Page 152 - Critical Care Nursing Demystified

Chapter 3 CARE OF THE PATIENT WITH CRITICAL CARDIAC AND VASCULAR NEEDS 137

Limit the patient’s activity to prevent further stress and increased O demand
2
on the heart.
Administer and monitor the use of analgesics and anti-inflammatory drugs
such as aspirin and ibuprofen in pericarditis to reduce inflammation
and pain.
Administer antibiotics to help destroy causative infectious agents.
Administer medications to treat HF.
Identify and treat dysrhythmias if they occur as a result of HF.

Teach antibiotic prophylaxis before invasive procedures (endocarditis) to
prevent common recurrence.

Teach patient to carry medical alert identification to communicate presence
of past history of pericarditis and institution of antibiotic prophylaxis when
treated.

NURSING ALERT

All patients who have had a past history of pericarditis should be treated with pro-
phylactic antibiotics before any invasive procedure. 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.

NURSING ALERT

Myocarditis predisposes the patient to digitalis sensitivity. Digoxin is given to
patients with myocarditis to improve contractility. Nurses need to closely monitor
patients for digitoxicity. Signs/symptoms include nausea, vomiting, headache, and
malaise.

Cardiac Tamponade

What Went Wrong?
Cardiac tamponade occurs when fluid accumulates in the pericardial sac, pre-
venting blood from entering the heart (preload increase) and decreasing CO so
that there is a profoundly decreased cardiac output. This would be almost like
someone squeezing the heart between the hands in a viselike grip. Nothing
could get into the heart and nothing could get out. This is called cardiac tam-
ponade because a tamponade means to apply pressure. This can happen