Question

Question:

Ariane Waters, 21 years of age, is a female patient who is admitted to the hospital with the diagnosis of infective endocarditis. Ariane had her tongue and nose pierced 6 weeks ago. The drug screen is negative. She presents with grade II tricuspid insufficiency murmur, and a temperature of 104F. the patient complains of extreme fatigue and anorexia. The echocardiogram reveals vegetations on the tricuspid valve (learning objective 4)

a) what risk factors predisposed Ms. Walters to develop infective endocarditis?

b) Explain the pathophysiology of the infective endocarditis as it relates to this case.

c) what additional clinical manifestation should the nurse include in the assessment of the patient?

d) what medical management should the nurse anticipate for the patient?

e) What nursing management should be provided for the patient and family?

Mrs Robbins , a 58 year old patient with suspected aortic stenosis, presents to the cardiac care clinic for evaluation. About 1 month ago she noticed that she was having increasing difficulty completing the 2-mile walk that she had been doing for the last 5 years. The cardiologist has ordered a Doppler echocardiogram to diagnose aortic stenosis definitely . (learning objective 1)

a) On this visit Mrs. Robbins states that she is having difficulty sleeping and has episodes of chest pains. How does the Nurse correlate these clinic manifestations to aortic stenosis?

b) The nurse assesses Mrs Robbins for what type of heart sounds that are consistent with aortic stenosis

c) What is the rationale for prophylactic antibiotics prior to invasive procedures for the patient with aortic stenosis

Answer 1

a.The procedure of piercing tongue and nose is a predisposed risk factor because in order to avoid this infection the provider usually prescribes an antibiotic course which is not done in Walter's case.

b.The organism enters the blood stream reaches the heart and affects the muscles of it .As a result of this the functions are affected leading to symptoms of elevated body temperature to fight infection. This infection appears via the blood stream reaching each organ and causing symptoms

c.Some of the additional clinical manifestation which the nurse can include are

• CVS:for chest discomfort or pain
• Respiratory:any shortness of breath
• Musculoskeletal:pain
• Integumentary: rash
• GIT:nausea,vomiting
• Others: weight

d.The medical management for this patient is antibiotics for four weeks to treat infection

e.The nursing management for this patient and family are

• Monitor vital signs , and a it is the baseline data to plan for care
• Educate them on the disease condition and its progress
• Completing the antibiotic course
• To report in case of any side effects
• Blood test to rike of infection periodically as per order
• Provide psychological support