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Nursing Rules!


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  • 1. HEART INFECTIONS Mr. Ryan Caoile Ricaña BSN RN
  • 2. nursing
  • 3. Endocarditis
    • inflammation of the inside lining of the heart chambers and heart valves (endocardium).
    • can involve the heart muscle, heart valves, or lining of the heart.
    • Most people who develop endocarditis have heart disease of the valves.
  • 4. Risk factors
    • Injection drug use
    • Permanent central venous access lines
    • Prior valve surgery
    • Recent dental surgery
    • Weakened valves
    • Bacteriak infection
    • Fungi
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  • 6. Symptoms  
    • Abnormal urine color
    • Blood in the urine
    • Chills
    • Excessive sweating
    • Fatigue
    • Fever
    • Heart murmur
  • 7.
    • Joint pain
    • Muscle aches and pains
    • Night sweats
    • Nail abnormalities ( splinter hemorrhages under the nails)
    • Paleness
    • Red, painless skin spots on the palms and soles (Janeway lesions)
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    • Red, painful nodes in the pads of the fingers and toes (Osler's nodes)
    • Shortness of breath with activity
    • Swelling of feet, legs, abdomen
    • Weakness
    • Weight loss
    • Note: Endocarditis symptoms can develop slowly (subacute) or suddenly ( acute ).
  • 10. Exams and Tests    
    • CBC anemia
    • Chest x-ray
    • Echocardiogram
    • ECG
    • Erythrocyte sedimentation rate (ESR)
    • Repeated blood culture and sensitivity
    • Serology
    • Transesophageal echocardiogram
  • 11. Treatment  
    • Long-term antibiotic therapy is needed to get the bacteria out of the heart chambers and valves.
    • usually have therapy for 6 weeks
    • must be specific for the organism
    • blood culture and the sensitivity tests
  • 12. Surgery to replace the heart valve is usually needed when:
    • The infection is breaking off in little pieces, resulting in a series of strokes
    • The person develops heart failure as a result of damaged heart valves
    • There is evidence of organ damage
  • 13. Possible Complications    
    • Arrhythmias , such as atrial fibrillation
    • Blood clots or an infected clot from the endocarditis that travels to the brain, kidneys, lungs, or abdomen, causing severe damage to, and infection of, these organs
    • Brain abscess
    • Brain or nervous system changes
  • 14.
    • Congestive heart failure
    • Glomerulonephritis
    • Jaundice
    • Severe heart valve damage
    • Stroke
  • 15. Prevention  
    • People with certain heart conditions often take preventive antibiotics before dental procedures or surgeries involving the respiratory , urinary, or intestinal tract.
    • Those with a history of endocarditis should have continued medical follow-up.
  • 16. Myocarditis
    • an inflammation of the heart muscle
    • an uncommon disorder that is usually caused by viral infections such as coxsackie virus, adenovirus, and echovirus
  • 17.
    • may also occur during or after various viral, bacterial, or parasitic infections (such as polio , influenza , or rubella ).
    • exposure to chemicals or allergic reactions to certain medications
    • associated with autoimmune diseases.
    • muscle becomes inflamed and weakened
  • 18. Symptoms   
    • History of preceding viral illness
    • Fever
    • Chest pain that may resemble a heart attack
    • Joint pain or swelling
    • Abnormal heart beats
  • 19.
    • Fatigue
    • Shortness of breath
    • Leg swelling
    • Inability to lie flat
    • *total absence of symptoms is common
  • 20. Additional symptoms
    • Fainting , often related to arrhythmias
    • Low urine output
    • Other symptoms consistent with a viral infection -- headache, muscle aches, diarrhea, sore throat, rashes
  • 21. Exams and Tests
    • Electrocardiogram (ECG)
    • Chest x-ray
    • Ultrasound of the heart ( echocardiogram ) -- may show weak heart muscle, an enlarged heart, or fluid surrounding the heart.
    • White blood cell count
  • 22.
    • Red blood cell count
    • Blood cultures for infection
    • Blood tests for antibodies against the heart muscle and the body itself
    • Heart muscle biopsy - rarely performed
  • 23. Treatment  
    • Antibiotics
    • reduced level of activity, and
    • low-salt diet.
    • Steroids and other medications may be used to reduce inflammation.
    • Diuretics
  • 24.
    • If the heart muscle is very weak, standard medicines to treat heart failure are also used.
    • Abnormal heart rhythm may require the use of additional medications, a pacemaker or even a defibrillator.
    • If a blood clot is present in the heart chamber, blood thinning medicine is given as well.
  • 25. Possible Complications   
    • Heart failure
    • Pericarditis
    • Cardiomyopathy
  • 26. Prevention  
    • Prompt treatment of causative disorders may reduce the risk of myocarditis.
  • 27. Pericarditis
    • a disorder caused by inflammation of the pericardium, which is the sac-like covering around the heart.
  • 28. Causes
    • usually a complication of viral infections, most commonly echovirus or coxsackie virus.
    • less frequently, it is caused by influenza or HIV infection.
    • Infections with bacteria can lead to bacterial pericarditis (also called purulent pericarditis).
  • 29.
    • Some fungal infections can also produce pericarditis.
    • can be associated with systemic diseases such as autoimmune disorders , rheumatic fever , tuberculosis , cancer, leukemia, kidney failure , HIV infection, AIDS , and hypothyroidism
  • 30.
    • Heart attack and myocarditis
    • radiation therapy to the chest
    • medications that suppress the immune system.
    • injury (including surgery) or trauma to the chest, esophagus, or heart
    • unknown (idiopathic pericarditis)
  • 31.
    • most often affects men aged 20-50, usually following respiratory infections
    • In children, it is most commonly caused by adenovirus or coxsackie virus.
  • 32. Symptoms    
    • Chest pain , caused by the inflamed pericardium rubbing against the heart
    • relieved by sitting up and leaning forward
    • Pleuritis type: a sharp, stabbing pain
    • radiate to the neck, shoulder, back or abdomen
    • increases with deep breathing and lying flat, and may increase with coughing and swallowing
  • 33.
    • Breathing difficulty when lying down
    • Need to bend over or hold the chest while breathing
    • Dry cough
    • Ankle, feet and leg swelling (occasionally)
    • Anxiety
    • Fatigue
    • Fever
  • 34. Exams and Tests    
    • pericardial rub
    • heart sounds may be muffled or distant
    • signs of fluid in the pericardium (pericardial effusion).
    • If the disorder is severe, there may be crackles in the lungs, decreased breath sounds , or other signs of fluid in the space around the lungs ( pleural effusion ).
  • 35.
    • Chest x-ray
    • Echocardiogram
    • Chest MRI scan
    • Heart MRI or heart CT scan
    • Radionuclide scanning
  • 36.
    • Blood culture
    • CBC , may show increased WBC count
    • C-reactive protein
    • Erythrocyte sedimentation rate (ESR)
    • Pericardiocentesis , with chemical analysis and pericardial fluid culture
  • 37. Treatment  
    • analgesics
    • anti-inflammatory drugs(NSAIDS) such as aspirin and ibuprofen.
    • Corticosteroids
    • Diuretics
  • 38.
    • Pericardiocentesis - if the buildup of pericardial fluid makes the heart function poorly or produces cardiac tamponade may be done using an echocardiography-guided needle or surgically in a minor procedure.
  • 39.
    • If the pericarditis is chronic , recurrent, or causes constrictive pericarditis, cutting or removing part of the pericardium may be recommended.
  • 40. Possible Complications    
    • Arrhythmias , such as atrial fibrillation
    • Cardiac tamponade
  • 41.
    • Constrictive pericarditis, where inflammation of the pericardial sac results in fibrosis and thickening of the pericardium with adhesions (sticky scars) between the pericardium and the heart.
    • The pericardium creates a rigid "case" around the heart, which can severely limit the ability of the heart to fill with blood. Patients with constrictive pericarditis may develop heart failure , which responds poorly to treatment.
  • 42. Non-Hodgkin's lymphoma
    • is cancer that starts in the lymphoid tissue. that makes up the lymph nodes, spleen, and other organs of the immune system.
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  • 45. Causes  
    • White blood cells called lymphocytes are found in lymph tissues. Most lymphomas start in a type of white blood cells called B lymphocytes.
    • For most patients, the cause of the cancer is unknown. However, lymphomas may develop in people with weakened immune systems. For example, after an organ transplant.
  • 46.
    • Non-Hodgkin's lymphoma is grouped, or staged, according to how fast the cancer spreads - low grade, intermediate grade or high grade.
    • Burkitt's tumor is an example of a high-grade lymphoma.
  • 47.
    • According to the American Cancer Society, a person has a 1 in 50 chance of developing non-Hodgkin's lymphoma.
    • Most of the time affects adults
    • High-risk groups - have received an organ transplant or with weakened immune system (immunosuppression).
    • more common in men
  • 48. Symptoms
    • Swollen lymph nodes in the neck, underarms, groin, or other areas (may occur as an armpit lump )
    • Fever
    • Excessive sweating with night sweats
    • Unintentional weight loss
    • Severe itchiness
  • 49.
    • Coughing or shortness of breath may occur if the cancer affects the thymus gland or lymph nodes in the chest, which puts pressure on the windpipe.
    • stomach pain or swelling, which may lead to a loss of appetite, constipation, nausea, and vomiting
    • headache, concentration problems, personality changes, or seizures.
  • 50. Exams and Tests     nursing
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  • 52.
    • Lymph node biopsy
    • Bone marrow biopsy
    • CBC with differential
    • CT scans of the chest, abdomen and pelvis
    • Blood chemistry tests
    • X-rays
    • PET (positron emission tomography) scan
  • 53. Treatment   
    • Chemotherapy
    • Rituximab (Rituxan) is often used to treat non-Hodgkin's lymphoma - a form of immunotherapy
  • 54.
    • Radioimmunotherapy - involves linking a radioactive substance with an antibody that helps the immune system fight infection, and injecting the substance into the body.
    • In select cases, a stem cell transplant may be needed.
  • 55. Possible Complications    
    • Infection
    • Autoimmune hemolytic anemia
  • 56. Hodgkin's vs. non-Hodgkin's lymphoma: What's the difference? nursing
  • 57.
    • Both are lymphomas, a type of cancer that originates in a subset of white blood cells called lymphocytes — an important component of immune system.
    • The main difference is in the specific lymphocyte each involves.
  • 58.
    • If in examining the cells, the doctor detects the presence of a specific type of abnormal cell called a Reed-Sternberg cell , the lymphoma is classified as Hodgkin's. If the Reed-Sternberg cell is not present , the lymphoma is classified as non-Hodgkin's .
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