Nursing 211

N211: Health Differences Across the Lifespan I of 148 Include bed rest, restricted sodium diet, antiarrhythmics (Pronestyl), antibiotics, anticoagulants (Coumadin), Digoxin to increase myocardial contractility and diuretics (Lasix). Interventions include watching for signs of Digoxin toxicity (anorexia, n/v, blurred, vision) and stressing the importance of bed rest to decrease oxygen demands on the heart. 1.22 Pericarditis Pericarditis is an inflammation of the outer lining of the heart. Causes include bacteria, fungus, virus, radiation, hypersensitivity or autoimmune disease (Lupus, Rheumatic Arthritis), neoplasms, injury, trauma and uremia or none of these at all. The presence of a friction rub is an indication of pericarditis. ST segment and T wave inversion are also signs of pericarditis. Signs and symptoms are pain, sudden and severe, substernal and radiating to the back or arm. Pain is aggravated by coughing, inhalation and deep breathing and relieved with rest. Pericardial friction rub (grating sound heard as the heart moves), fever. Diagnostics Echocardiogram confirms free space between the ventricular wall and pericardium. EKG shows elevated ST segments without significant changes in the QRS. Nursing Interventions Bed rest and possibly surgery depending on symptoms. Drug therapy includes antibiotics, corticosteroids, and NSAIDs. Interventions include bed rest to decrease oxygen demands on the heart, relieve dyspnea and chest pain by placing the patient in an upright position, reassurance to promote patient comfort and allay anxiety. 1.23 Cardiomyopathy Cardiomyopathy is increased muscle mass to compensate for a flabby left ventricle, altering cardiac function and resulting in decreased cardiac output. The causes include alcoholism, infection, metabolic and immunologic disorders, pregnancy and postpartum disorders, hypertension, amyloidosis and cancer or other infiltrative disease. Signs and symptoms include murmur (S3, S4), dyspnea, cough, crackles, jugular vein distention, dependent pitting edema and fatigue. Diagnostics Echocardiogram indicates left ventricular hypertrophy and nonspecific changes. Nursing Interventions ©2012 Achieve Page 36