Cardiovascular Disorders - Infalmmatory Disease (Pericarditis) Flashcards Preview

NUR 102- Test 4 > Cardiovascular Disorders - Infalmmatory Disease (Pericarditis) > Flashcards

Flashcards in Cardiovascular Disorders - Infalmmatory Disease (Pericarditis) Deck (20):
1

Cardiovascular Disorders - Pericarditis (Chapter 17)

What is pericarditis?

It is the inflammation of the pericardium, the outermost layer of the heart.

2

Cardiovascular Disorders - Pericarditis (Chapter 17)

What is the origin of acute pericarditis? What does pericarditis usually follow?

Origin is usually viral. It may also follow a myocardial infartion or open-heart surgery

3

Cardiovascular Disorders - Pericarditis (Chapter 17)

Explain the pathophysiology of the pericarditis.

It may damage the pericardial tissue which triggers an inflammatory response. The inflammatory response causes fluid and exudate to collect in the pericardial space.

Accumulation of a large volume of fluid may compress the heart and interfere with cardiac filling. In some cases, scar tissue and adhesions may form between pericardial layers.

4

Cardiovascular Disorders - Pericarditis (Chapter 17)

What are the classic manifestations of acute pericarditis?

Chest pain
Pericardial friction rub
Fever
Dyspnea (common)
Tachycardia (common)

5

Cardiovascular Disorders - Pericarditis (Chapter 17)

Describe the pain in acute pericarditis.

It is often abrupt. It is usually sharp and may radiate to the back or neck. It may be steady or intermittent and is aggravated by deep breathing, coughing, movement or swallowing.

The client often sleeps upright and leans forward to reduce the discomfort.

6

Cardiovascular Disorders - Pericarditis (Chapter 17)

What is a pericardial friction rub? Describe its characteristics. Where is it best heard?

It is the characteristic sign of pericarditis. It is a leathery, grating sound produced by the inflamed pericardial layers rubbing against the chest wall or pleura. It is best heard at the left lower sternal border with the client sitting up or leaning forward.

7

Cardiovascular Disorders - Pericarditis (Chapter 17)

What are some complications as a result of pericarditis?

Pericardial effusion
Cardiac Tamponade

8

Cardiovascular Disorders - Pericarditis (Chapter 17)

What is a pericardial effusion? Describe it's pathophysiology.

It is an abnormal collection of fluid between the pericardial layers.

If the fluid collects gradually, the pericardial sac stretches to accommodate it. Heart function it not affected, however, heart sounds may be muffled.

9

Cardiovascular Disorders - Pericarditis (Chapter 17)

What is cardiac tamponade? Explain its pathophysiology.

It is the rapid buildup of pericardial fluid. It does not allow the sac to stretch and can compress the heart, interfering with myocardial function.

It is considered a medical emergency that is fatal if it is not aggressively treated.

10

Cardiovascular Disorders - Pericarditis (Chapter 17)

What is a hallmark sign of cardiac tamponade? Describe its characteristics.

It is a paradoxical pulse, in which the systolic blood pressure dropsmore than10 mm Hg during inspiration. Peripheral pulses weaken or disappear as well during inspiration.

11

Cardiovascular Disorders - Pericarditis (Chapter 17)

What are other manifestations of cardiac tamponade?

Muffled heart sounds
Dyspnea
Tachypnea
Tachycardia
Narrowed pulse pressure

12

Cardiovascular Disorders - Pericarditis (Chapter 17)

What does chronic pericardial inflammation cause? What are the manifestations?

It may cause scar tissue to develop, restricting cardiac filling. Manifestations include progressive dyspnea, fatigue and weakness. Neck veins are distended, and ascites may develop

13

Cardiovascular Disorders - Pericarditis (Chapter 17)

What is the interdisciplinary care of acute pericarditis? What medications may be ordered?

Although it is uncomfortable, it is usually self-limiting and will resolve with or without treatment.

Antibiotics (Broad-spectrum initially) to treat the infection, Aspirin, acetaminophen, or NSAIDs are ordered to reduce fever and inflammation and to promote comfort. Diuretics (Thiazide, Loop diuretics, or K+ sparing)

14

Cardiovascular Disorders - Pericarditis (Chapter 17)

What is a pericardiocentesis? When is it usually done?

It is a procedure done to remove fluid from the pericardial sac. The physician inserts a large (16- to 18- gauge) needle into the pericardial sac and withdraws excess fluid.

This procedure is done as an emergency procedure for cardiac tamponade.

15

Cardiovascular Disorders - Pericarditis (Chapter 17)

What are the nursing implications for a pericardiocentesis?

Obtain an inform consent.
Have emergency resuscitation equipment available.
Obtain baseline VS
Position the client at 45-60º.
Record I&O (after the procedure)

16

Cardiovascular Disorders - Pericarditis (Chapter 17)

When should the doctor be notified in the event of a pericarditis diagnosis? Why?

When distant, muffled heart sounds are heard (sign of cardiac tamponade). Decreasing quality of peripheral pulses, distended neck veins, decreased level of consciousness, decreased urine output, cold clammy mottled skin; delayed capillary refill and weak peripheral pulses.

Remember: Acute pericarditis effusion (gradual buildup of fluid in the pericardial sac) and tamponade interfere with cardiac filling and pumping, causing venous congestion, decreased cardiac output and impaired organ and tissue perfusion.

17

Medical Surgical Nursing Care Text Book - Chapter 17

A female client is diagnosed with pericarditis. The nurse expects which of the following assessment findings?

A. Peripheral edema
B. Wheezing breath sounds
C. Absence of chest pains
D. Pericardial friction rub

D. Pericardial friction rub

Rationale:
A pericardial friction rub is a manifestation of pericarditis and therefore an expected assessment finding. Peripheral edema and respiratory wheezes are not expected findings, and should be report to the physician. Pericarditis typically causes chest pain that increases with movement and breathing.

18

Medical Surgical Nursing Care Text Book - Chapter 17

The nurse is caring for a client with acute pericarditis assess carefully for manifestations of cardiac tamponade, including:

A. A distinct line of demarcation and pallor of the lower extremities.
B. A loud systolic murmur accompanied by a palpable thrill.
C. Muffled heart sounds and an ausculatory gap in the blood pressure
D. An irregularly irregular pulse of variable intensity.

C. Muffled heart sounds and an ausculatory gap in the blood pressure

Rationale:
A collection of fluid or blood in the pericardial sac can obscure or muffle the heart sounds and affect cardiac filling and output. Filling is impaired to a great extend during inspiration, leading to ausculatory gap in the blood pressure as output falls.

19

Medical Surgical Nursing Care Workbook - Chapter 17

A client in end-stage renal disease has been diagnosed with pericarditis. Which intervention would the nurse expect to include in the nursing care plan?

A. Assist with a pericardiocentesis
B. Administer NSAIDs
C. Assess the lung sounds q8h.
D. place the bed in low-Fowler's position.

B. Administer NSAIDs

20

Medical Surgical Nursing Care Text Book - Chapter 15

The nurse is obtaining a focused assessment of a client with pericarditis. Which for the following assessment data does the nurse recognize as pertaining to the client's heart function?

A. The client relates having recently been exposed to chickenpox.
B. Numerous flat moles are noted on the client's neck and back.
C. The client states he takes two extra-strength Tylenol several times a week for a headache.
D. The clients states he often sleeps in a recliner.

D. The clients states he often sleeps in a recliner.