Study Guide/Review for Final Exam Practice Questions for Exam 1 Endocarditis/Pericarditis The pericardium layer consists of a fibrous layer that is made
... [Show More] up of two layers called the parietal and vi sceral layers. a.True b.False A patient is recovering from a myocardial infarction (MI) and develops chest pain on day 3 that increases when taking a deep breath and is relieved by leaning forward. Which action should the nurse take next? a. Assess the feet for pedal edema. b. Palpate the radial pulses bilaterally. c. Auscultate for a pericardial friction rub. d. Check the heart monitor for dysrhythmias. True or False: Endocarditis only affects the atrioventricular and semi-lunar valves in the heart. False Rationale: Endocarditis can affect not only the heart valves but the interventricular septum and chordae tendineae as well. You're providing discharge teaching to a patient being treated for endocarditis. Which statement by the patient demonstrated they understood your teaching about this condition? A. "I will stop taking the antibiotics once my fever is gone in order to prevent antibiotic resistance." B. "I will only wash my hands with soap and water." C. "I will inform my dentist about my history of endocarditis prior to any invasive procedures." D. "I will avoid eating fish and organ meats." A patient being treated for infective endocarditis is complaining of very sharp radiating abdominal pain that goes to the left shoulder and back. As the nurse familiar with complications of infective endocarditis, what do you suspect is the cause of this patient finding? A. Renal embolic event B. Pulmonary embolic event C. Central nervous system embolic event D. Splenic embolic event You are providing care to a patient with pericarditis. Which of the following is NOT a proper nursing intervention for this patient? A. Monitor the patient for complications of cardiac tamponade. B. Administer Ibuprofen as scheduled. C. Place the patient in supine position to relieve pain. D. Monitor the patient for pulsus paradoxus and muffled heart sounds. A patient with severe pericarditis has developed a large pericardial effusion. The patient is symptomatic. The physician orders what type of procedure to help treat this condition? A. Pericardiectomy B. Heart catheterization C. Thoracotomy D. Pericardiocentesis A child is admitted to the pediatric unit with a diagnosis of infective endocarditis. Which of the following interventions should the healthcare provider anticipate? Select all that apply. 1. Seizure precautions 2. Contact isolation 3.Echocardiogram 4. Intravenous antibiotics 5. Blood cultures The nurse conducts a complete physical assessment on a patient admitted with infective endocarditis. Which finding is significant? a. Respiratory rate of 18 and heart rate of 90 b. Regurgitant murmur at the mitral valve area c. Heart rate of 94 and capillary refill time of 2 seconds d. Point of maximal impulse palpable in fourth intercostal space Rationale: B ---A regurgitant murmur of the aortic or mitral valves would indicate valvular disease, which is a complication of endocarditis. All the other findings are within normal limits. When caring for a patient with infective endocarditis, the nurse will assess the patient for which vascular manifestations (select all that apply)? a. Osler's nodes b. Janeway's lesions c. Splinter hemorrhages d. Subcutaneous nodules e. Erythema marginatum lesions Rationale: Osler's nodes, Janeway's lesions, and splinter hemorrhages are all vascular manifestations of infective endocarditis. Subcutaneous nodules and erythema marginatum lesions occur with rheumatic fever. The patient with pericarditis is complaining of chest pain. After assessment, which intervention should the nurse expect to implement to provide pain relief? a. Corticosteroids b. Morphine sulfate c. Proton pump inhibitor d. Nonsteroidal antiinflammatory drugs Rationale: Nonsteroidal antiinflammatory drugs (NSAIDs) will control pain and inflammation. Corticosteroids are reserved for patients already taking corticosteroids for autoimmune conditions or those who do not respond to NSAIDs. Morphine is not necessary. Proton pump inhibitors are used to decrease stomach acid to avoid the risk of GI bleeding from the NSAIDs. The nurse completes a nursing history with a patient with infective endocarditis. A significant finding that constitutes a risk factor for infective endocarditis is: a. A recent myocardial infarction b. Recent cardiac catheterization c. Hypertension d. Recent streptococcal pharyngitis While caring for a patient who has acute pericarditis, the nurse suspects the development of cardiac tamponade based on which assessment finding? a. A pulsus paradoxus of 8 mmHg b. Jugular vein distention c. Increased systolic blood pressure with widening pulse pressure d. Hiccoughs and hoarseness The nurse has identified a nursing diagnosis of pain related to inflammatory process for a patient who has acute pericarditis. Which nursing intervention planned by the nurse ismost appropriate for this problem? a. Force fluids to 3000 mL/day to decrease fever and inflammation b. Teach the patient to take shallow, rapid respirations to control the pain c. Position the patient in Fowler's position, leaning forward on a padded overbed table d. Consult with the physician to provide intravenous narcotic analgesics for pain control Rationale: NOT SUPINE !!! The nurse is caring for a client admitted for acute pericarditis. Which nursing diagnosis should take priority during the first 24 hours of nursing care? 0 Risk for falls related to weakness, pain, and dizziness 0 Acute pain related to inflammation of the pericardium 0 Imbalanced nutrition: less than body requirements related to decreased intake, nausea and anorexia 0 Activity intolerance related to fatigue and physical weakness Rationale: There is acute pain associated with the inflammation of the pericardium. Pericarditis causes severe pain with rapid onset that worsens with breathing, coughing, and/or changing positions. Leaning forward can help alleviate the pain. Such pain prevents the ability to help respiratory efforts. It worsens as excessive accumulation of fluid in the pericardial sac occurs. The result is decreased stroke volume and compression of the heart. Another very common finding with pericarditis is a pleural friction rub. A pleural friction rub has a scratching, grating sound similar to leather rubbing against leather. 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