Pericarditis

  1. General information
    1. An inflammation of the visceral and parietal pericardium
    2. Caused by a bacterial, viral, or fungal infection; collagen diseases; trauma; acute MI; neoplasms; uremia; radiation therapy; drugs (procainamide, hydralazine, doxorubicin HCl [Adriamycin])
  2. Medical management
    1. Determination and elimination/control of underlying cause
    2. Drug therapy
      1. Medication for pain relief
      2. Corticosteroids, salicylates (aspirin), and indomethacin (Indocin) to reduce inflammation
      3. Specific antibiotic therapy against the causative organism may be indicated.
  3. Assessment findings
    1. Chest pain with deep inspiration (relieved by sitting up), cough, hemoptysis, malaise
    2. Tachycardia, fever, pleural friction rub, cyanosis or pallor, accentuated component of S2, pulsus paradoxus, jugular vein distension
    3. Elevated WBC and ESR, normal or elevated AST (SGOT)
    4. Diagnostic tests
      1. Chest x-ray may show increased heart size if effusion occurs
      2. ECG changes: ST elevation (precordial leads and 2- or 3-limb heads), T wave inversion
  4. Nursing interventions
    1. Ensure comfort: bed rest with semi- or high-Fowler's position.
    2. Monitor hemodynamic parameters carefully.
    3. Administer medications as ordered and monitor effects.
    4. Provide client teaching and discharge planning concerning
      1. Signs and symptoms of pericarditis indicative of a recurrence (chest pain that is intensified by inspiration and position changes, fever, cough)
      2. Medication regimen including name, purpose, dosage, frequency, side effects.

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