Infective endocarditis

Kessenich, Cathy R.; Flanagan, Megan

doi:10.1097/01.npr.0000452982.66503.b5

Cited by 3 publications

(7 citation statements)

References 6 publications

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“…[4][5][6] Patients with history of structural heart disease and immunodeficiency are also at an increased risk. They include men older than age 60; patients with poor dentition, a history of I.V.…”

Section: Risk Factorsmentioning

confidence: 99%

“…4 The TEE has been shown to have a sensitivity of 100% for detecting infective endocarditis; the TTE' s sensitivity is much lower. Nurses must have a high index of suspicion for infective endocarditis when patients present with ongoing fatigue, fever, chills, malaise, a new murmur, stroke signs and symptoms, or congestive heart failure.…”

Section: Diagnosismentioning

confidence: 99%

“…Nurses must have a high index of suspicion for infective endocarditis when patients present with ongoing fatigue, fever, chills, malaise, a new murmur, stroke signs and symptoms, or congestive heart failure. 4 The American Heart Association/ American College of Cardiology guidelines state that a "TTE is recommended (See Identifying dermatologic diagnostic clues.)…”

Section: Diagnosismentioning

confidence: 99%

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Infective endocarditis

Laing

2015

Nursing

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Although the paramedics administer a dose of I.V. naloxone, JM' s clinical status doesn't improve. Upon arrival at the ED, his vital signs are core body temperature, 102.4° F (39.1° C); heart rate, 114; respiratory rate, 26; SpO 2 96% on supplemental oxygen at 4 L/minute via nasal cannula; and BP, 84/49. Two large-bore peripheral I.V. catheters are inserted and 2 L of 0.9% sodium chloride solution is administered I.V. bolus. An additional dose of naloxone doesn't improve his clinical status. Blood and urine specimens are obtained and sent to the lab, including specimens for lactate level, two sets of blood cultures, and urine culture and sensitivity.About 25 minutes after JM' s arrival to the ED, his BP hasn't increased significantly despite the fluid challenge. His SpO 2 has dropped to 81% on supplemental oxygen at 15 L/ minute via non-rebreather mask, and he' s dyspneic. A stat portable chest X-ray shows bilateral pulmonary edema. Due to his increased work of breathing and hypoxemia, he' s endotracheally intubated and placed on mechanical ventilation. A diuretic can't be safely administered because of his hypotension. Diagnostic testingSee Close up on abnormal lab values for JM' s abnormal blood work results. A urinalysis displays no evidence of infection. A 12-lead ECG shows sinus tachycardia with no significant abnormalities. A broad-spectrum antibiotic is initiated, and he' s admitted to the medical ICU for suspected sepsis.That evening, JM' s parents arrive at the hospital and inform the staff that their son has an ongoing heroin addiction. The nurse relays this information to the healthcare provider and a stat bedside transthoracic echocardiogram (TTE) is ordered. The echocardiogram shows severe left ventricular dysfunction with a left ventricular ejection

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Section: Risk Factorsmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

See 1 more Smart Citation

Infective endocarditis

Laing

2015

Nursing

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“…3 Because many other microorganisms can cause infective endocarditis, blood should be drawn for cultures before starting antibiotics. [4][5][6] Patients with history of structural heart disease and immunodeficiency are also at an increased risk. 3 Proper identification of the causative organism is critical to successful treatment.…”

Section: What's Infective Endocarditis?mentioning

confidence: 99%

“…A score of 13 or higher correlates with mild brain injury; a score of 9 to 12 correlates with moderate injury; and a score of 8 or less represents severe brain injury. 4 The TEE has been shown to have a sensitivity of 100% for detecting infective endocarditis; the TTE's sensitivity is much lower. 3 In patients with both prosthetic valve endocarditis and native valve endocarditis, early surgical intervention is recommended instead of delaying surgery for completion of antibiotic therapy.…”

Section: Totalmentioning

confidence: 99%