Page 151 - Critical Care Nursing Demystified

136 CRITICAL CARE NURSING DeMYSTIFIED

Prognosis
Prognosis is good if the patient does not go into heart failure and the symptoms
are caught early.

Interpreting Test Results
In any inflammatory disease, the nurse can see
• Elevated WBCs.
• Elevated ESR.

• Positive blood cultures isolating the causing organism.
• ECG in pericarditis shows ST segment elevation with an upward concav-
ity and PR segment depression.
• ECG in other inflammatory diseases show nonspecific ST changes.

Nursing Diagnoses for Inflammatory
Heart Disease Expected Outcomes
Decreased CO RT ineffective pumping of The patient will have normal VS
the heart The patient will have baseline Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
ECG
Hyperthermia RT invasion of the heart by The patient will have a normal
infectious organisms temp.

Interventions
Assess VS, especially temperature. The patient will have an elevated tem-
perature in most inflammatory diseases and it may be present for
weeks.
Assess heart sounds for S3, new or worsening murmurs, or friction rub that
may indicate HF (S3), compromised valvular functioning (murmur), or peri-
carditis (friction rub).
Assess for systemic embolization in endocarditis, which can lead to PE and
stroke.
Monitor for signs of cardiac tamponade in pericarditis as fluid accumulation
can compress the heart.
Monitor laboratory values, especially BNP, for signs of worsening heart failure.
Monitor serial chest x-rays for signs of worsening heart failure.