Page 1706 - Saunders Comprehensive Review For NCLEX-RN

7. Instruct the client to avoid large amounts of caffeine,
found in coffee, tea, cocoa, chocolate, and some
carbonated beverages.
8. Instruct the client about the prescribed low-sodium,
low-fat, and low-cholesterol diet.
9. Provide the client with a list of potassium-rich foods,
because diuretics can cause hypokalemia (except for
potassium-retaining diuretics).
10. Instruct the client regarding fluid restriction, if
prescribed, advising the client to spread the fluid out
during the day and to suck on hard candy to reduce
thirst.
11. Instruct the client to balance periods of activity and
rest.
12. Advise the client to avoid isometric activities, which
increase pressure in the heart.
13. Instruct the client to monitor daily weight.
14. Instruct the client to report signs of fluid retention
such as edema or weight gain.
XI. See Chapter 69 for a discussion on cardiogenic shock and associated invasive
monitoring.
XII. Inflammatory Diseases of the Heart

A. Pericarditis

1. Description
a. Pericarditis is an acute or chronic
inflammation of the pericardium.
b. Chronic pericarditis, a chronic
inflammatory thickening of the
pericardium, constricts the heart,
causing compression.
c. The pericardial sac becomes inflamed.
d. Pericarditis can result in loss of
pericardial elasticity or an
accumulation of fluid within the sac.
e. Heart failure or cardiac tamponade may
result.
2. Assessment
a. Pain in the anterior chest that radiates
to the left side of the neck, shoulder, or
back

b. Pain is grating and is

aggravated by breathing (particularly
inspiration), coughing, and swallowing

c. Pain is worse when in the supine

1706