PERICARDITIS
Pericarditis is an inflammation of the pericardium.
1. Acute pericarditis: may be dry or may cause excessive fluid accumulation in the pericardial space.
2 Chronic pericarditis: fibrous thivkening of the visceral and parietal pericardium; thickening inhibits cardiac filling during systole.
Assessment
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Risk factors/iology
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Acute.
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Infection.
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Myocardial Injury.
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Hypersensitivity (collagen diseases, systematic lupus erythematosus, drug reactions).
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Renal failure.
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Clinical Manifestations.
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Acute.
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Precordial pain.
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Pericardial friction rub caused by myocardium rubbing against inflamed pericardium.
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Pain increases with respiration; sitting may relieve pain.
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Chronic: symptoms are characteristic of gradually occurring CHF; chest pain is not a prominent symptom.
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Diagnostics (acute and chronic).
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ECG changes.
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increased WBCs.
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History of precipitating causes.
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CT scan.
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Complications.
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Pericardial effusion resulting in cardiac tamponade.
PA and lateral close-ups show thick pericardial calcification around
apex of heart from patient with history of tuberculous pericarditis
Treatment
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Acute episode.
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Treat underlying problem.
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Bed rest.
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Antiinflammatory medications.
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If pleural effusion and tamponade occur, then pericardiocentesis (aspiration of fluid from the pericardial sac) is performed.
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Nursing Intervention
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GOAL: To maintain homeostasis and promote comfort.
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Assess characteristics of pain; administer appropriate analgesics.
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Upright position, with client leaning forward, may relieve the pain.
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Decrease anxiety, because client often associates problem with an MI; assist client to distinguish the difference.
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Observe for symptoms of cardiac tamponade.
-Paradoxical blood pressure: precipitous decrease in systolic blood pressure on inspiration.
-CVP increased; presence of jugular venous distention.
-Narrowing pulse pressure.
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In a client with chronic pericarditis, evaluate for symptoms of CHF and initiate nursing intervention.
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