S/S FOR PERICARDITIS

Overview of Pericarditis

  • Definition: Pericarditis is the inflammation of the pericardium, the fibrous sac surrounding the heart.

  • Complication: Constrictive pericarditis and pericardial effusion are complications associated with pericarditis.

Mnemonic for Signs and Symptoms of Pericarditis: "Friction"

F - Friction Rub

  • Definition: A pericardial friction rub is a sound heard through a stethoscope that occurs due to the rubbing of inflamed pericardial layers.

  • Description: It sounds like a harsh, grating noise similar to sandpaper sliding against one another.

F - Fever

  • Symptom: Patients may exhibit a fever alongside other symptoms of pericarditis.

R - Radiating Substernal Pain

  • Description: This pain can radiate from the chest to the left shoulder, neck, and back, resembling the pain experienced during a myocardial infarction (heart attack).

  • Patient perception: Patients may confuse this pain with that of a heart attack.

I - Increased Pain in Supine Position

  • Observation: Patients report increased chest pain when lying flat as opposed to sitting up or leaning forward.

  • Indication: This increased pain in the supine position distinguishes pericarditis from myocardial infarction.

C - Chest Pain

  • Hallmark symptom: Severe chest pain is a central sign of pericarditis.

T - Trouble Breathing When Lying Down

  • Symptom: Difficulty in breathing that is exacerbated in the supine position.

I - Increased Pain with Inspiration or Coughing

  • Mechanism: Pain intensifies during deep breathing or coughing due to the expansion of the lungs, which increases pressure on the inflamed pericardial layers.

O - Overall Feeling Sick and Weak

  • Patient experience: Patients describe a general feeling of malaise or unwellness associated with other symptoms.

N - Noticeable ST Segment Elevation on ECG

  • Observation: ST segment elevation is evident on an electrocardiogram (ECG) during pericarditis.

Summary of Most Common Signs and Symptoms

  • Friction rub

  • Increased pain in supine position

  • Radiating substernal pain

  • Chest pain

  • Trouble breathing while lying down

  • Increased pain with inspiration/coughing

  • Overall feeling of sickness

  • Notable ST segment elevation

Nursing Interventions for Management of Pericarditis

Pain Assessment

  • Importance: Assessing the patient’s pain level is crucial due to the intensity of the discomfort.

  • Nursing action: Administer pain relief medication as per physician’s orders.

Patient Education

  • Instruction: Advise the patient to sit in high Fowler's position or lean forward to alleviate pain.

  • Recommendation: Encourage avoiding the supine position as it exacerbates pain.

Monitoring for Cardiac Tamponade

  • Definition: Cardiac tamponade is a condition where fluid accumulates in the pericardial space, potentially leading to life-threatening cardiac issues.

  • Nursing responsibility: Monitor the patient closely for signs of cardiac tamponade as part of pericarditis management and treatment.