INFECTIVE ENDOCARDITIS + VALVUE DISEASE + HF

infective endocarditis pathophysiology

infection of the heart valve = usually bacterial, often related to dental or invasive procedures

infective endocarditis S/S

oslars nodes (hands), janeway lesions (palms), splinter hemorrhage (nail beds), MURMUR!, fever, fatigue, confusion

infective endocarditis precautions

good oral hygiene, prophylactic antibiotics before procedures, complete antibiotics

infective endocarditis treatment

IV antibiotic therapy

prophylaxis for procedures

an antibiotic given before a procedure to prevent infection - given to high risk heart condition patients

valve disease causes

regurgitation, left/right sided heart failure

valve disease S/S

murmur, SOB, crackles, angina, syncope, dysrhythmias, palpitations, fatigue, weight gain, edema, cool/pale extremities with weak pulses

valve disease treatment

(ACE inhibitors to dec. BP/HR, diuretics to dec. Pulmonary congestion), surgery (valve replacement/repair)

valve disease complications

HF, cardiogenic shock, thromboembolism, endocarditis, dysrhythmias

HF cause

insufficient blood supply/oxygen to tissues and organs (Involves diastolic or systolic disfunction)

HF risk factors

CAD, Hypertension, CM, metabolic syndrome, obesity, smoking, high sodium

HF S/S

fatigue, weight gain. Tachycardia. Hyper/hypotension. Murmurs, dyspnea, orthopnea, sleep apnea = FACES - fatigue, activity limitations, chest congestion/cough, edema, SOB

HF relevant lab

BNP levels, echocardiogram, ECG, chest Xray

backward/forward effects for L sided HF

most common = Inability of the Left ventricle to empty and fill heart - causes blood backup in pulmonary veins - causing pulmonary congestion and edema

backward/forward effects for R sided HF

RV fails to pump effectively, fluid builds up in Venous system - fluid goes to tissues and organs = Left sided hf can cause right sided HF

backward/forward effects for ventricular failure

low BP/CO and poor perfusion = RAAS system kicks in to help increase BP and SNS Activation - release of catecholamines (Epinephrine and norepinephrine) - inc. HR/BP, Vasoconstriction

HF treatment

Diuretics (dec. fluid volume overload), vasodilators, morphine, positive inotropes (Digoxin), beta blockers or surgical management

HF nursing care

oxygen, rest, exercise program,, daily weights, low sodium diet (DASH diet), sodium restrictions to 2 g/day, elevate HOB

HF diet

DASH diet = low sodium of 2g/day