Group two will present on pericarditis. They will define pericarditis, explain its etiology and pathophysiology, identify clinical manifestations, diagnostic studies, nursing assessment and management. They will also discuss medical/surgical management and complications. The presentation aims to provide knowledge on managing pericarditis.

1.  GROUP TWO PRESENTATION
 GROUP MEMBERS
 VIOLET GONDWE
 MARTHA JERE
 TITIOUS CHILUDZI
 RUTH DZIWANI
 MAUREEN GOURGE
 DOROTHY MWANGALIKA

2.  PERICADITIS
 BROAD OBJECTIVES
 By the end of this presentation, student nurses should be able to
acquire knowledge and skills on managing pericarditis.
 SPECIFIC OBJECTIVES
 Define pericarditis
 Explain etiology and pathophysiology
 Name the clinical manifestation of pericarditis
 Its diagnostic evaluation studies
 Nursing assessment and diagnosis
 Nursing management
 Medical surgical management and know its complications

3.  DEFINITION
 Pericaditis refers to an inflammation of a visceral or pericardium
which is a membranous sac enveloping the heart (Phillip (2010)
medical surgical nursing .

4.  Pericaditis can be acute or chronic. Acute pericarditis occurs due to
complications of infections, immunological conditions or even as a
result of heart attack.
 Chronic pericarditis is however less common a form of constrictive
pericarditis. It can also be a primary illness which develop as a
result of medical and surgical disorders

5.  ETIOLOGY
 Chemotherapy
 Radiation therapy
 Trauma and surgical interventions
 Infections e.g bacteria fungal and viral
 Renal failure
 Tuberculosis
 Disorders of connective tissue

6.  PATHOPHYSIOLOGY
ACUTE
In acute pericarditis when microbes are inhaled or ingested, they
migrate to myocardium and cause inflammation. So when these
membranes are inflamed, they rub against each other and cause
classic sounds of which the patient complains of severe chest pains
which increases when the patient lies supine and decreases when in
sitting position.
This acute inflammation causes accumulation of fluid in the pericardial
sac called pericardial effusion. The fluid may be serus which
accompanies heart failure, purulent accompanying tuberculosis and
haemorrhage accompanying trauma in the heart.

7.  Patho acute cont’ed
 The excessive accumulation of fluid in the sac causes compression
of the heart, resulting in decrease venous retain of the heart
resulting in ventricular filling and a decrease in stroke volume.
These events will eventuary lead to cardiac failure, shock and death.

8. CHRONIC
Chronic pericarditis occurs when the layers adhere to each other
causing fibrosis of the pericardial sac due to surgery which later
restrict movement of the heart. So the fibrosis pericardium tightens
the heart decreasing cardiac filling and output and later patient may
report symptoms of heart failure.

9.  CLINICAL MANIFESTATION
Sharp chest pain with a rapid onset that worsens when an individual
breaths, coughs and changes position
Mild fever of 37.5 to 38 degrees Celsius
Anaemia
Chest pain
Chills
Night sweats

10.  DIAGNOSTIC EVALUATIN STUDIES
 ECG which detect inflammation, pericardial effusion and heart
failure
 CT scan to determine location of pericardial effusion
 Biopsy of pericardium to obtain tissue sample for culture and
microscopic examination

11.  NURSING ASSESMENT
 Physical assessment to obtain the base line data
 Vital signs
 Assess patient in various positions in order to detect pain whether it
is influenced by respiratory movements, coughing and swallowing

12.  NURSING DIAGNOSIS
 Ineffective breathing pattern related to chest pain
 Altered thermoregulation , hyperthermia, related to infection and
inflammation as evidenced by temp of 37.5 to 38 degrees Celsius
 Altered comfort pain related to inflammation of the pericardium
 Risk for cardiogenic shock related to decreased cardiac output
 Ineffective tissue perfusion related to decrease blood flow
 Anxiety related to therapeutic interventions and uncertainty of
prognosis.

13.  NURSING MANAGEMENT
 Explain every procedure to the patient in order to get consent,
cooperation and array anxiety.
 Position patient in semi fowlers to relieve pain and allow expansion
of chest for effective breathing
 Explain the pathophysiology to the patient
 Encourage gradual increase activity
 Monitor vital signs closely to detect infections

14.  MEDICAL MANAGEMENT
 Administer analgesics, paracetamol 1g orally 6hrly for pain relief
 Indocid to decrease coronary blood flow
 Drainage of pericardial fluid
 Aspirin as 300mg orally 6hrly as an antiflammation

15.  COMPLICATION
 Pericarditis progresses to heart failure
 Peripheral oedema
 Increase systemic venous pressure

16.  REFERENCES
 Smeltzer S.C, Bare B.G. & Hinke J.L (1999). Brunner & Suddarth’s
textbook of medical surgical nursing. (9th E.D). Philadelphia: J.B.
Lippincott
 Linton A.D (2007) Introduction to medical – surgical nursing. (4th ed)
Saunders Elsevier.