Page 1708 - Saunders Comprehensive Review For NCLEX-RN

infection, or allergic response
2. Assessment
a. Fever
b. Dyspnea
c. Tachycardia
d. Chest pain
e. Pericardial friction rub
f. Gallop rhythm
g. Murmur that sounds like fluid passing
an obstruction
h. Pulsus alternans
i. Signs of heart failure
3. Interventions
a. Assist the client to a position of comfort,
such as sitting up and leaning forward.
b. Administer oxygen as prescribed.
c. Administer analgesics, salicylates, and
NSAIDs as prescribed to reduce fever
and pain.
d. Administer digoxin as prescribed.
e. Administer antidysrhythmics as
prescribed.
f. Administer antibiotics as prescribed to
treat the causative organism.
g. Monitor for complications, which can
include thrombus, heart failure, and
cardiomyopathy.

C. Endocarditis

1. Description
a. Endocarditis is an inflammation of the
inner lining of the heart and valves.
b. Occurs primarily in clients who are IV
drug users, have had valve
replacements or repair of valves with
prosthetic materials, or have other
structural cardiac defects
c. Ports of entry for the infecting organism
include the oral cavity (especially if the
client has had a dental procedure in
the previous 3 to 6 months), infections
(cutaneous, genitourinary,
gastrointestinal, and systemic), and
surgery or invasive procedures,
including IV line placement.
2. Assessment
a. Fever
b. Anorexia, weight loss

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