Inflammatory and Structural Heart Disorders nursing traps

IE NCLEX red flag triad

Fever + new or worsening heart murmur + IV drug use = suspect infective endocarditis

Most common IE organism trap

Staphylococcus aureus causes ~50% of infective endocarditis cases

Subacute vs acute IE trap

Subacute = preexisting valve disease; Acute = healthy valves

HACEK organism trap

HACEK organisms are normal oropharyngeal flora but can cause IE

IV drug use trap

IV drug use increases risk for bacterial AND fungal infective endocarditis

Prosthetic valve trap

Prosthetic valves significantly increase IE risk

Dialysis patient trap

Renal dialysis patients are high risk for infective endocarditis

Intravascular device trap

Lines and catheters increase risk for MRSA-related IE

Bacteremia trap

Bacteria in bloodstream can adhere to endocardium and form vegetations

Vegetation definition trap

Vegetations are infected clots on heart valves

Embolization trap

Vegetations can break off and travel through circulation

Right-sided IE emboli trap

Right-sided emboli travel to the lungs

Left-sided IE emboli trap

Left-sided emboli travel to brain, kidneys, spleen, extremities

Stroke risk trap

Left-sided infective endocarditis increases stroke risk

Osler vs Janeway trap

Osler nodes are tender; Janeway lesions are non-tender

Petechiae trap

Petechiae are tiny, flat pink or red dots

Roth spots trap

Roth spots are retinal hemorrhages seen in IE

Subacute IE symptom trap

Clubbing of fingers suggests subacute infective endocarditis

Murmur trap

New or worsening systolic murmur is common in IE

Heart failure trap

Valve damage from IE can lead to heart failure

Inflammatory lab trap

ALL inflammatory heart conditions have elevated ESR and CRP

IE diagnosis trap

Duke Criteria are used to diagnose infective endocarditis

Blood culture trap

Blood cultures must be obtained before antibiotics when possible

Echocardiogram trap

Echo is used to visualize vegetations and valve damage

Antibiotic therapy trap

IE requires long-term IV antibiotics via PICC line

Repeat culture trap

Repeat blood cultures are needed to confirm treatment effectiveness

Surgical intervention trap

Valve replacement may be required if severe valve damage occurs

Prophylactic antibiotic trap

High-risk patients need antibiotics before dental or infected tissue procedures

Pericarditis complication trap

Pericarditis can lead to pericardial effusion and tamponade

Cardiac tamponade trap

Fluid accumulation compresses the heart and reduces cardiac output

Pulse pressure formula trap

Pulse pressure = systolic BP − diastolic BP

Pericarditis BP trap

Pericarditis causes a narrow pulse pressure

Myocarditis cause trap

Coxsackie A and B viruses are the most common cause

Myocarditis outcome trap

Myocarditis is a leading cause of heart transplant

Dilated cardiomyopathy trap

Myocarditis is linked to dilated cardiomyopathy

Rheumatic heart disease cause trap

Rheumatic heart disease results from untreated Strep A pharyngitis

Valve involvement trap

Mitral and aortic valves are most affected in rheumatic heart disease

Carditis trap

Rheumatic fever affecting the heart causes murmurs and heart failure

Joint manifestation trap

Rheumatic fever can cause monoarthritis or polyarthritis

CNS manifestation trap

Sydenham chorea indicates CNS involvement

Skin manifestation trap

Erythema marginatum and subcutaneous nodules indicate skin involvement

Rheumatic diagnosis trap

Modified Jones Criteria are used to diagnose rheumatic fever

History question trap

Always ask about recent sore throat in suspected rheumatic heart disease