University:
Texas Lutheran University
Course:
NURS 332 | Fundamental Nursing Concepts & Practice
Academic year:

2019
Views:

176

Pages:

2
Author:

TwoCyber

Infective endocarditis: Organism : Bacteria Staphylococcus: Staphylococcus aureus- coagulase negative Gram negative :HACEK was a rare but now common Brcella – Chlamydia –rickerssia rare Fungi: Candida –aspergillus rare Viral : Type : Acute : less common Sudden,strong , very sever and dangerous , high virulence organism , can affect normal and abnormal heart , and lead to death Subacute: common Gradual , diagnosis is not direct because symptom not clear , low virulence organism , usually affect abnormal place in heart , more common in congenital Risk factor : Drug abuser Dental extraction. Symptom: pyrexia ,myalgia. Sign:        embolism Skin lesion : Osler's nodes are painful, red, raised lesions found on pulp of finger, Janeway lesions are painless ,erythematous Splinter hemorrhages: vascular hemmorge under nail Peteciae: decease in platlate account and vaculitis Retinal : Roth's by ophthalmoscope spots. MCQ Renal : microscopic hematuria   Neuro: vasculitis or emboli Abdomen: splenomegaly Diagnosis by : 1- culture :three sample 95% but Candida –aspergillus - Brcella – Chlamydia cant be culture should do serology & other investigation. 2- ECHO: detect valve- vegetion How we think about Infective endocarditis in ER: Major :1- echo 2- culture Minor: 1- fever 2- glumnonephritis 3- emboli 4- auscultation 5- predispose factor . If we found 1 major and 3 minor Or 2 major or 5 minor endocarditis we immediate treat patient as Infective Treatment : broad spectrum antibiotic : pencilline & IV for 6 weeks We should give Prophylactic to high risk group : 1- Dental extraction : one dose amoxilln 3 gram , one hour before procedure if patien allergic from amoxilln we use gentamicin ,erythromycin 2- Operation under Anastasia : ampicillin 2 dose before procedure if patien allergic we use gentamicin . 3- Renal , lower abdomen and genital surgery : as above but we use gentamicin .

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