Case Study Directing Operating Room Affairs

Case Study Directing Operating Room Affairs
Directing operating room affairs is complicated even in the best case scenarios. However, patient
use of opiods can make assessments and choices more challenging. Intravenous drug users are often
diagnosed with endocarditis, an expensive considtion to treat. How often are you seeing addicts with
this serious heart condition in your facility, and how are you handling it? In many facilities, the
patient receives various treatments, including a replacement heart valve and extensive antibiotics.
The aspect of patient care that has not been included in the past is addiction services. Once the
infection is cured and the valve replaced, the patients are discharged, often hitting the streets hard in
search of their drug of choice. A cardiologist at Catholic Medical Center in Manchester, NH,
Jonathan Eddinger, became increasingly frustrated wondering what happened to these patients once
they left his care. He used the web to search for patients from the previous five years who met both
criteria; diagnosis with endocarditis and addiction. ... Show more content on Helpwriting.net ...
From his small sample of the population, one in four patients had died. Many of those who hadn't
returned for multiple treatments, to the average tune of one–half million dollars each. Whether the
patient has Medicaid or private insurance, those costs are exorbitant for those who are not caring for
themselves outside of the
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La Insuficiencia Cardiaca ( Ic )
Insuficiencia cardíaca
La insuficiencia cardíaca (IC) es la incapacidad del corazón de bombear sangre en los volúmenes
más adecuados para satisfacer las demás del metabolismo; si lo logra, lo hace a expensas de una
disminución crónica de la presión de llenado de los ventrículos cardíacos.
La IC es un síndrome que resulta de trastornos, bien sean estructurales o funciones, que interfieren
con la función cardíaca. No debe confundirse con la perdida de latidos, lo cual se cesa, con el
subsecuente colapso hemodinámico, que lleva a la muerte. Debido a que no todos los pacientes
cursan con sobre carga de volumen en el momento de la evaluación por sobre el más anticuado
término insuficiencia cardiaca por sobre el más anticuado término insuficiencia cardíaca congestiva.
Epidemiología
La prevalencia de la insuficiencia cardiaca es elevada en países industrializados, debido a la mayor
edad de la población, la insuficiencia de hipertensión arterial y una mejoría en la sobrevida de las
enfermedades de la arteria coronaria, especialmente seguido de un infarto al miocardio. La tasa total
estimada gira entre 3 y 20 casos por cada mil habitante en personas mayores de 65 años, sube entre
30 y 130 por cada mil personas de esa edad, la tasa mortalidad de la IC en un año del diagnóstico es
de 35–45%.
La IC es una enfermedad común, costosa, incapacitante y potencialmente mortal. En los países
desarrollados, alrededor del 2% de los adultos sufren de insuficiencia cardíaca, pero aumenta en

Prosthetic Valve Endocarditis
We read with great interest the paper by Richard van Valen and his colleagues that evaluated patients
with prosthetic valve endocarditis (PVE) due to opportunistic bacterial pathogen Propionibacterium
acnes (P. acnes). The authors should be congratulated for publishing the largest single–centre series
to date on the topic, as thus far the literature was dominated by single case reports. We would like to
add some thoughts on the microbiological aspects of PVE caused by this facultative anaerobic
species.
Diagnosis of PVE caused by this microorganism is often delayed due to oligosymptomatic and
nonspecific presentation, hence microbiological confirmation is pivotal for adjusting treatment.
Unfortunately, aside for establishing positivity of blood and/or tissue cultures, there is no further
elaboration on the microbiological techniques employed to diagnose P. acnes in this study, probably
due to its retrospective design. It would also be interesting to know the incidence of neurologic
symptoms in this case series of 13 patients, as these are more commonly observed in P. acnes PVE
than in any other type of infective endocarditis (x). ... Show more content on Helpwriting.net ...
acnes (up to two weeks). Recently it was shown that a technique that couples polymerase chain
reaction (PCR) with an an electrospray ionization mass spectrometry can be applied to heart valves
and prosthetic material to diagnose P. acnes with increased sensitivty and speed when compared to
culture methods (x). Still, one has to bear in mind the expensive equipment and cost–effectiveness
issues of implementing such technology in the diagnostic

Oral Hygiene And Oral Health
The oral cavity is more often than not viewed as a separate entity than the rest of the body. This is a
mistake due to the overriding effect the mouth has on the rest of the body. This view needs to cease
immediately due to the fact that oral health affects what people eat, their quality of life, and their
speech.1 Oral health also plays an important role with chronic diseases. Unfortunately, oral health
has not been a priority among many healthcare professionals, and this has lead to millions of
patients suffering from toothaches and over poor oral hygiene.2
Health policies should be dicussed to involove oral health using sociodental approaches to finding
out the needs and the practical risk factor approach for oral cavity health ... Show more content on
Helpwriting.net ...
There are few efficient dental care systems to cope with their problems, and where there are, the cost
is beyond most people's means. Many people have untreated carries yet healthcare workers continue
to loverlook this and focu on other parts of the body making oral health an afterthought.
Oral health affects people not just physically but also psychologically and it really influences how
they grow up in life.1 Denta caries takes away from people's quality of life. Pain, discomfort,
disfigurement, acute and chronic infections, and eating and sleep disruption as well as higher risk of
hospitalization, sre all in play when oral health is not tended to properly. With children, nutrition,
and weight gain are affected by propoer oral health care. Children will develop toothaces, which
leads to less eating, which leads to unhealthy habits for growing chilfredn. Poor helath care is like a
chain reaction of bad descisions. Poor oral health can also lead to poor sleeping habits which
decreases hemoglobin and a depressed erthyroctyre count. 3
In Brazil, in 2009, ninety per cent of pre–adolescents reported an issue related to oral health4. The
prevalence of dental pain was up to around thirty four percent among Brazilian teenagers. In the
United States, dental issues led to over 117,000 hours of school lost per 100,000 children.

Case Study 15: Endocarditis Essay
Case Study 15
Scenario
J.F. is a 50–year–old married homemaker with a genetic autoimmune defi ciency; she has suffered
from recurrent bacterial endocarditis. The most recent episodes were a Staphylococcus aureus
infection of the mitral valve 16 months ago and a Streptococcus mutans infection of the aortic valve
1 month ago.
During this latter hospitalization, an ECG showed moderate aortic stenosis, moderate aortic insuffi –
ciency, chronic valvular vegetations, and moderate left atrial enlargement. Two years ago J.F.
received an 18–month course of parenteral nutrition (PN) for malnutrition caused by idiopathic,
relentless nausea and vomiting (N/V). She has also had coronary artery disease (CAD) for several
years, and 2 years ago ... Show more content on Helpwriting.net ...
However, it can also result from certain neurologic disorders – especially life–threatening increased
intracranial pressure (ICP) – or from cardiovascular disorders that cause blood backflow into the
heart with each contraction such as aortic insufficiency. Widened pulse pressure can easily be
identified by monitoring arterial blood pressure and is commonly detected during routine
sphygmomanometer recordings (Lippincott, 2005, pg 527–528).
With acute aortic insufficiency, pulse pressure widens as the valve deteriorates. Signs and symptoms
may include a bounding pulse, atrial and ventricular gallops, chest pain, palpitations, pallor,
crackles, dyspnea, and jugular vein distention, may also be present.
Tachycardia: Tachycardia typically refers to a heart rate that exceeds the normal range for a resting
heart rate. When the heart beats rapidly, the heart pumps less efficiently and provides less blood
flow to the body and the heart. The rapid heartbeat increases the workload and oxygen demand of
the heart. Problems will occur with the heart as tachycardia persists over time. The heart is
maintaining less oxygen, which will lead to an MI due to death of the myocardial cells. Patient will
start to have angina because of this. Tachycardia is noted in many diseases and disorder like: fever
endocarditis, anemia, HTN, pericarditis, abnormal heart impulses, anxiety, older age, sleep apnea,
COPD, electrolyte imbalances, and many more.
Tachycardia can be an

Case Study Infective Endocarditis
Case Study #3
Management of Patients with Structural, Infectious, and Inflammatory Cardiac Disorders
Ariane Waters is 21 years of age and is a female patient who is admitted to the hospital with the
diagnosis of infective endocarditis. Ariane had her tongue and nose pierced 6 weeks ago. The drug
screen is negative. She presents with tricuspid insufficiency murmur grade II, and a temperature of
104°F. The patient complains of extreme fatigue, and anorexia. The echocardiogram reveals
vegetations on the tricuspid valve.
What risk factors predisposed Ms. Waters to develop infective endocarditis?
Body piercings can be major risk factors for infected endocarditis, especially the tongue piercing
since the oral cavity is a main port of ... Show more content on Helpwriting.net ...
Blood cultures should be negative, VS should be within normal limits and the patient should not be
showing s/s of heart failure at the time of discharge. Proper home care teachings will be provided.
What nursing management should be provided for the patient and family?
The patient and her family should be taught to monitor for s/s of heart failure (stated above). They
should be able to check for heart murmurs and assess VS for sign of infection–especially
temperature. She will need adequate rest. The patient and her family should both be educated on
aseptic technique to prevent an opportunity for more organisms to enter her body, especially during
treatment. Teaching should also include how to administer IV antibiotics safely and care of the
infusion site. The patient should be informed on proper oral care –such as brushing twice per day
with a soft tooth brush staying away from devices that could contain

Informative Speech On Aorta
Definition
The aorta is the largest artery of the body. Its job is to disperse blood to smaller arteries to be sure all
of the parts of the body receive an efficient supply of well oxygenated blood. This artery connects to
the aortic valve of the heart. This valve opens and closes, so blood can leave the heart. It has to close
completely and open widely for the right amount of blood to be able to flow through. If there are
any problems with it, and it can't push through blood from the aorta, a person might end up needing
aortic valve replacement surgery.
Symptoms
The symptoms of problems with the aortic valve are similar to that of a heart attack. There is chest
pain and pressure that some describe as feeling like the heart is being squeezed. The heart might also
have a sensation of fullness that seems different, and the left arm might also go numb. Some of the
other symptoms include:
Breaking out in a cold sweat
Shortness of breath
Nausea
Vomiting
Treatment ... Show more content on Helpwriting.net ...
First, a cardiologist will determine how serious a person's condition is. Sometimes, the problem is
minor, and it can be repaired. But, if the aortic valve has completely stopped functioning, then
surgery must be done quickly to keep the person alive. This usually requires a complete replacement
of the valve with either a donated human aortic valve, a patient's own pulmonary valve, or a pig or
cow heart valve. The surgery is tedious and stressful on the body, and unfortunately, the heart valve
will wear out over time. Because of this, mechanical aortic valves are usually used on younger
patients, so they don't have to go through the painful surgery again later

Chronic Hepatitis C Case Study
Chronic hepatitis C (HCV) is a common infection in injecting drug users and the prevalence of HCV
infection in this subpopulation is up to 60% (ROUX). Patients with infective endocarditis (IE) are at
higher risk of developing neurological complications such as cardioembolic stroke. In 10–50% of
patients with IE in the left heart, it may cause stroke, usually in the first two weeks of illness.
(GRECU) According to the latest recommendations the IE is diagnosed on the basics of
transthoracic and transesophageal echocardiography (HORSTKOTTE) but doubts of IE can be set
on the basis of Doppler ultrasonography of the carotid arteries and observed changes in blood flow
through the arteries that can indicate changes in the valves that may exist within

Treatment Of Intravenous Drug Use
Abstract
Intravenous drug use is a dangerous, yet increasing activity around the world. Persons who inject
themselves with illicit drugs are at risk for several complications such as infection caused by
contaminated needles. These infections can be serious and often lead to hospitalization as well as
other health–related complications. A situation that often arises is determining the best type of
treatment for IV drug users who are being discharged from the hospital. Physicians and pharmacists
are commonly faced with choosing outpatient IV antibiotic therapy versus oral antibiotics when
treating infections caused by IV drug use. This presents an ethical dilemma, particularly concerning
the ethical principles of beneficence and ... Show more content on Helpwriting.net ...
Unfortunately, the trend in intravenous drug use has increased in recent years. Results from the 2013
National Survey on Drug Use and Health show that of individuals aged 12 or older in America,
current users of cocaine and heroin were approximately 1.5 million and 289,000 respectively
(Substance Abuse and Mental Health Services Administration, 2014). As the number of intravenous
drug users continues to rise, so does the risk of dangerous and potentially fatal complications that
are associated with illicit drug use. In this population, death rates are higher due to overdose, AIDs–
related mortality, and other blood–borne viruses (Mathers et al., 2013). Mortality rates remain high
even though precautions have been taken to reduce them. According to Lavender & McCarron
(2013), "Mortality in injecting drug users is up to 22 times higher than for the age–adjusted
population, despite increased provision of needle and syringe programs, reduced needle and syringe
sharing, and higher uptake of hepatitis B vaccination" (p. 511).
In addition to higher rates of mortality, intravenous drug users are at increased risk of infection.
Mertz, et al. (2008) stated, "Malnutrition, immunodeficiency, homelessness, and needle–sharing
contribute to a high infection rate in these patients" (p. 2). Common infections range from simple
cutaneous abscesses and cellulitis to more serious infections such as

Study Population And Clinical Data
STUDY POPULATION AND CLINICAL DATA
This study is a retrospective chart review of 360 patients with definite or possible Infective
Endocarditis according to modified Duke Criteria [1–2] who were admitted to Detroit Receiving
Hospital and Harper University Hospital in Detroit from 2006 to 2014. Both hospitals are teaching
hospitals in Detroit, Michigan. For a patient with repeated episodes of Infective Endocarditis, one
episode was only included at our institutions. Clinical, microbiological, and echocardiographic data
of all patients with definite IE were collected using a standard data collection form.
Analysis of Data
Analysis of data was conducted using the SPSS software system version 22. In table 1, bivariate
analysis was used to compare IE patients who died during admission versus those who survived to
hospital discharge.
Continuous variables were expressed as means ± standard deviation (SD) and binary regression
analysis was used to examine the associations between a continuous variable and a categorical
variable with two categories. Categorical variables were presented numbers (percentage) and the
association between them analyzed using The Chi–square test. Variables that achieved a P value less
than 0.10 in the bivariable analysis were included in the multivariable logistic regression model to
adjust the effects of any possible confounding variable. The independent predictors of the mortality
were selected using a backward stepwise.
RESULTS
During the study

Infective Endocarditis Research
Infective endocarditis has been around for many centuries. A man named Lazaire Riviere, while
performing an autopsy, first discovered infective endocarditis in 1674 (Brusch, 2015). Since the first
findings documented were after death, there was still much research to do in this area of
cardiovascular science. William Olser was the first person to compile an in–depth explanation of
infective endocarditis in English in the year of 1885. Furthermore, in 1966, the first modern–times
symposium of infective endocarditis was developed as a series of journal articles by authors Lerner
and Weinstein, which was published in the New England Journal of Medicine (Brusch, 2015).
Although the understanding and research of this disease is well understood ... Show more content on
Helpwriting.net ...
In other words, would it be useful to diagnose infective endocarditis with the help of advanced
imaging tools to closely examine how the tissues and organs appear? Patients that were gram–
positive for certain bacteria were included in the study, and there were 72 people that underwent the
F–FDG PET/CT. Results were evaluated and determined by nuclear medicine physicians. Overall,
the study yielded that the sensitivity for diagnosing those with infective endocarditis using F–FDG
PET/CT was low; it was only 39%. Due to the low sensitivity, the value of using F–FDG PET/CT as
diagnostic criteria for those with infective endocarditis was deemed not satisfactory (Kouijzer et al.,
2013). Still, another study took a deeper look into ways of diagnosing infective endocarditis.
An additional study investigated the usefulness of histopathological findings in the diagnosis of
infective endocarditis. Histopathology is the study of tissues viewed under a microscope to
determine manifestations of disease. In countries outside of the United States, histopathological
findings are the gold standard in confirming infective endocarditis in humans. Researchers intended
to challenge this idea and see if histopathological findings really are the best form of diagnosing
infective endocarditis, and if those findings can stand by

How To Write A Case Study Endocarditis
Endocarditis is inflammation close to the inner lining of the left ventricle, which is the endocardium
caused by a bacterial infection. Once the bacteria go into the bloodstream then towards the left
ventricle of the heart an inflammatory response begins to occur because the immune system cells are
not familiar with the foreign bacteria. When the bacteria have been detected, cells such as basophils
and mast cells release histamines, a key compound in the inflammatory response. Which causes
smooth muscle cells in blood vessels to relax and coronary arterioles to vasodilate. The
inflammatory response that is occurring is increased blood flow to the endocardium. The blood
vessels involved are coronary blood vessels which are going to help increase

Staphylococci Research Paper
They are two medically important genera of gram positive cocci–staphylococci and streptococci.
Both are non–motile and do not form spores. Staphylococci are catalase positive while streptococci
are catalase negative Staphylococci are Gram–positive cocci that divide perpendicular to the last
plane of division, forming clumps or clusters. Depending on the age of human culture, they can be
observed single, in pairs, in short chains, or in grape–like clusters. They are tough organisms
because they are relatively resistant to heat and drying. Metabolically, the Staphylococci are
facultative aerobes, and possess both superoxide dismutase and catalase. Clinically, the most
important distinction is between S. aureus and all other species that are nonpathogenic members.
The coagulase test is a simple way to differentiate S. aureus from the coagulase–negative
Staphylococci. While there are six species of coagulase–negative Staphylococci, the most numerous
species on the skin is Staphylococcus epidermidis. The other coagulase–negative species of clinical
relevance is S. sapro. Staphylococcus aureus is a common infectious agent of humans, and tends to
cause localized or toxin–mediated disease. ... Show more content on Helpwriting.net ...
They are still new feeding evolutionary ways that keeps on evolving for either research purposes or
to help with the poor with limited amount of food. For an example: astronauts traveling to space and
eating food that are in containers without gravity being present. Also poor individuals, such as
Haitians, have no source of food, but using creative ways to gain energy by using water and mixing
it with sugar in order to

Psychiatric Mental Health Nurses: A Case Study
The average salary for APRNs in Ohio is 96,520 dollars (Bureau of Labor Statistics [BLS], 2015).
Psychiatric–mental health nurse practitioner makes an average salary of 89,903 dollars
("Indeed.com," 2017). This figure does not include the benefit and other miscellaneous cost
associated with hiring new employment such are training cost, physical, and drug screening.
The return of investment for every dollar spend is four to seven dollars saving reduced drug–related
crime, criminal justice costs, and theft (NIDA, 2012, p. 11). Related to healthcare cost, it is
estimated 12 dollars return for every dollar spent (NIDA, 2012, p. 11). These benefits are improved
society and not directly benefit RHH.
RHH personality needs to see direct bereft to invest on this epidemic. The direct benefit includes
cost reduction, increase patients satisfaction, and employee satisfaction. These benefits will be
discussed below as follows.
The chance of patients with heroin addiction not having health insurance is about 60% (CDC, 2015).
It is mostly likely RHH is not get reimbursed for the treatment. In 2013, the cost of valve
replacement surgery was more than 150,000 US dollars (Benjamin et al., 2017). This figure does not
include other costs such as post–surgery follow–ups, complications, and additional treatment for a
deterioration of ventricular function or ... Show more content on Helpwriting.net ...
If psychiatric–mental health nurse practitioner established treatment plans with clear expectation,
both party will know the plan and will have a goal to achieve. There will be minimal disagreement
since the limits are set and expectations are clearly stated upon admission. The patients also get a
treatment that geared toward accomplishing absences. In general, the patients and caregivers
relationship will be improved which ultimately increase

Infective Endocarditis Case Summary
The patient, a 21–year–old female with infective endocarditis secondary to infective embolism. The
patient with cerebrovascular accident was a transfer towards tertiary hospital and rehabilitation
center. On admission she presents with dense left hemiplegia with minimal active movement at left
upper and lower limb.
Decreased sensation and hemi–inattention to left side. Bed mobility was very limited due to
hemiparesis and patient required full facilitation to roll and sit up. Patient initially appeared to have
mild cognitive deficit in terms of memory recall and planning. Patient also experienced difficult in
swallowing. She has a weight of 70kg with no allergies. Drug and treatment was antibiotics
intravenous penicillin units 6 hourly for 4 weeks. Gentamycin 160mg intravenously 12hourly for 7
days and continue with rehabilitation. ... Show more content on Helpwriting.net ...
Pain in right arm and left shoulder. During clinical presentation patient was not distressed or
anything blood pressure 114/76 mmHg, heart rate 96 beats per minute, respiratory rate 20 beats per
minute and saturation of 100%. General signs were pallor, weight loss, fever (Hammer & McPhee,
2014, pp. 69–72). Patient reports a history of difficult with regular bowel movements, which has
been an ongoing issue during her hospital stay.
The increase mobility (patient getting out of bed and moving around in wheelchair) there has been
an improvement. Initially patient's endurance was very poor, she could tolerate 15–20minutes of
treatment before tiring. Patient made some improvement with occupational therapist, she had a
wheelchair, thin positioner and a tray table. She is able to transfer her wheelchair with minimal
facilitation. Her wheelchair mobility is still limited because of difficult self–propelling with her right
arm and leg, but she is

Enterococcus Faecalis Research Paper
Enterococcus Faecalis In 1899, Thiercelin found a new gram positive diplococcus that he named
enterocoque, suggesting that he believed that this bacterium had something to do with the intestines.
He also described finding this bacterium in patients who had enteritis, appendicitis and meningitis
(Murray). In 1906, Andrewes and Hoarder isolated this same bacterium from a patient suffering
from endocarditis and they also discovered a relationship with urinary tract infections. They named
it Streptococcus faecalis, again because of similarities to the human intestinal tract (Murray). Other
early 20th century instances of infection where S. faecalis has been associated but not known to be
definitively causative include wound infections after World War I, osteomyelitis, ... Show more
content on Helpwriting.net ...
In 1984, Schleifer and Kilpper– Balz used DNA–DNA and DNA–rRNA hybridization, a form
nucleic acid testing, to prove that Streptococcus faecalis and Streptococcus faecium were unique

Causes And Treatment Of Infective Endocarditis
Before discussing Infective Endocarditis, it's imperative to understand where the endocardium is
along with its function because endocarditis affects this area of the heart. The Endocardium is the
innermost layer of heart tissue that lines the cavities and valves of the heart and is composed of
loose epithelial and connective tissue. The endocardium regulates contractions of the heart and helps
regulate the composition of the blood that feeds the tissues of the heart (Kenney, 2015). Infective
Endocarditis, IE, is an infection of the endocardium that generally occurs when bacteria or germs
from another part of the body, such as the mouth, spread through the bloodstream and attach to
damaged areas in the heart (Endocarditis Definition, 2015). Individuals that have an increased risk
of developing Endocarditis include:
Those with Pacemakers or Implantable Cardioverter–Defibrillator (ICD)
Individuals with existing conditions of the heart valves
HIV (What Increases Your Risk of Endocarditis?, 2015).
Diabetes Mellitus and long term hemodialysis (Infective endocarditis in adults, 2001).
According to the American Heart Association, endocarditis affects twice as many men as women
and eight times as many older men as older woman. More than a quarter of all cases occur in
individuals that are older than 60 years of age (Heart Valves and Infective Endocarditis, 2014). In
the United States alone, national data indicated that in 2009 there were up to 28,000 hospital

Heart Valve Diseases: A Case Study
Heart valves are tissue paper thin membranes attached to the heart wall that constantly open and
close to regulate blood flow. The heart has 4 valves: Mitral and tricuspid valve, which control blood
flow from the atria to the ventricles and aortic and pulmonary valve, which control blood flow out of
the ventricles. A normal, healthy heart valve minimizes any obstruction and allows blood to flow
smoothly and freely in one direction. It closes completely and quickly, not allowing any blood to
flow back through the valve. (Rongrong et al, 2016).
Heart valve diseases occur when one or more of the heart valves is damaged. The causes include
degenerative valve disease, calcification due to aging, coronary artery disease, rheumatic fever,
congenital ... Show more content on Helpwriting.net ...
The current general recommendation for patients older than 60 to 65 years is a bioprosthetic valve
and for patients less than 60 to 65 years is a mechanical valve. Patients older than 65 years typically
do not outlive the life expectancy of a tissue valve. Therefore, implanting a tissue valve in an elderly
patients can avoid anticoagulation and risk for bleeding. . Patients younger than 50 years are more
likely to experience structural valve deterioration and a need for reoperation; so mechanical valves
are generally recommended for younger patients. (Tilquist and Maddox

Aneurysm : A Focal Dilation Of An Infected Arterial Wall
Mycotic aneurysm is a focal dilation of an infected arterial wall. This uncommon disease follows an
aggressive and unpredictable clinical course with significant mortality, and presents unique
diagnostic and therapeutic challenges. This review discusses the pathogenesis, diagnosis, and
therapeutic management of mycotic aneurysms.
Historical Perspective Virchow first described a saccular outpoutching along an arterial wall
corresponding to an embolic source in 1847 [1]. Mycotic aneurysms were initially considered a
physical change secondary to mechanical pressure of emboli against the artery wall [2]. Infectious
etiology was first hypothesized by Goodhart in 1877 [3]. The term 'mycotic' originates from Osler's
Gulstonian Lectures in 1885 [4] in which he associated aortic aneurysms resembling a fungus
growth with a severe or "malignant" form of endocarditis and coined the term "mycotic aneurysms."
The term "mycotic" is a misnomer suggesting fungal infection, though it was originally intended to
refer to all microorganisms [5]. Osler established a clear connection between endocarditis and its
bacterial origin ("micrococci") through histology using bacterial Gram staining, which at the time
was novel in medical practice. He defined the mycotic process in the setting of endocarditis as the
transference of microbes from the growth of the valves to distant parts. In 1887, Langton and
Bowlby corroborated Osler's findings with observations of numerous bacteria derived from the

Acute Q Fever Research Paper
The clinical manifestation of disease in animals, stillbirth or delivery of weak lambs, calves or kids,
are the most frequent clinical signs of the disease. The abortion occurs at the end of gestation
without specific clinical signs and pathognomic pathological findings, the intercotyledonary fibrous
thickening and discolored exudates, may observed (Shakespeare, 2009). The vast majority of the
overt disease cases are acute Q fever with incubation period last a few days to several weeks, The
vast majority of the overt disease cases are acute Q fever. Fatalities in acute Q fever cases are rare,
with less than 1% of cases resulting in death. The incubation period can last a few days to several
weeks, and the severity of infection varies in

Symptoms And Treatment Of Hospital Survivors
During the study period from 2006 to 2014, three hundred sixty patients with a definitive infective
endocarditis diagnosis were included. The mean age of the patients was 53 ± 13 (range 18–94). Two
hundred thirteen (59%) patients were male and one hundred forty seven were female. 80 of the 362
patients died during hospitalization and in– hospital mortality rate was 22% for the entire study. A
total of 295 (83%) of the patients were African American. 76patients had a previous episode of IE
(21%). At admission, the difference in the acute physiology (P=0.000) and chronic health points
(P=0.020), with similar age showed that the total APACHE II score had a significant difference
between in–hospital survivors versus deaths (P =0.001). The mean duration of hospital stay was
(24+–17) days (range of 2–112 days) with the mean length of stay in ICU (9+–14). During
hospitalization, 132 (37%) patients used vasopressor agents and 162(45.5) patients were on
mechanical ventilation. Clinical evaluation showed the most common symptom was fever (72%)
throughout hospitalization. Other manifestations were dyspnea (56%), edema (46%), chills (35%),
chest pain (32%), delirium (18%), headache (18%), sweating (16%), back pain (25%), weight loss
(10%), hemoptysis (5%) and abdominal pain (30 %). Physical examination revealed a new or
worsening murmur in 210 (60%) patients, skin lesions in 65(18.5 %), conjunctival hemorrhage in 9
(1%) and splenomegaly in 11(3%). Other classic signs of IE included

Infective Endocarditis Case Study
Lorma Colleges
City of San Fernando 2500 La Union
College of Nursing
NCM 103 First Semester School Year 2013 – 2014
Case Study: Management of Patients With Dysrhythmias and Conduction Problems
Abby, is 21 years of age and is a female patient who received a permanent atrial–ventricular
pacemaker for the diagnosis of sick sinus rhythm, a disorder that leads to periods of tachycardia and
periods of extreme bradycardia or sinus arrest. The nurse received the end–of–shift report and
arrives at Ms. Abby's's room where she assesses the patient's incision dressing on the upper left
chest and it is dry. The patient's left arm is edematous and ecchymotic and twice the size of the other
... Show more content on Helpwriting.net ...
Jeffa Hextee Jeco had her tongue and nose pierced 6 weeks ago. The drug screen is negative. She
presents with tricuspid insufficiency murmur grade II, and a temperature of 104°F. The patient
complains of extreme fatigue, and anorexia. The echocardiogram reveals vegetations on the
tricuspid valve.
1. What risk factors predisposed Ms. Waters to develop infective endocarditis? 2. Explain the
pathophysiology of infective endocarditis as it relates to this case. 3. What additional clinical
manifestations should the nurse include in the assessment of the patient? 4. What medical
management should the nurse anticipate for the patient? 5. What nursing management should be
provided for the patient and family?
Case Study: Management of Patients With Complications From Heart Disease
James Hitler is 72 years of age and is a male patient who is admitted with the diagnosis of acute
pulmonary edema secondary to acute left ventricular heart failure. The patient has a history of
coronary artery disease that has been treated medically. The patient is anxious, pale, cold, clammy,
and dyspneic. The vital signs are: BP 88/50, P 110, R 32, and T 97°F. There are bubbling crackles
and wheezing throughout the lung fields and the patient is raising frothy

Infective Endocarditis
Infective endocarditis is the inflammation of the damaged parts of the heart due to an infection
usually from elsewhere in the body. In this disease the endocardium (the inner lining of the heart) is
inflamed and can lead to damaged heart valves and to other life–threatening complications. William
Osler was the first one to recognize this disease and gave a name to it in 1885 in his Gulstonian
lectures.
When a patient's heart has a defect or a part that is not as strong as the rest then that part is
susceptible to infective endocarditis. This tends to come from blood flowing from a higher pressure
area in the heart to a lower pressured area. This causes an 'indention' in the heart's endocardium that
collects deposits. When patients have bacteremia, the presence of infectious bacteria in the blood,
the bacteria often fall into these 'indentions' and start to collect. Once they have started to collect
they will multiply and are called vegetation.
Once vegetation happens there is an increased risk of having an abnormal alignment in the valve
that the vegetation is around. This can cause a decreased blood flow or even a blocked valve. This
may cause emboli to escape from the heart and head to other sections of the body (i.e. the lungs or
the brain) depending which valve is being effected. Different ways that the bacteria can get in the
blood are: dental procedures, skin rashes, infections, abscesses, invasive procedures, and surgeries.
The nursing process should be

Aortic Insufficiency Lab Report
Introduction
Aortic insufficiency is a condition where the aortic valve does not close all the way. The aortic valve
is a gate–like structure that is located between the lower left chamber of the heart (left ventricle) and
the blood vessel that leads away from the heart (aorta). The aortic valve opens when the left
ventricle squeezes to pump blood into the aorta, and it closes when the left ventricle relaxes.
In aortic insufficiency, blood in the aorta leaks through the aortic valve after it has closed. As a
result, the heart works harder to pump the same amount of blood through the valve as it would if the
valve closed tightly. When left untreated, aortic insufficiency causes enlargement and weakening of
the left ventricle. When this happens, ... Show more content on Helpwriting.net ...
MRI.
Electrocardiography. This is a test that records the electrical impulses of the heart.
Angiography. This is a test that produces images of arteries in your body. You may need aortic
angiography or CT angiography. In aortic angiography, a dye flows to your heart through a soft,
flexible tube (catheter) while X–rays are taken. CT angiography uses a CT scanner and MRI in
addition to the catheter, dye, and X–rays.
How is this treated?
Treatment depends on how severe the aortic insufficiency is, the problems it is causing, and your
symptoms.
Observation. If the aortic insufficiency is mild, no treatment may be needed. However, you will
need to have the condition checked regularly to make sure it is not getting worse or causing serious
problems.
Surgery. If the aortic insufficiency becomes severe, you may need surgery to repair or replace the
valve. Surgery is usually recommended if the left ventricle enlarges beyond a certain point. If aortic
insufficiency occurs suddenly, surgery may be needed immediately.
Medicines. Some medicines may help the heart work more efficiently.
Follow these instructions at home:
Keep all follow–up visits as directed by your health care provider. You may need to have tests done
regularly to monitor your condition and how well your heart is pumping

Curricular Infection: A Case Study
TREATMENT GOALS o Maintain clinical stability until patient receives definitive treatment by a
specialist o Refer patient to appropriate specialist depending on severity of condition and presence
of comorbidities DISPOSITION
Admission criteria o Admission to the hospital is recommended for patients with:8 o Severely
immunocompromised status o Poorly controlled diabetes mellitus o Tuberculosis o Severe viral
infections o Severe vesiculobullous disorders
Criteria for ICU admission o Patients with life–threatening emergencies from spread of infection to
the cervical or fascial spaces in the head:2,8
 Compromised airway
 Significant facial swelling or trismus
 Signs of systemic infection or sepsis Recommendations for specialist referral ... Show more
content on Helpwriting.net ...
12 Bard–Parker knife and drained of pus and bacteria Indication
 Small to moderate abscess that is palpable Contraindications
 Extremely large abscess that would require extensive debridement and irrigation
 Deep abscesses that are difficult to access without more invasive surgery Interpretation of results
 Reduction of swelling and pain indicates successful procedure; however, prompt dental
consultation recommended for definitive treatment Co–morbidities
 Antibiotic prophylaxis recommended 1 hr before dental procedure that involves manipulation of
the gingiva, periapical region of teeth, or perforation of the oral mucosa in the patients with:14
Prosthetic cardiac valve
History of infective endocarditis
Congenital heart disease
Unrepaired cyanotic congenital heart disease
Repaired congenital heart disease with defects at the site
Cardiac transplantation recipients with history of cardiac valvulopathy
 Patients who have hypertension or congestive heart failure should not take NSAIDs for pain
relief12 Special

Dental Clearance Research Paper
Healthcare teams often work together to augment the oral health of patients prior to cardiac surgery.
This is commonly referred to as dental clearance prior to cardiac surgeries in this essay; I will focus
on the rationale behind dental clearance for patients undergoing cardiac valve replacement. Dental
clearance is the process when the patients who are referred from the cardiac surgery division, are
assessed by the dental team for dental and oral concerns. And based on the finding the dentist might
recommend a treatment plan before clearing the patient. These might include but not limited to,
tooth extractions, dental hygiene, periodontal evaluation, fillings and oral surgery procedures.
According to the AHA(American Heart Association ) guidelines

Serratia Marcescens Research Paper
I discovered that my unknown organism was Serratia marcescens. This organism is gram negative
and bacillus shaped. It is a member of the Enertobacteriae family. This organism appears a red blood
like color when it grows on media. It is anaerobic, but can also survive under aerobic conditions.
There are some strains of Serratia marcescens that are motile and have flagellum. It is able to
produce the enzymes chitinase, lipase, protease, nuclease, and serrawttin. It is a non–endospore
forming bacteria, chromogenic, and does not ferment lactose. (Falkiner, 1997)
This bacterium can be found just about anywhere in the environment and thrives in the presence of
oxygen and without it. Majority of the time it is found on plants, animals, growing on food, in dead
organic material, soil, water, and in the air. Serratia marcescens is a mesophile and grows between
30° and 37°C. ... Show more content on Helpwriting.net ...
The organism adheres to the epithelial cells in its host by pilli. This opportunistic pathogen can
affect people of all ages and specifically targets patients that have immune deficiencies, debilitating
diseases, and infants in the NICU. Patients are at greater risk of contracting the organism if they
have recently had a surgery, mechanical ventilation, central venous catheter, arterial catheterization,
inhalation medication therapy, tracheal tubes, or have low apgar scores. It can cause a variety of
diseases and infections such as urinary tract infections, meningitis, pneumonia, respiratory tract
infections, keratoconjunctivitis, osteomyelitis, keratitis, endocarditis, cutaneous infections, and
endophthalmitis. (Currey,

Infective Endocarditis Case Study
Since it has been determined by researchers that causative agents of infective endocarditis play a
major role in treatment, it is important to know what exact causes those are. In a study by Zauner et
al. (2013), "IE–causing pathogens were Staphylococcus aureus, viridans streptococci, enterococci,
streptococci, coagulase–negative staphylococci, and miscellaneous pathogens" (637). Depending
upon the organism that infects the heart, there are different outcomes. For example, those infected
by staphylococcus aureus suffered noticeably higher sepsis rates, or severe blood infections. S.
aureus also tended to cause more cases of emboli activity, or blockages in the bloodstream. In
contrast, other organisms affected the body differntly. On ... Show more content on Helpwriting.net
...
For many patients, surgery is performed on the damaged valves. Surgery types differ for each
individual depending upon which valves were affected, how severely they were infected, and if
valves had previously been replaced artificially. Before surgery, patients must undergo a series of
strenuous tests and careful assessments to be sure he or she qualifies for surgery. In a particular
study, several patients were able to undergo valve replacement surgery. In a specific study, following
surgery, patients spent time in a rehabilitation center and had frequent, regular check–ups with the
health care team. Thankfully, 90% of patients that survived the surgery had significant
improvements. Limited functioning was only prevalent in 10% of the post–surgery group. In total,
there were 80 people in the study, and ten of them died. Few passed away before and during surgery,
while 7 of them died within one month after surgery (Rostagno et al., 2011). Factors that were
related to death were: old age, lack of function in the left ventricle, and intense body wide infection.
Overall, it has been concluded that the survival rate after surgery is rather high (70–85%) with a low
chance of recurrence (Rostagno et al.,

Catalase Test Essay
Results The catalase test was positive for unknown #4. After addition of hydrogen peroxide the
sample began to bubble. The bubbles indicated that the unknown produced catalase that broke down
the hydrogen peroxide into water and oxygen gas ("Microbugz"). The initial coagulase test was
inconclusive. After the addition of coagulase in the second attempt, the sample began to clump
indicating that the unknown bacteria possessed the ability to produce fibrin barriers ("Microbugz").
After the 18–hour incubation period, the bile esculin tube turned completely brown. This indicated
that unknown #4 could hydrolyze esculin to esculetin and dextrose which reacts with the ferric
citrate in the media to produce a dark brown or black color ("Microbugz"). ... Show more content on
Helpwriting.net ...
aureus. Since B. subtilus was not an organism available in the lab, at this point, it was safe to
assume that unknown #4 was S. aureus. The positive results for the bile esculin and blood agar and
the negative SFB results provided further evidence of S. aureus. The only test that did not go as
planned was the MSA. No growth was observed on either of the plates even though S. aureus can
grow in hypersaline environments and ferment mannitol. The plate should have turned yellow from
acid production and exhibited growth. Perhaps the sample was dying and couldn't grow on either
MSA plate or the strain possessed a mutation that took away its ability to grow on that media. The
only way to know for sure would be to run more tests and perhaps a sequence of the genome to scan
for mutations or abnormalities. However, the back–up TSA slant turning blue, albeit not a
biochemical test, also supported the conclusion that S. aureus was unknown #4 because S. aureus
can turn TSA slants blue. The Gram–negative rod, Pseudomonas aeruginosa, can also turn TSA
slants blue because of pyocyanin production, but the majority of the biochemical tests supported S.

Enterococci
Enterococci are gram positive cocci that can occur singly, in pairs or as short chains. They are
facultative anaerobes, possessing the ability to grow in the presence or absence of oxygen.
Enterococci can withstand harsh environmental conditions. There are currently 23 enterococci
species and they are divided into five groups based on their interaction with mannitol, sorbose and
arginine 5 .E. faecalis can survive extreme challenges. Its pathogenicity ranges from life–threatening
diseases in compromised individuals such as bacteremia, septicemia, endocarditis, and urinary tract
infections to less severe conditions, such as infection of obturated root canals with chronic apical
periodontitis.The persistence of E.faecalis might be due to the

Dental Issues Like Gum Disease
Dental issues, like gum disease, do more than just affect your oral health. In fact, research shows
that heart disease and stroke are often associated with gum disease, and while no clear cause–and–
effect relationship has been proven by doctors just yet, studies show that gum disease directly
increases the risk of developing serious heart conditions. For this reason, the dentists at Kenton
Dental Care, Kenton, Ohio's leading center for family dentistry, say that routine dental exams along
with good oral hygiene habits are essential to fighting off gum disease and keeping your heart
healthy.
Gum disease, also known as periodontal disease, is a common condition among adults in the U.S.
and is the infection of the mouth's gum tissue, usually

Heart Valve Infection
What is Heart Valve Infection in Cats?
The heart wall is composed of three separate layers: the inner endocardium, the middle myocardium
and the outer epicardium. When the endocardium becomes infected, infective endocarditis results,
causing infection in the inner heart wall and one or more heart valves. Any generalized infection can
cause an infection in this portion of the heart.
Though the condition is rare in cats, the complications of it can lead to heart failure and death.
Prompt treatment of the underlying infection is necessary in order to save the cat's heart and life.
Symptoms of Heart Valve Infection in Cats
Symptoms can differ in type and intensity depending on the site of the initial infection, the health of
the heart and complications ... Show more content on Helpwriting.net ...
An echocardiogram (ECG), which is an ultrasound of the heart, will be performed. The
echocardiogram can show the veterinarian any inflammation that may be present as a result of the
infection and show how the heart is functioning. As blood cultures are only positive in 50 to 90
percent of cases, the ECG is the most important diagnostic tool in heart valve infection cases. An
electrocardiogram (EKG) may also be done. An EKG shows the electrical activity in the heart and
can show any skipped heart beats or palpitations that are occurring.
Treatment of Heart Valve Infection in Cats
Fluid Therapy
Cats who have been diagnosed with infective endocarditis will need to be hospitalized for treatment.
Fluids will be administered intravenously to prevent dehydration and ensure that the other organs
have the fluids necessary to function properly. The veterinarian will monitor the fluid's effect on the
other organs, such as the kidneys and lungs, if the heart isn't pumping properly.
Antibiotic Therapy
Antibiotics will need to be given for approximately 12 weeks in order to clear the underlying
infection that caused the infective endocarditis. A generalized antibiotic will be given until the blood
culture has identified the infectious organism and the proper antibiotic to treat

Microbial Synergy
Microbial synergy increases the net pathogenic effect and wound infections severity, which show a
correlation between microflora of the gut, skin or oral cavity and pathogens infect wounds (Bowler
et al., 2001). Staphylococcus aureus is a commensal gram–positive cocci that considered as a
leading cause of wound infections and a potential cause of life–threating infections as sepsis,
endocarditis, toxic–shock syndrome, osteomyelitis and pneumonia (Breathnach, 2013). It is an
opportunistic pathogens possess many virulence factors, including formation of biofilm that resist
host immunity (Foster et al., 2014). Methicillin–resistant S. aureus has a gene known as mecA
responsible for resistance to methicillin which revealed high prevalence of infections lately ... Show
more content on Helpwriting.net ...
aeruginosa is one of the most common isolated strains exhibited natural resistance to antibiotics, in
addition to its ability to develop resistance to further drugs (Yezli et al., 2014). A gram–negative
Escherichia coli colonizes the gastrointestinal tract of human as normal flora and some of them
acquired a virulence features that confers their ability to cause infections (Croxen et al., 2013). It is a
major cause of urinary tract, enteric diarrhoea and systemic infections as bacteraemia, cellulitis,
nosocomial pneumonia, infectious arthritis, peritonitis and the leading cause of neonatal meningitis
(Pitout, 2012). Recently, E. coli has a global dissemination as one of the most predominant isolates
with resistance to β– lactam and other antibiotics (Yezli et al., 2015). Enterococcus species are
gram–positive cocci spread in an intestinal tract, airways, skin and other mucosal surfaces that the
most important species are E. faecalis and E. faecium (Savini et al., 2012). Enterococci become one
of the infection sources acquired in hospitals that cause urinary tract infections, bacteraemia,
endocarditis, wound infections, meningitis as well as intraabdominal and pelvic infections (Agudelo
Higuita and Huycke,

Vasculitis Research Paper
Vasculitis is a condition where the blood vessels this condition is caused when the body's immune
system attacks the blood vessels by mistake. This can be caused as a result of infection, medicine or
another disease or condition. Inflammation is the body's response to injury, the inflammation of
blood vessels can cause pin, swelling and loss of function to affected tissues, National Heart, Lung,
and Blood Institute http://www.nhlbi.org July 16, 2014. Vasculitis can be chronic or acute. Meaning
that it could be something that last long term or it could affect a person short term. On another note,
an angiospasm is defined by Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier, as a sudden
construction of blood vessels; Which is similar ... Show more content on Helpwriting.net ...
As a result of cardiomyopathy a person might get, congestive heart failure is a very chronic
condition at which the heart doesn't pump blood as well as it should. Coronary artery disease is also
called atherosclerotic heart disease. CAD is damage or disease of the heart, fatty deposits build in
the arteries and block the bloods flow, www.mayoclinc.com. Endocardium is the smooth membrane
that lines the inside of the chambers of the heart and it also forms the surface of the heart valves.
Endocarditis is the inflammation of that smooth thin membrane. Endocarditis happens when bacteria
from other parts of the body, spread to the blood stream. Endocarditis can do major damage to the
areas of heart if it's left untreated, Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The
McGraw–Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.asp. Unlike the rest
of these diseases cardiomegaly is a symptoms of another condition. Cardiomegaly is decribed by
mosbys medical dictionary, as the enlargement of the heart. An aneurysm is described as the
ballooning and weakened area in an artery. It happens when part of a blood vessel swells. A
aneurysm can be present at birth but most often they just happen. Atheroma is, the degeneration of
the walls of the arteries caused by accumulated fatty deposits and scar tissue. Periodontics is the
branch of dentistry

Essay On Infective Endocarditis
National statistics of maintaining a lifestyle of poor diet, little exercise, and frequent drug use are
steadily climbing. Increases in lipid and cholesterol intake, as well as decreases in regular physical
activity is causing an increase in obesity and disease with widely known effects. 1 These behaviors
are deeply rooted in the cause of heart diseases. It has been shown through animal testing that a high
lipid, calcium, and carbohydrate increases the incidence of aortic valve hardening, thickening, and
lipidemic lesion formation. 2 Obesity is alarmingly prevalent in children at or below the age of five.
In fact, the World Health Organization (WHO) approximates that 18 million children in this age
group are overweight with high risk of becoming ... Show more content on Helpwriting.net ...
Infective endocarditis is an infection of microorganisms, whether it be bacterial or viral, which form
colonies within the endothelial lining of the heart tissue. This initiates an immune response that
causes the infected sites to grow. Figure 1 8 shows vegetations on the aortic valve which prevent it
from functioning properly. Without the ability to fully seal during diastole, blood is pulled back
through the aortic valve from the aorta. This disrupts the pressure in the left ventricle in such a way
that creates unnecessary stress on the muscle. Infective endocarditis that is present on the right side
of the heart (including the aortic valve) is of highest incidence within the population of recreational
intravenous drug users at 46% – 78% of reported cases. 9 The risk of infective endocarditis causing
vegetation on and around the aortic valve increases after valve replacement surgery. A study done in
Australia observed 2443 aortic valve replacement surgeries, taking into consideration their pre–and–
post–operation condition. Of said patients, 3.7% developed infective endocarditis. All valve
prostheses were either of allograft (human), xenograft (porcine, bovine, or equine), or mechanical
design (composite synthetics), the xenograft being the most popular.

Patient Teaching Pl Bacterial Endocarditis
Patient Teaching Plan: Bacterial Endocarditis second to Genetic Autoimmune Deficiency 0244186
Technical College of the Lowcountry Introduction Nurses have many jobs and one of those jobs is
being an educator to their patients. Through patient teaching nurse's assistance patients and their
families in developing and maintaining a healthy lifestyle plan. As nurses it is our responsibility to
educate our patients and their families about their health issues, treatment plans, medications, and
when to seek medical attention. Effective patient teaching plays a huge role in the health outcomes
of patients and their safety. Nurses spend the most time with patients, they assess and see the "whole
picture," which helps them form a plan of care for each individual patient. Nurses see firsthand what
patients need, such as home health, assistive devices, help with medication expenses, transportation,
and any other resources a patient may need to be able to maintain effective health behaviors. As a
result of effective health teaching to patients, it cuts down on readmissions to the hospital, which in
turn helps lower the cost for hospitals and overall health care. Client Background J.F is a fifty–year–
old married homemaker. She suffers from recurrent bacterial endocarditis secondary to a genetic
autoimmune deficiency. In the last six–teen months she has been hospitalized twice, once for
Staphylococcus Aureus infection in the mitral valve and then for Streptococcus Mutans

NICE Review Essay
Impact of the NICE guideline recommending cessation of antibiotic prophylaxis for prevention of
infective endocarditis: before and after study: A Review Thornhill et al.'s article on the cessation of
antibiotic prophylaxis and its impact on infective endocarditis examined, both, prescriptions for
antibiotics of a standard premedication dose (3g amoxicillin or 600mg clindamycin) and diagnoses
or deaths due to infective endocarditis between January 2000 and April 2010. The time frame
chosen for this study was critical due to the release of updated NICE guidelines, stating providers
should cease use of any antibiotic prophylaxis for dental and other medical procedures. By
examining the time surrounding the NICE guidelines, the researchers hoped to evaluate any
relationship between premedicative prescriptions and incidents of infective endocarditis. They
hypothesized that in order to see evidence that the NICE guidelines were valid, there would be
minimal to no change in rate of infective endocarditis after the NICE guidelines became effective
compared to before, even though the amount of prescription decreased. The researchers felt that this
study was necessary due to the limited large–scale studies relating to recent changes in ... Show
more content on Helpwriting.net ...
The two most significant weakness related to the lack of specificity in etiological origin of the
endocarditis, and an expanded discussion in relevance of results. The researchers explained that due
to gathering their data from hospitals there was often a lack in specificity of microorganism
identification in the codes submitted. More importantly, the researchers largely discussed the
limitations in their study, rather than discussing the uses and significance of the article. While it is
good to identify possible sources of error, the researchers overly focused on this, decreasing the
confidence for readers in their

Research Paper On Pericardiitis
Two cardiovascular conditions that are rare is Pericarditis and acute/ subacute bacterial endocarditis.
Pericarditis is the inflammation of the pericardium (two thin layers of the sac like that encloses the
heart or the myocardium). Within this sac, there is small amount of fluid, that keeps the layers apart,
therefore no friction occurs between them, as the heart pumps blood to body. This condition can
occur secondary to a heart attack (MI), a condition name Dressler's syndrome, or following a
coronary artery surgery. Furthermore, it is also commonly seen in patients with connective tissue
disorders such as Rheumatoid arthritis(RA), Systemic Lupus Erythematosus(SLE), scleroderma, and
sarcoidosis. Other possible factors, that can be attributed ... Show more content on Helpwriting.net
...
Symptoms are apparent when there is 50–70% of coronary artery blockage, which decrease the
oxygenated blood supply to heart. When patients complaint of chest pain, others symptoms may be
also present, this include shortness of breath, pain that radiates to left arm and in some cases to the
jaw, like seen in elder women. Furthermore, patients may experience nausea, vomiting, and
diaphoresis(Goolsby, Grubbs, & Goolsby,

Orthostatic Hypotension Case Study Essay
Case Study
Julia Atungsiri
Purdue University Global
Case study
1. What is the significance of the orthostatic hypotension, tachycardia, abdominal tenderness,
hematuria, joint pain, and petechiae? What is splinter hemorrhages and what is their significance?
Orthostatic hypotension is the reduction of the systolic pressure of at least 20mmHG or the dropping
of diastolic pressure of at least 10mmHg within three minutes of standing as compared to baseline as
such, the body is often unable compensate for the changes in the blood pressure values (Fournier et
al., 2016). The fall in the blood pressure is attributes to the fact that a small amount of blood collects
in the leg veins when a person stands as a result of gravity hence reducing ... Show more content on
Helpwriting.net ...
What are the major causes of infections?
References
Baddour, L. M., Wilson, W. R., Bayer, A. S., Fowler, V. G., Tleyjeh, I. M., Rybak, M. J., ... &
Bolger, A. F. (2015). Infective endocarditis in adults: diagnosis, antimicrobial therapy, and
management of complications: a scientific statement for healthcare professionals from the American
Heart Association. Circulation, 132(15), 1435–1486.
Fournier, P. E., Watt, G., Newton, P. N., Lamas, C. C., Tattevin, P., & Raoult, D. (2016). Blood
culture–negative endocarditis. In Infective Endocarditis (pp. 245–258). Springer, Cham.
Morton, P. G., Fontaine, D., Hudak, C. M., & Gallo, B. M. (2017). Critical care nursing: a holistic
approach (p. 1056). Lippincott Williams & Wilkins.
Pettersson, G. B., Coselli, J. S., Hussain, S. T., Griffin, B., Blackstone, E. H., Gordon, S. M., ... &
Woc–Colburn, L. E. (2017). 2016 The American Association for Thoracic Surgery (AATS)
consensus guidelines: surgical treatment of infective endocarditis: executive summary. The Journal
of Thoracic and Cardiovascular Surgery, 153(6), 1241–1258.
Thuny, F. (2016). Diagnostic Criteria for Infective Endocarditis. In Infective Endocarditis (pp. 81–
86). Springer,

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