AH III Exam 2 - Infectious heart & valve disorders

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Last updated 7:56 PM on 10/11/26
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28 Terms

1
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Assessment finding of infective endocarditis (4)

  • Osler’s nodes

  • Janeway lesions

  • Splinter hemorrhage

  • Murmur


<ul><li><p>Osler’s nodes</p></li><li><p>Janeway lesions </p></li><li><p>Splinter hemorrhage </p></li><li><p>Murmur</p></li></ul><p></p>
2
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What are osler’s nodes (infective endocarditis)

Red, painful lesions in pads of fingers & toes

<p>Red, painful lesions in pads of fingers &amp; toes</p>
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What are janeway lesions? (infective endocarditis)

Red, painless spots on the palms & soles

4
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What are splinter hemorrhages (infective endocarditis)

Tiny blood clots that run vertically under nails

<p>Tiny blood clots that run vertically under nails</p>
5
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Diagnostic testing for infective endocarditis (3)

  • Blood cultures

  • Echo - TTE or TEE

  • Elevated WBC


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What is a TTE echo?

Transthoracic echo; classic echo

7
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What is a TEE echo?

Transesophageal echo → camera in esophagus to see the back side of the ❤ - invasive!!

<p>Transesophageal echo → camera in esophagus to see the back side of the <span data-name="heart" data-type="emoji">❤</span> - <span style="color: rgb(235, 10, 10);"><strong>invasive</strong></span>!!</p>
8
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Treatment for infective endocarditis (3)

  • IV abx

  • Need a PICC line!!

  • Treatment is 4-6 w


<ul><li><p>IV abx</p></li><li><p>Need a <span style="color: rgb(215, 14, 207);"><strong>PICC line</strong></span>!!</p></li><li><p>Treatment is 4-6 w </p></li></ul><p></p>
9
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Is surgery recommended for infective endocarditis?

NOOO!! - high risk!

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Complications of infective endocarditis (3)

  • ****Embolic events***** → vegetation breaks off

    • MAJOR complication

    • RS: PE (breathing issues - rare)

    • LS: TIA, stroke, kidney spleen, bowel & extremities

  • Heart failure

  • Dysrhythmia


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Nursing interventions for infective endocarditis (4)

  • Look for abnorm in assessment

  • Good oral hygiene

  • Prophylactic abx b4 dental work

  • Hx of drug use


<ul><li><p>Look for abnorm in assessment </p></li><li><p>Good oral hygiene </p></li><li><p>Prophylactic abx b4 dental work</p></li><li><p>Hx of drug use</p></li></ul><p></p>
12
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Assessment findings in Myocarditis (5)

  • Common in *young athletes*!!!

  • Chest pain

  • Dyspnea

  • Heart failure

  • Gen s/s


<ul><li><p>Common in <span style="color: rgb(67, 15, 228);"><strong>*<em>young athletes</em>*!!!</strong></span></p></li><li><p>Chest pain</p></li><li><p>Dyspnea</p></li><li><p>Heart failure</p></li><li><p>Gen s/s</p></li></ul><p></p>
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Diagnostic testing for Myocarditis (4)

  • Labs

    • Troponin, c-reactive protein, BNP (fluid vol overload)

  • ECG

  • Echo

  • MRI


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What is the definitive test for Myocarditis

Myocardial biopsy → RISKYY! Only if can't figure out cause

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Priority education for Myocarditis

Athletes need cardiac clearance b4 participating in sports!!!

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Treatment for Myocarditis

Treat their symptoms → no definitive tx :(

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Complications of Myocarditis (4)

  • Dilated cardiomyopathy → impacts EF; ❤ can’t pump blood through bod

  • HF

  • Dysrhythmias

  • Sudden cardiac death (young athletes)


<ul><li><p>Dilated cardiomyopathy → impacts EF; <span data-name="heart" data-type="emoji">❤</span> can’t pump blood through bod</p></li><li><p>HF</p></li><li><p>Dysrhythmias</p></li><li><p>Sudden cardiac death (young athletes) </p></li></ul><p></p>
18
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Pericarditis findings (3)

  • Pleuritic chest pain!!! → chest pain goes away when sit up + forward

  • Friction rub → scratchy sounds auscultated

  • Pericardial effusion


<ul><li><p>Pleuritic chest pain!!! → chest pain goes away when sit up + forward </p></li><li><p>Friction rub → scratchy sounds auscultated </p></li><li><p>Pericardial effusion </p></li></ul><p></p>
19
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ECG changes in pericarditis (HALLMARK)

ST-elevation across all 12-leads or PR depression

<p>ST-elevation across all 12-leads or PR depression</p>
20
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Diagnostic testing for pericarditis (4)

  • ECG

  • CXR → cardiomegaly may indicate pericardial effusion

  • Echo

  • Labs → serial cardiac biomarkers to rule out MI


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Priority nursing interventions for pericarditis (3)

  • Elevate hob!!!

  • Stop inflammation → ASA, NSAIDs

  • Help w pain


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Complications of pericarditis (2)

  • Pericardial effusion → fluid >60 mL

    • DX w CXR, echo, ECG

    • Tx: pericardiocentesis

  • Can L/T pericardial tamponade

    • Becks triad → JVD, muffled ❤ sounds, hypoten w narrowed pulse pressure


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What does pulsus paradoxus indicate w pericarditis

Cardiac tamponade!!!

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Teaching for pericarditis

Avoid strenuous activities

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What is stenosis?

Narrowed valve opening reduces blood flow

<p>Narrowed valve opening reduces blood flow </p>
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What can stenosis lead to?

Ventricular hypertrophy occurs to generate force to open valve, ventricle will fail & progress to HF

27
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What is regurgitation + s/s?

  • Valve leaflets doesn’t properly close, blood goes back to atrium

  • S/S of R or L heart failure develop


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What is prolapse? (3)

  • Valve flaps don’t close smoothly or eveningly

  • No tx, just monitor

  • Can progress to regurgitation


<ul><li><p><span style="color: rgb(234, 9, 9);">Valve flaps don’t close smoothly or eveningly</span></p></li><li><p>No tx, just monitor</p></li><li><p>Can progress to regurgitation</p></li></ul><p></p>