Angelite Nurses: Endocarditis

Endocarditis

General information

Inflammation of the endocardium; platelets and fibrin deposit on the mitral and/or aortic valves causing deformity, insufficiency, or stenosis.
Caused by bacterial infection: commonly S. aureus, S. viridans, B-hemolytic streptococcus, gonococcus
Precipitating factors: rheumatic heart disease, open-heart surgery procedures, GU/Ob-Gyn instrumentation/surgery, dental extractions, invasive monitoring, septic thrombophlebitis

Medical management

Drug therapy

Antibiotics specific to sensitivity of organism cultured
Penicillin G and streptomycin if organism not known
Antipyretics

Cardiac surgery to replace affected valve

Assessment findings

Fever, malaise, fatigue, dyspnea and cough (if extensive valvular damage), acute upper quadrant pain (if splenic involvement), joint pain
Petechiae, murmurs, edema (if extensive valvular damage), splenomegaly, hemiplegia and confusion (if cerebral infarction), hematuria (if renal infarction)
Elevated WBC and ESR, decreased Hgb and Hct
Diagnostic tests: positive blood culture for causative organism

Nursing interventions

Administer antibiotics as ordered to control the infectious process.
Control temperature elevation by administration of antipyretics.
Assess for vascular complications (see Thrombophlebitis, and Pulmonary Embolism).
Provide client teaching and discharge planning concerning

Types of procedures/treatments (e.g., tooth extractions, GU instrumentation) that increase the chances of recurrences
Antibiotic therapy, including name, purpose, dose, frequency, side effects
Signs and symptoms of recurrent endocarditis (persistent fever, fatigue, chills, anorexia, joint pain)
Avoidance of individuals with known infections.

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