CHAPTER 1 Cardiovascular System^31
- Heat rate >100 beats per minute (tachycardia).
- Crackles in lungs.
- Neck vein distention.
- Edema, usually of extremities; may also be of sacrum in bed-bound
patients. - Weight gain.
- Monitor for embolism—a piece of vegetation from valve may have broken
off into circulation. - Blood in the urine (hematuria).
- Pain with each breath due to pulmonary embolism.
- Monitor renal function.
- Increased BUN (blood urea nitrogen).
- Increased creatinine clearance.
- Decreased urine output.
- Prophylatic antibiotics before, during, and after medical procedures that
expose the patient’s blood to microorganisms—otherwise it is easy for micro-
organisms to enter bloodstream and colonize the heart valves. - Explain to the patient:
- Need to complete antibiotic course.
- Can have a relapse.
- Call the physician, nurse practitioner, or physician assistant if the patient
develops fever, chills, night sweats.
Heart Failure [Congestive Heart Failure (CHF)]
WHAT WENT WRONG?
In congestive heart failure, the heart is unable to pump sufficient blood to maintain
adequate circulation. This results in a backup of blood and the extra pressure may
cause accumulation of fluid into the lungs. Heart failure is primarily due to prob-
lems with ventricular pumping action of the cardiac muscle, which may be caused
by diseases such as myocardial infarctions (heart attacks), endocarditis (infection in
the heart), hypertension (high blood pressure), or valvular insufficiency.
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