Medical-surgical Nursing Demystified

(^30) Medical-Surgical Nursing Demystified

• Fatigue—due to infectious process.


• Murmurs—new or changing.

INTERPRETING TEST RESULTS

• Blood culture and sensitivity test.
  
  
  • Three sets of cultures one hour apart to determine the specific organism
    so treatment can be started.
  
  
  
  


• Echocardiogram is used to detect vegetation on valves or heart valves dam-
  aged by the microorganism, and also to determine which valves are involved.


• Transesophageal echocardiogram offers a view to detect vegetation on heart
  valves or view heart valves damaged by a microorganism.


• Chest x-ray to look for underlying cardiac abnormality and pulmonary
  infiltrate.

TREATMENT

Treatment depends on the underlying infectious agent. Empiric treatment should

be started while waiting for culture results. Outcomes are affected by possible

valvular destruction, emboli, and growth of bacteria on the valves or endocardium.

• Administer antibiotics based on the result of culture and sensitivity test.


• Valve replacement may be necessary if damage to valves is significant.


• Bed rest to decrease demand on heart.

NURSING DIAGNOSES

• Decrease cardiac output


• Risk for injury


• Activity intolerance

NURSING INTERVENTION

• Monitor for signs of heart failure due to increased stress on heart due to
  altered valve function.
  
  
  • Breathing difficulties (dyspnea).