Nursing Rules!


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Nursing Rules!

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