site care
-Refrain from using IUDs whenever feasible
-Take antibiotics for the entire duration they are prescribed

Question 11

Advised patient to:

Answer 11

-Avoid using toothpicks or other sharp objects in the oral cavity
-Avoid nail biting
-Avoid body piercing, branding, tattooing
-Minimize outbreaks of acne, psoriasis

Question 12

Diagnostics Findings for Infective Endocarditis

Answer 12

-Blood Cultures
-CBC
-Elevated erythrocyte sedimentation rate (ESR) or C-reactive protein

Question 13

Medical Management

Answer 13

Antibiotic Therapy
-Penicillin (Drug of Choice)
-Must give for 2 to 6 weeks every 4 hours or continuously by IV
-High concentration is needed for a significant period to ensure eradication of the dormant bacteria within dense vegetation

Question 14

Surgical Management

Answer 14

Indicated if infection does not respond to medications or patient has prosthetic valve endocarditis

Question 15

Nursing Management of Infective Endocarditis

Answer 15

-Monitor temperature closely
-Administer medications, as ordered
-Educate patient to take medication as prescribed
-Encouraged increased oral fluids
-Promote rest between activities
-Provide meticulous IV site care
-Monitor heart sounds
-Watch out for symptoms of systemic embolization and organ damage

Question 16

Drug of choice for Infective Endocarditis

Answer 16

Penicillin

Question 17

For at-risk patients undergoing a dental procedure

Answer 17

Antibiotic Prophylaxis

Question 18

Characteristics of a good oral hygiene

Answer 18

-Use of soft toothbrush at least 2x a day
-Mouthwash rinsing with an antiseptic mouthwash for 30 seconds

Question 19

Blood cultures

Answer 19

-(+) if the microbe is seen in two separate blood cultures
- 2 sets of blood should be taken 12 hours apart and from different venipuncture sites

Question 20

CBC

Answer 20

(+) leukocytes
(+) anemia