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Endocarditis

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  • 1. ENDOCARDITIS Group three presentation
  • 2. Group members Shida mbeye Taonga kanyenda Panesi white Chigomezgo munthali Maria kamanga Gilly banda
  • 3. BROAD OBJECTIVE By the end of the presentation the audience must acquire knowledge and skills on the condition of endocarditis
  • 4. SPECIFIC OBJECTIVES Definition of endocarditis Etiology Risk factors Pathophysiology Clinical manifestation Diagnostic evaluation Nursing assessment Nursing diagnosis Nursing management Medical management complications
  • 5.  Introduction  The heart is a vital organ that pumps blood and it has three layers which are endocardium, myocardium and pericadium.
  • 6. definition• Endocarditis is an inflammation of the inner layer of the heart, the endocardium. it usually involves the valves and other structures like the intraventricular and septum.
  • 7. etiology Fungus e.g. candida, aspagellus Gram negative organisms e.g. pseudomonas Bacterias e.g. staphylococci Acute rheumatic fever which cause enlarged and tender lymph nodes, damages the valves Congenital heart disease
  • 8. Risk factors Previous heart damage Dental procedures which lead into the introduction of bacterias Heart surgery Intubations Procedures involving gastrol intestinal and genitourinaly tracts e.g. barium, enemas, sigmoidoscopy, catheterisation and cytoscopy Reproductive conditions like delivery of new babies, abortions and pelvic inflammatory disease
  • 9. pathophysiology Usually in this case the bacterias or any other causing agents enter the blood stream through invasive procedures like dental procedures, surgery , urinary catherisation. Then they accumulate on the valves of the heart or endocardium Finally they form vegetations or crusters These vegetation they lead into damage heart valves by perforating and deforming the valves leaflets This at the end leads to tearing which means there is poor flow of blood and lead into accumulation of blood in chambers of the heart hence endocarditis
  • 10. Clinical manifestations Loss of vision Ischemia Fever Shortness of breath Shock Finger clubbing Myocardial infarction Weight loss Malaise Chills Night sweats Chest and abdominal pain anorexia
  • 11. Diagnostic evaluation Blood culture; helps in testing the presence of microorganisms Urinalysis to see microscopic hematuria. Doppler echocardiography assist in the diagnosis by demonstrating a muscle on the valve. Computerized tomography rule out heart damage Review bun and creatinine levels to evaluate renal function Review endocardiography finding if available for valvuler and ventricular function and presence of vegetation Review white blood cell count to evaluate course if infection
  • 12. Nursing assessment It includes history taking like; – Subjective data: – past medical history: patient asked of signs of the disease and the onset of the disease and review with patient history of risk factors like cardiac failure, shock – Medication history: has the pt ever taken any medication, what happened afterwards – Family history:asked of any case at home of the similar conditions
  • 13. – Social history: social behaviours that can trigger the problem– Surgical history: if ever operated on– Objective data: assess for temperature elevations, heart mummer, evidence of cough , peripheral edema and embolism, alscultate for heart sound, monitor arterial blood gas, rapid purse rate,dyspnea, restlessness and manifestation of heart failure
  • 14. Nursing diagnoses Infective breathing pattern related to inflammation of heart muscle as evidenced by use of accessory muscle, dyspnea. Impaired gaseous exchange related to fluid accumulation in the lungs as evidenced by shortness of breath Decreased cardiac output related to valvular dysfunction as evidenced by poor tissue perfusion Imbalanced nutrition less than body requirement related to anorexia as evidenced by loss of weight.
  • 15.  Altered thermoregulation related to infection as evidenced by increased body temperature (fever). impaired physical mobility related to fatigue Ineffective tissue perfusion related to embolisation Anxiety related to hypoxia or life threatening situation as evidenced by patient verbalization Altered comfort pain related to use of accessory muscle as evidenced by patient verbalization
  • 16. Nursing management Position the patient at semi fowlers position to help in infective breathing through providing enough room for lung expansion as abdominal contents goes down Administer oxygen therapy 4-6 l/min to help pt in breathing effectively through supplementing oxygen Monitor arterial blood gas , carbon dioxide, oxygen saturation hourly and document to monitor signs of respiratory acidosis Encourage and provide small frequent meals reach in proteins helping in repairing worn-out tissues Monitor vital signs , heart and lung sound, level of consciousness to evaluate how effectively the organs like the heart and the lungs are working
  • 17.  Schedule nursing activities to allow rest Encourage and assist pt to cough and deep breath to promote chest expansion provide tepid sponging to reduce raised body temperature by evaporation and conduction Encourage patient on exercises in order to improve patients mobility through making the body physically fit Make yourself available to the patient and nurse with love and respond well to his/her questions to array pain and anxiety Educate the patient on disease process to make pt cope up with therapy and the condition
  • 18. Medical management if the patient is having poor intake of oxygen administer oxygen therapy 4-6 l/m in helping the patient get supplemented with enough oxygen Administer antibiotic treatment like ampicillin + flucloxacilin +gentamicin Administer pcm 1g tds p.o as analgesic that help in relieving pain Administer inotropic drugs like digoxin that help in increasing contractility of the heart The patient can also be administered with morphine which help to decrease anxiety
  • 19. complications Chronic heart failure Shock Stroke embolism
  • 20. In conclusion Endocarditis as explained above it is the inflammation of endocardium and it brings a lot complications  Therefore:
  • 21. references PAUL ONEILL (2012), MASTER MEDICINE. SECOND EDITION LINTON (2007). INTRO. TO MEDI-SURGE NURSING,4TH EDITION •S. Lewis, M. Heitkemper, S. Dirksen, P. Obrien and L. Bucher (2007) Medical Surgical Nursing; Assessment and Management of Clinical problems (7th edition)St Louisi, Mosby.