Endocarditis is an infection of the inner lining of the heart that is usually caused by bacteria entering the bloodstream from another part of the body. It most commonly affects the heart valves. If not treated quickly, it can damage or destroy heart valves. It is diagnosed using the Duke criteria and treated with antibiotics or surgery to replace damaged valves. Nursing care focuses on pain management, preventing complications, administering medications correctly, and preventing infection. Complications can include heart problems, stroke, abscesses, and kidney damage.
this is a infectious condition of bone and for b.bsc. and gnm students for their refrence for the care of patients in bone disorder this topic includes its definition, etiology, pathophysiology, clinical menistification, diagnostic evaluation and its management
Gastrointestinal bleeding (GI bleed), also known as gastrointestinal hemorrhage, is all forms of bleeding in the gastrointestinal tract, from the mouth to the rectum. When there is significant blood loss over a short time, symptoms may include vomiting red blood, vomiting black blood, bloody stool, or black stool.
this is a infectious condition of bone and for b.bsc. and gnm students for their refrence for the care of patients in bone disorder this topic includes its definition, etiology, pathophysiology, clinical menistification, diagnostic evaluation and its management
Gastrointestinal bleeding (GI bleed), also known as gastrointestinal hemorrhage, is all forms of bleeding in the gastrointestinal tract, from the mouth to the rectum. When there is significant blood loss over a short time, symptoms may include vomiting red blood, vomiting black blood, bloody stool, or black stool.
Trends and issues in medical surgical nursing pptseema dhiman
current trends and issues in medical surgical nursing is quite important on the basis of improvement of care based on new technologies and situation.
Trends and issues in medical-surgical nursing
What do you mean by issues?
What do you mean by trends?
INTRODUCTION- Nursing has been called the oldest of the art, and the youngest of the profession. As such, it has gone through many stages and has been an integral part of social movements. Nursing has been involved in in the existing culture, shaped by it and yet beeping to develop it. The trend analysis and future scenarios provide a basis for sound decision making through mapping of possible futures and aiming to create preferred futures.
The world health organization (who) has been considering the future and predicts that by 2000 the world experiences:
Major growth in the elderly population
Decline in birth rate, especially in western counteries
Increase in chronic illness
Continuing social unrest
AIDS a major problem
Many infectious diseases under control
Mental health a key issue
Poverty continuing to plague mach of the world
TRENDS IN NURSING: Education changes due to changes in demographics
2. Embracing of technology
3. Advancements in communication and technology
4. Working with more educated consumers
5. Increasing complexity of patient care
. Increased cost of health care
7. Changes in federal and state regulation
8. Interdisciplinary skills
9. Nurses working beyond retirement age
10. Advances in nursing and science research.
TRANSITIONS TAKING PLACE IN HEALTH CARE: Curative - Preventive approach
Specialized care - Primary health care
Medical diagnosis - Patient emphasis
Discipline stovepipes - Programme stovepipes
Professional identity - Team identity
Trial and error - Evidence based practice
Self – regulation - Questioning of professions
Focus on quality - Focus on costs
IN THE WORKPLACE: High tech - Humanistic
Competition - Cooperation
Need to supervise - Caching, mentoring
Hierarchies - Decentralized approach
IN NURSING: Continued competencies - Competencies a condition
Hospital environment - Community environment
Quality as excellence - Quality as safe
Clear role - Blurring roles
Precise guide for DGNM, B.Sc Nursing & M.Sc Nursing Students .. regarding Bowel Incontinence / Fecal Incontinence, and its management. Highly recommended for II B.Sc Nursing Students
Arteriosclerosis is the most common disease of the arteries; the term means “hardening of the arteries”.
It is the diffuse process whereby the muscle fibers and the endothelial lining of the walls of small arteries and arterioles become thickened.
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism.
Infective endocarditis is an infection of the valves and endothelial surface of the heart. Endocarditis usually develops in people with cardiac structural defects (eg, valve disorders).
Trends and issues in medical surgical nursing pptseema dhiman
current trends and issues in medical surgical nursing is quite important on the basis of improvement of care based on new technologies and situation.
Trends and issues in medical-surgical nursing
What do you mean by issues?
What do you mean by trends?
INTRODUCTION- Nursing has been called the oldest of the art, and the youngest of the profession. As such, it has gone through many stages and has been an integral part of social movements. Nursing has been involved in in the existing culture, shaped by it and yet beeping to develop it. The trend analysis and future scenarios provide a basis for sound decision making through mapping of possible futures and aiming to create preferred futures.
The world health organization (who) has been considering the future and predicts that by 2000 the world experiences:
Major growth in the elderly population
Decline in birth rate, especially in western counteries
Increase in chronic illness
Continuing social unrest
AIDS a major problem
Many infectious diseases under control
Mental health a key issue
Poverty continuing to plague mach of the world
TRENDS IN NURSING: Education changes due to changes in demographics
2. Embracing of technology
3. Advancements in communication and technology
4. Working with more educated consumers
5. Increasing complexity of patient care
. Increased cost of health care
7. Changes in federal and state regulation
8. Interdisciplinary skills
9. Nurses working beyond retirement age
10. Advances in nursing and science research.
TRANSITIONS TAKING PLACE IN HEALTH CARE: Curative - Preventive approach
Specialized care - Primary health care
Medical diagnosis - Patient emphasis
Discipline stovepipes - Programme stovepipes
Professional identity - Team identity
Trial and error - Evidence based practice
Self – regulation - Questioning of professions
Focus on quality - Focus on costs
IN THE WORKPLACE: High tech - Humanistic
Competition - Cooperation
Need to supervise - Caching, mentoring
Hierarchies - Decentralized approach
IN NURSING: Continued competencies - Competencies a condition
Hospital environment - Community environment
Quality as excellence - Quality as safe
Clear role - Blurring roles
Precise guide for DGNM, B.Sc Nursing & M.Sc Nursing Students .. regarding Bowel Incontinence / Fecal Incontinence, and its management. Highly recommended for II B.Sc Nursing Students
Arteriosclerosis is the most common disease of the arteries; the term means “hardening of the arteries”.
It is the diffuse process whereby the muscle fibers and the endothelial lining of the walls of small arteries and arterioles become thickened.
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism.
Infective endocarditis is an infection of the valves and endothelial surface of the heart. Endocarditis usually develops in people with cardiac structural defects (eg, valve disorders).
The inflammation of the heart muscles, such as myocarditis, the membrane sac which surrounds the heart called as pericarditis, and the inner lining of the heart or the myocardium, heart muscle as endocarditis are known as the inflammatory heart diseases.
Rheumatic fever is an inflammatory disease that can develop when strep throat or scarlet fever isn't properly treated , it can caused rheumatic heart disease . Strep throat and scarlet fever are caused by an infection with group A beta hemolytic streptococcus bacteria.
UNIT 5.2 PHYSIOLOGICAL CONCEPTS AND PHYSICAL CHARACTERISTICS: Estrogens replacement therapy is commenced on the basis of dependent or previously estrogen sensitive women.
Low dose estrogens for short period to improve metabolic state. Estrogens therapy relieves unpleasant symptoms such as hot flashes and vaginal dryness and also appeared to protect against postmenopausal conditions such as osteoporosis and heart disease
A wound is a break or cut in the continuity of any body structure, internal or external caused by physical means.
A wound is a type of injury which happens relatively quickly in which skin is torn, cut, or punctured (an open wound), or where blunt force trauma causes a contusion (a closed wound).
“Trauma” = Injury of one or more systems,that results in excessive bleeding and mayaffect the normal body functioning.
Defined as cellular disruption caused by anexchange with environmental energy that isbeyond the body's resilience.
Substance abuse can be defined as using a drug in a way that is inconsistent with medical or social norms and despite negative consequences.
Substance abuse denotes problem in social vocational, or legal area of the person’s life
Substance abuse refers to the harmful or hazardous use of psychoactive substances , including alcohol and illicit drugs.
Poisoning is injury or death due to swallowing, inhalation, touching or injecting various drugs, chemical, venoms or gases.
Many substances such as drugs, carbon monoxide, food poisoning, organo-phosphorus are poison.
Poisoning can be an accident or a planned action.
Organophosphate poisoning is poisoning due to organophosphates (OPs). Organophosphates are used as insecticides, medications, and nerve agents.
Symptoms include increased saliva and tear production, diarrhea, vomiting, small pupils, sweating, muscle tremors, and confusion.
Other names: Organophosphate toxicity
Causes: organophosphates
Hypovolemic shock is a life-threatening emergency in which severe blood or other fluid loss makes the heart unable to pump enough blood to the body. This type of shock can cause many organs to stop working.
Hypovolemic shock is a dangerous condition that happens when suddenly lose a lot of blood or fluids from body. This drops blood volume, the amount of blood circulating in body. That’s why it’s also known as low-volume shock.
Heat stroke a core temperature ≥40°C accompanied by CNS dysfunction in patients with environmental heat exposure. This condition represents a failure of the body's ability to maintain thermoregulatory homeostasis.
Hemorrhage is the loss of blood escaping from the circulatory system.
Bleeding can occur internally, where blood leaks from blood vessels inside the body, or externally either through a natural opening such as mouth, nose, ear, urethra or anus or through a break in the skin.
Uncontrolled bleeding can rapidly lead to shock and death.
Excessive or uncontrollable bleeding, often caused by trauma, surgical or obstetrical complications, or the advanced stages of certain illnesses such as cirrhosis and peptic ulcer disease.
An airway obstruction is a blockage in any part of the airway.
The airway is a complex system of tubes that conveys inhaled air from nose and mouth into the lungs.
An obstruction may partially or totally prevent air from getting into lungs.
Acute upper airway obstruction is a life-threatening medical emergency.
Emergency nursing is a nursing specialty in which nurses care for patients in the emergency or critical phase of their illness or injury.
While this is common to many nursing specialties, the key difference is that an emergency nurse is skilled at dealing with people in the phase when a diagnosis has not yet been made and the cause of the problem is not known.
Traction is the application of a pulling force to a part of the body.
It is used primarily as a short term interventions.
Traction produces physical &
emotional frustration.
Rheumatoid arthritis (RA) facts
Rheumatoid arthritis is an autoimmune disease that can cause chronic inflammation of the joints and other areas of the body.
It can affect people of all ages.
The cause of rheumatoid arthritis is not known.
In rheumatoid arthritis, multiple joints are usually, affected in a symmetrical pattern.
Paget disease is a chronic bone disorder that typically results in enlarged, deformed bones due to excessive breakdown and formation of bone tissue that can cause bones to weaken and may result in bone pain, arthritis deformities or fractures.
Osteoporosis is a chronic, progressive disease of multifactorial etiology.
It is most frequently recognized in particularly in elderly people and does occur in sexes, all races, and all age groups.
Osteoporosis is a preventable disease that can result in disturbing physical, psychosocial, and economic consequences.
Osteoporosis is a systemic skeletal disease characterized by low bone mass and micro architectural deterioration of bone tissue.
The root words osteon (bone) and myelo (marrow) are combined with itis (inflammation) to define the clinical state in which bone is infected with microorganisms.
Osteomyelitis is an inflammation of bone caused by an infecting organism.
Cancer is a disease of the cells in the body. The body is made up from millions of tiny cells. There are several types of oral cancers, but around 90% are squamous cell carcinomas originating in the tissues that line the mouth and lips.
Oral or mouth cancer most commonly involves the tongue.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
4. ENDOCARDITIS
Endocarditis is a rare and potentially fatal infection
of the inner lining of the heart (the endocardium)
most often involving the valves . It's most commonly
caused by bacteria entering the blood and travelling
to the heart
5. If it's not treated quickly, endocarditis can damage
or destroy heart valves.
Endocarditis is usually caused by an infection.
Bacteria, fungi or other germs from another part of
our body, such as mouth, spread through your
bloodstream and attach to damaged areas in heart.
6.
7. INCIDENTS
Infective endocarditis (IE) is a relatively rare
disorder with an estimated incidence of 3–10 cases
per 100 000 per year. Despite diagnostic and
therapeutic advances, prognosis remains poor, as
reflected by hospital mortality of about 22%, rising
to 40% at 5 years. Morbidity rates are also high;
50% of patients require operative management in
the acute phase of the disease, often with ongoing
consequences for quality of life.
8. RISK FACTOR
Previous heart damage
Dental procedure which leads into the introduction
of bacteria's
Heart surgery
Intubation
Procedure involving gastro intestinal and
genitourinary tracts egg . Barium enema,
sigmoidoscopy, catherization and cystoscopy .
9. CAUSES
a. Organism
Bacteria's e.g. Streptococci, Staphylococci,
Enterococci
Fungus e.g. candida, aspergillus
Gram negative organism pseudomonas
b. Cardiac pathological condition:
Rheumatic valvular disease
Acute rheumatic fever
Congenital heart disease
Cardiac surgery
10. CONT…
c. Intrusive procedures:
Dental procedure
Minor surgery
Insertion of indwelling catheter
Vaginal Operation/surgery
d. Immunosuppression related to:
Diabetes
Burns
Cancer
Hepatitis
14. MORE SPECIFIC SIGN
Osler's nodes: painful red nodes on palm of
fingers and toes, usually late sign of endocardial
infection.
Janeway's lesion-light pink macules on palms or
sole, non tender or fade in 1 or 2 weeks: usually an
early sign of endocardial infection
15.
16. DIAGNOSIS ( DUKE CRITERIA )
The Duke criteria are a set of clinical criteria set
forward for the diagnosis of infective endocarditis
For diagnosis the requirement is:
• 2 major and 1 minor criterion or
• 1 major and 3 minor criteria or
• 5 minor criteria
17. Major criteria
• positive blood cultures for infective endocarditis
• typical microorganism for infective endocarditis
from 2 separate blood cultures
• Viridans streptococci, Streptococcus bovis, and
HACEK group or
• community-acquired Staphylococcus
aureus or enterococci in the absence of a
primary focus or
• persistently positive blood cultures, defined as
recovery of a microorganism consistent with
infective endocarditis from:
18. evidence of endocardial involvement
positive echocardiogram for infective endocarditis
oscillating intracardiac mass on valve or supporting
structures or in the path of regurgitant jets or on
implanted material in the absence of an alternative
anatomical explanation or
abscess or
new partial dehiscence of prosthetic valve or
new valvular regurgitation
19. Minor criteria
• predisposing heart condition or intravenous drug
• fever: 38°C
• vascular phenomena: major arterial emboli, septic
pulmonary infarcts, mycotic aneurysm, intracranial
haemorrhage, conjunctival haemorrhages, and
Janeway lesions
21. MEDICAL MANAGEMENT
Antibiotic Prophylaxis for Patients with Previous
Infectious Endocarditis Undergoing Dental or
Other Procedures
Amoxicillin (adults: 2 g; children: 50 mg per kg) taken orally
one hour before procedure
If Unable to take oral medication, Ampicillin (adults: 2 g;
children: 50 mg per kg) IM or IV within 30 minutes of procedure
Penicillin allergy and unable to take oral medications,
Clindamycin (adults: 600 mg; children: 20 mg per kg) IV within
30 minutes of procedure
22. CONT..
Penicillin-susceptible viridans Streptococcus or Streptococcus
bovis;
Penicillin G or ceftriaxone (Rocephin) for four weeks or
Penicillin G plus gentamicin for two weeks or
Ceftriaxone plus gentamicin for two weeks or
Vancomycin for four weeks
23. CONT..
penicillin-resistant viridans Streptococcus or S. bovis ;
Penicillin G or ceftriaxone for four weeks, plus gentamicin for
two weeks or
Vancomycin for four weeks or
24. CONT..
Analgesic to reduce pain
Antipyretic to reduce fever
Appropriative antibiotic therapy for long time
depending on the infective organisms
Digoxin I/V or oral in the case of congestive
cardiac failure
Diuretic in the case of right sided heart failure
25. CONT..
Rest in comfortable position
Steroid of reduction of inflammation in the heart.
Anticoagulant therapy
low salt diet
27. NURSING MANAGEMENT
Nursing assessment :
It includes history taking like ;
Subjective Data
Past medical history ; asked for sign of the
disease and the onset of the disease and review
with patients history of risk factor like cardiac failure
, shock
Medication history
Family history
Social history
Surgical history
28. Objective data
Assess for temperature elevation , heart murmur,
evidence of cough, peripheral edema an embolism,
, auscultate for heart sound dyspnea, restlessness,
and manifestation of heart failure .
29. NURSING DIAGNOSIS
Ineffective breathing pattern related to inflammation
of heart muscles as evidenced by use of accessory
muscle , dyspnea
Impaired gas 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
Impaired physical mobility related to fatigue
Altered thermoregulation related to infection as
evidenced by increased body temperature
30. NURSING MANAGEMENT
1. Pain and comfort management
Complete bed rest to reduce oxygen demand
Place the patient in upright position to relieve dyspnea
and chest pain.
Provide analgesics to relieve pain and oxygen to
prevent tissue hypoxia.
Assess the patient’s cardiovascular status frequently.
Monitor the patient’s pain level and the effectiveness of
analgesics
Limiting activities
Providing calm and quiet environment
Offering support to reduce anxiety.
31. CONT..
2. Administering medications & IV fluids:
Monitor vitals before and after administering
medications & IV fluids.
Give drugs as indicated (Aspirin, Steroids).
Give antipyretic drug if fever present.
Administer prescribed medications & fluids
accurately (Follow10 Rights).
Assess IV infusion site for bleeding or any allergic
response.
32. CONT...
3. Prevent complication
Check vital sign and record it carefully.
Carefully monitor intake output.
Closely monitor sign for cardiac tamponade
4. Nutrition
Ensure high protein, high carbohydrate,
Low sodium diet.
Serve attractive meals that stimulate appetite
33. CONT..
6. Prevent infection
Apply infection prevention measures such as
hand washing, linen changes and sterility
during procedures.
Encourage short stay to prevent nosocomial
infections
Maintain skin and mucosal integrity:
Provide primary care such as bathing, frequent
nappy changes, mouthcare.
Use a soft toothbrush to prevent gum mucosal
breakdown.
34. COMPLICATION
• Heart problems, such as heart murmur, heart valve
damage and heart failure
• Stroke
• Pockets of collected pus (abscesses) that develop
in the heart, brain, lungs and other organs
• pulmonary embolism
• Kidney damage
• Enlarged spleen
35.
36. REFERENCE
MandalG.N.,“Text book of adult nursing” Makalu
publication house (P) Ltd, Dili bazar, Kathmandu
R.N. Wilma J. phipps “Shafer’s Medical Surgical
Nursing”B.I. Publications PVT LTD, New Delhi
Datta BN, (1992). “Text book of Pathology” 2nd
edition, Jaypee brothers (p). Ltd, New Delhi
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