Flashcards in Endocarditis & Iron deficiency Anemia Deck (44)
an inflammation of the endocardium (inner lining of the heart) from a pathogen that has damaged endocardial tissue
What are the types of inflammatory diseases of the heart?
Infective Endocarditis (endocardium)
◦A unique form of Infective Endocarditis
How can infective endocarditis be classified?
as an acute or subacute infection
How is acute infective endocarditis caused? Which organism is involved?
• Caused by a new infection
• Organism - frequently staphylococci
How is subacute infective endocarditis caused? Which organism is involved?
• Occurs in an already defective heart valve
• Organism – often streptococci or E.coli
What is infective endocarditis?
Microbial infection of the endocardium
Deformity or injury of endocardium
What can occur as a result of infective endocarditis?
Results in clot formation on endocardium
Infective organisms invade clot &; form lesion
What do the lesions (vegatations) form and become as a result of the infective organisms invading and forming a clot?
What are some examples of infective organisms?: (usually bacteria)
◦ Staphylococci, Enterococci or Pneumococci, Streptococci
◦ Fungi – Candida, Aspergillus
What can cause the progression of infective endocarditis?
◦ Tears in endocardium
◦ Deformities of valve leaflets
◦ Dehiscence of prosthetic valves
◦ Deformity of the chordae tendineae
What do the signs & symptoms of endocarditis develop due to?
Toxic effect of the infection
Destruction of the heart valves
Embolization of fragments of vegetative growths
What are the signs & symptoms of endocarditis?
*fever and new heart murmur
Petechiae- skin small pinpoint hemorrhages
Splinter hemorrhages of nails
◦ Black lines or red streaks on nails
What are roth spots?
◦ White spots seen on retina
◦ Round or oval
What are janeway lesions?
◦ Painless, hemorrhagic lesions
◦ Palms, soles, nose, ear
what are osler's nodes?
◦ Small painful nodules
◦ Tender, red lesions, white centers
◦ On fingers & toes
What are the risk factors for endocarditis?
Frequent introduction of pathogens
Valvular heart disease-Valve replacement or repair
IV drug abuse
Indwelling IV catheters-esp if IV tip lies near heart
Recent dental work
Compromised immune system
Recent body piercing or tatooing
What are the labs and diagnostics done for endocarditis?
◦ Anemia - low hemoglobin
◦ Positive blood culture-definitive diagnosis
◦ ASO Titer (Antistreptplysion O titer)
Blood test to measure antibodies produced by
the groups A-Streptococcus bacteria
A-strep can cause Bacterial Endocarditis
The inflammatory process involves what labs?
◦ WBC count, ESR are elevated
What does the endocardiogram lab test for?
◦ Identify diseased valves
◦ Vegetations-lesions on valves
◦ Ventricular hypertrophy
◦ Heart failure
What are the interventions for endocarditis?
Prevention = best plan
AHA guidelines for high-risk patient
◦ Prophylactic antibiotics before invasive
◦ Such as-invasive dental, GI & GU procedure
Strict aseptic technique
◦ Health care procedures
◦ Invasive lines
◦ Invasive procedures
Proper hand washing Long-term IV antibiotics
◦ May need long-term IV catheter
◦ Central line or PICC
◦ Monitor therapeutic antibiotic levels
◦ Effectiveness of medication (temp, WBC)
Discharge referrals –follow up care
◦ Home with IV therapy
◦ Home anticoagulant therapy
Monitor for worsening of condition
Monitor for emboli
What are the surgical interventions for endocarditis?
◦ Damaged valve replaced with mechanical
(prosthetic) or biological valve (bovine,
What is valvuloplasty?
Balloon-tipped catheter inserted via peripheral
vessel into heart
Balloon inflated in valve to increase valve diameter
Then balloon removed
What is an annuloplasty?
Sternal incision made remove stenotic tissue at valve
“O” ring is placed in valve leaflets
What is chordoplasty?
Surgical repair made-shapes chordate tendinease
to prevent regurgitation
What is the goal of care for endocarditis?
Endocarditis can be prevented
◦ Goal of initial treatment is avoiding the
Goal of care- if the patient does develop endocarditis:
◦ Curing the infection
◦ NO residual damage to heart or valves
What are the priority nursing diagnosis for endocarditis?
Cardiac Output, Decreased
Tissue Perfusion, Decreased
Blood loss due to bleeding disorders
Acute / chronic blood loss
◦ Surgical, traumatic
◦ GI bleed
What is hypoproliferative anemia?
◦Decreased or defective production of RBCs
What are the signs & symptoms of anemia?
Affected by the following issues
Based on the severity
Speed at which it developed
Metabolic needs of the patient
Presence of other problems