PERICARDITIS

Question 1

It refers to an inflammation of the pericardium (outer layer) – is the membranous sac enveloping the heart.

Answer 1

PERICARDITIS

Question 2

acts as a lubricant to
prevent friction between the parietal and
visceral pericardium because it may lead to
chest pain.

Answer 2

Pericardial Fluid

Question 3

EXPLAIN

pericardial effusion

cardiac tamponade

Answer 3

Due to inflammation of the pericardium, the body compensates by releasing chemical mediators, and one of its effects is increased capillary permeability. This causes plasma (albumin) to move from the intravascular to the interstitial space, and water follows, resulting in the accumulation of fluid in the pericardial space. This condition is known as pericardial effusion.

pleural effusion is <300 cc
– there is increase fluid in pericardial sac and compress the heart

If this fluid increases by more than 300cc, it is then referred to as cardiac tamponade.

Excessive fluid compresses the heart, preventing it from expanding to receive blood, resulting in reduced cardiac output.

Question 4

If accumulation is rapid, as little as 100 to 150 mL of blood in the pericardial space can adversely affect cardiac output.

Answer 4

❖ CARDIAC TAMPONADE

Question 5

S/Sx of cardiac tamponade

Answer 5

▪ Confused, anxious, and restless
▪ Tachypnea and Tachycardia
▪ Distended Neck Veins
▪ Muffled Heart Sounds – due to the
presence of fluid (blood)

Question 6

2 types of Infectious

Answer 6

viral and bacterial

Question 7

Viral examples

Answer 7

Echo virus, mumps, HIV, Hepatitis

Question 8

Bacterial examples

Answer 8

Pneumococci, Streptococci

Question 9

5 types of non-infectious

Answer 9

Uremia

Question 10

the kidneys can’t remove the
toxins leading to accumulation of urea in
the body and this can reach the heart
leading to inflammation of pericardium

Answer 10

Uremia

Question 11

the flow of blood into the heart
is blocked due to excess fluid and may
lead to necrosis

Answer 11

Acute MI

Question 12

❖ CLASSIC TRIAD OF SYMPTOMS

Answer 12

→ Chest Pain – sharp, stabbing
→ Fever
→ Pericardial Friction Rub

Question 13

EXPLAIN

chest pain classic triad sx

Answer 13

Plenty of fluids in the pericardial sac because of inflammation -> there is compression of the heart -> less space for the heart -> less blood going to the ventricle -> less blood going to heart -> cardiac ischemia ! aerobic respiration – anaerobic respiration ! lactic acid ! stimulate nerve endings ! CHEST PAIN

Question 14

cause of fever - classic triad sx

Answer 14

due to inflammation

Question 14

assessment of doctor to know if patient have pericarditis

Answer 14

Place patient in a Left Lateral Decubitus Position to palpate if there is enlargement of the left ventricle: (+) if there is a strong beat.

▪ This position puts the heart near the chest.

▪ The heartbeat can be felt at the Left Anterior Axillary Line if the heart is enlarged.

++ fluid in pericardial causes increase pressure
- putting plenty fluid in pericarial sac that increase pressure in heart that is
- it prevent heart from expanding to receive blood

Question 15

The most characteristics clinical manifestation is:

Answer 15

creaky, scratchy, grating in quality of friction rub

Question 16

The pain is generally worse with

Answer 16

deep inspiration and when lying supine or turning

Question 17

EXPLAIN

Dyspnea

Answer 17

Sitting up and leaning forward stretches pericardium away from the pleura which relieves discomfort.

Question 17

chest is relieved

Answer 17

▪ Sitting – leaning forward over 2 to 3 pillows.

Question 17

how can Sitting – leaning forward over 2 to 3 pillows relieved chest pain

Answer 17

It relieves chest pain because the fluid goes down by gravity and it pushes the parietal layer (has many nerve endings) forwards and away from the fluid which lessens the friction and reduces chest pain.

Question 18

in pericardial effusion, what happen if there is less cardiac output is the brain

Answer 18

drowsy, confused

less blood going to brain

compensate: tachycardia

breath sound: not clear

presence of water in pericardial space

Question 18

common symptoms of pericarditis

Answer 18

sharp, stabbing chest pain

Question 19

It is performed with the guidance of ultrasound.

During this procedure, a 16–18- gauge needle or catheter is carefully inserted into the pericardial space to aspirate or remove excess fluid.

This minimally invasive technique is used to relieve pressure on the heart

Answer 19

Pericardiocentesis

Question 20

may be prescribed for pain relief during the acute phase in pericarditis

Answer 20

Analgesic Medications and NSAIDs such as
aspirin, indomethacin, or ibuprofen

Question 21

drugs can be used as an alternative when NSAIDs are contraindicated

Answer 21

Corticosteroids (e.g., prednisone)

Question 21

drug that may be prescribed if the pericarditis is severe as an additive therapy to NSAIDs

Answer 21

Colchicine

Question 22

what does colchicine do for pericarditis

Answer 22

It prevents the WBCs to migrate in the inflamed site, because if WBCs migrates, it further enlarges the heart which increases the pressures; that is why it is only given if it is severe.

➢ It prevents WBCs to go to the inflamed site to lessen pain and swelling

Question 22

health teaching of colchine

Answer 22

➢ Advise patient to increase fluid intake while taking antigout drugs to promote uric acid excretion and to prevent renal calculi.

➢ Advise patient to avoid foods high in purine such as sardines, salmons, alcohol drinks, Organ meats (liver and kidneys), anchovies, scallops.

➢ Advise patient to take this drug with food to avoid GI irritation.

➢ To reduce acidity, acetaminophen should be taken for discomfort instead of aspirin.

Question 23

❖ NURSING CARE for Pericarditis

Answer 23

→ Monitor vital signs regularly, paying close attention to heart rate, blood pressure, and signs of cardiac tamponade (e.g., decreased blood pressure, increased heart rate).

→ Monitor and document intake and output, as well as electrolyte levels, especially if diuretics or colchicine are prescribed.

→ Advise the patient to rest and limit physical activity, especially during the acute phase. This helps reduce cardiac strain and discomfort.

→ Instruct the patient to report any worsening of symptoms promptly, such as increasing pain, shortness of breath, or signs of cardiac tamponade.

→ Implement safety measures to prevent falls, as some medications or pain can cause dizziness or weakness

+ Bed rest until fever, chest pain subsides
+ Pain maybe relieved in sitting and leaning forward
+ Reassure the patient that the pericardial pain does not indicate MI
+ Six small meals a day
+ Avoid gas forming foods, will distent abdomen -> diaphragm higher -> not give good cardiac output