Page 1707 - Saunders Comprehensive Review For NCLEX-RN

position and may be relieved by
leaning forward.
d. Pericardial friction rub (scratchy, high-
pitched sound) is heard on
auscultation and is produced by the
rubbing of the inflamed pericardial
layers.
e. Fever and chills
f. Fatigue and malaise
g. Elevated white blood cell count
h. Electrocardiographic changes with
acute pericarditis; ST-segment
elevation with the onset of
inflammation; atrial fibrillation is
common.
i. Signs of right ventricular failure in
clients with chronic constrictive
pericarditis
3. Interventions
a. Assess the nature of the pain.
b. Place the client in a high-

Fowler’s position, or upright and
leaning forward.
c. Administer oxygen.
d. Administer analgesics, nonsteroidal
anti-inflammatory drugs (NSAIDs), or
corticosteroids for pain as prescribed.
e. Auscultate for a pericardial friction rub.
f. Check results of blood culture to
identify the causative organism.
g. Administer antibiotics for bacterial
infection as prescribed.
h. Administer diuretics and digoxin as
prescribed to the client with chronic
constrictive pericarditis; surgical
incision of the pericardium (pericardial
window) or pericardiectomy may be
necessary.

i. Monitor for signs of cardiac

tamponade.
j. Notify the PHCP if signs of cardiac
tamponade occur.
B. Myocarditis
1. Description: Acute or chronic inflammation of the
myocardium as a result of pericarditis, systemic

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