Endocarditis & Iron deficiency Anemia Flashcards Preview

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Flashcards in Endocarditis & Iron deficiency Anemia Deck (44)
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1

an inflammation of the endocardium (inner lining of the heart) from a pathogen that has damaged endocardial tissue

endocarditis

2

What are the types of inflammatory diseases of the heart?

 Infective Endocarditis (endocardium)
 Rheumatic Endocarditis
◦A unique form of Infective Endocarditis
 Myocarditis (myocardium)
 Pericarditis (pericardium)

3

How can infective endocarditis be classified?

as an acute or subacute infection

4

How is acute infective endocarditis caused? Which organism is involved?

• Caused by a new infection
• Organism - frequently staphylococci

5

How is subacute infective endocarditis caused? Which organism is involved?

• Occurs in an already defective heart valve
• Organism – often streptococci or E.coli

6

What is infective endocarditis?

 Microbial infection of the endocardium
 Deformity or injury of endocardium

7

What can occur as a result of infective endocarditis?

 Results in clot formation on endocardium
 Infective organisms invade clot &; form lesion

8

What do the lesions (vegatations) form and become as a result of the infective organisms invading and forming a clot?

thromboemboli

9

What are some examples of infective organisms?: (usually bacteria)

◦ Staphylococci, Enterococci or Pneumococci, Streptococci
◦ E.coli
◦ Rickettsia
◦ Fungi – Candida, Aspergillus
◦ Chlamydiae

10

What can cause the progression of infective endocarditis?

◦ Tears in endocardium
◦ Deformities of valve leaflets
◦ Dehiscence of prosthetic valves
◦ Deformity of the chordae tendineae
◦ Abscesses

11

What do the signs & symptoms of endocarditis develop due to?

 Toxic effect of the infection
 Destruction of the heart valves
 Embolization of fragments of vegetative growths

12

What are the signs & symptoms of endocarditis?

*fever and new heart murmur
 Petechiae- skin small pinpoint hemorrhages
 Splinter hemorrhages of nails
◦ Black lines or red streaks on nails
 Roth Spots
 Janeway Lesions
 Osler’s Nodes

13

What are roth spots?

◦ White spots seen on retina
◦ Round or oval

14

What are janeway lesions?

◦ Painless, hemorrhagic lesions
◦ Palms, soles, nose, ear

15

what are osler's nodes?

◦ Small painful nodules
◦ Tender, red lesions, white centers
◦ On fingers & toes

16

What are the risk factors for endocarditis?

 Frequent introduction of pathogens
 Valvular heart disease-Valve replacement or repair
 IV drug abuse
 Indwelling IV catheters-esp if IV tip lies near heart
 Recent dental work
 Compromised immune system
 Previous endocarditis
 Recent body piercing or tatooing

17

What are the labs and diagnostics done for endocarditis?

 Inflammatory process:
 Echocardiogram
 Kidney damage
◦ Anemia - low hemoglobin
 Infection:
◦ Positive blood culture-definitive diagnosis
◦ ASO Titer (Antistreptplysion O titer)
 Blood test to measure antibodies produced by
the groups A-Streptococcus bacteria
 A-strep can cause Bacterial Endocarditis

18

The inflammatory process involves what labs?

◦ WBC count, ESR are elevated

19

What does the endocardiogram lab test for?

◦ Identify diseased valves
◦ Vegetations-lesions on valves
◦ Ventricular hypertrophy
◦ Heart failure

20

What are the interventions for endocarditis?

 Prevention = best plan
 AHA guidelines for high-risk patient
◦ Prophylactic antibiotics before invasive
procedures
◦ Such as-invasive dental, GI & GU procedure
 Strict aseptic technique
◦ Health care procedures
◦ Invasive lines
◦ Invasive procedures
 Proper hand washing Long-term IV antibiotics
◦ May need long-term IV catheter
◦ Central line or PICC
Monitor labs
◦ Monitor therapeutic antibiotic levels
◦ Effectiveness of medication (temp, WBC)
Discharge referrals –follow up care
Patient education
◦ Home with IV therapy
◦ Home anticoagulant therapy
Monitor for worsening of condition
Monitor for emboli

21

What are the surgical interventions for endocarditis?

Defective valves:
 Surgical debridement
 Surgical repair
 Value replacement
◦ Damaged valve replaced with mechanical
(prosthetic) or biological valve (bovine,
porcine, cadaver)
*Valvuloplasty
*Annuloplasty
*Chordoplasty

22

What is valvuloplasty?

 Balloon-tipped catheter inserted via peripheral
vessel into heart
 Balloon inflated in valve to increase valve diameter
 Then balloon removed

23

What is an annuloplasty?

 Sternal incision made remove stenotic tissue at valve
 “O” ring is placed in valve leaflets
 Prevents regurgitation

24

What is chordoplasty?

 Surgical repair made-shapes chordate tendinease
to prevent regurgitation

25

What is the goal of care for endocarditis?

 Endocarditis can be prevented
◦ Goal of initial treatment is avoiding the
infection
 Goal of care- if the patient does develop endocarditis:
◦ Curing the infection
◦ NO residual damage to heart or valves

26

What are the priority nursing diagnosis for endocarditis?

 Activity intolerance
 Cardiac Output, Decreased
 Tissue Perfusion, Decreased
 Knowledge Deficit

27

 Blood loss due to bleeding disorders
 Acute / chronic blood loss
◦ Surgical, traumatic
◦ GI bleed

anemia

28

What is hypoproliferative anemia?

◦Decreased or defective production of RBCs

29

What are the signs & symptoms of anemia?

Affected by the following issues
 Based on the severity
 Speed at which it developed
 Metabolic needs of the patient
 Presence of other problems

30

 Most common type of anemia
 Causes: either due to
◦ Blood loss
◦ Hypoproliferative: caused by
Decreased RBC
Defective RBC

Iron deficiency anemia