Cardiology Quiz: Pericarditis Insights

Tracheostomy

• Maintain patent airway
• Monitor respiratory status
• High fowler's position
• Mechanical ventilation support of tracheostomy collar if indicated
• Maintain surgical drains in neck if present
• Observe for hemorrhage and edema in the neck
• Monitor vital signs (decreased BP with blood loss, increased HR due to hypovolemia and pain)
• Monitor oxygenation status (edema and increased secretions may cause shortness of breath and decreased oxygen)
• Monitor tracheostomy patency (bleeding/edema may occur impairing patency)
• Monitor nutritional intake (swallowing impairments impact adequate nutrition)
• Institute aspiration precautions (at risk for aspiration due to removal of upper airway structures)
• Provide means of communication
• Consult with nutritional specialist and speech/language pathologist
• Monitor IV fluids or parental nutrition until enteral nutrition can be administered.

Mechanical Ventilation

• Provides ventilation when the patient cannot breathe on their own
• Provides airway access via orotracheal intubation or tracheostomy tube

Nursing Interventions

• Protect airway
• Monitor vital signs, lung sounds, respiratory status, and breathing pattern
• Monitor chest for bilateral expansion
• Obtain pulse oximetry and blood gas analysis (ABGs)
• Assess the need for suctioning
• Investigate ventilator alarms and manually ventilate client with resuscitation bag if necessary.
• Provide humidification

Suctioning

• Hyperoxygenate before suctioning
• Suction for 10-15 seconds (3 times total)
• Allow 60 seconds of rest and oxygen between each pass
• Perform when adventitious breath sounds are detected
• Perform when secretions are present
• Ensure all equipment is sterile

Ostomy Care

• Colostomy is a surgical opening on the abdomen for fecal elimination
• Ileostomy is a similar procedure when the entire colon is removed.
• Assess the stoma color and integrity frequently (reddish pink and moist)
• Address any unusual bleeding, skin irritation, and stoma ischemia
• Empty the appliance when it's one-third to one-half full
• Monitor the stool consistency (liquid to formed based on ostomy location)

Chest Tube

• Monitor the amount and color of drainage. (Excessive bloody drainage concerns bleeding within the chest; cloudy drainage may suggest infection)
• Observe the water-seal chamber. (Persistent bubbling indicates an air leak in the chest tube system)
• Maintain a closed chest tube system to prevent air leaks.
• Never clamp the chest tube
• Assess the patient's position for optimal oxygenation (e.g., semi-Fowler's)

Infective Endocarditis (IE)

• IE is an inflammation of the inner lining of the heart and its valves
• Risk factors: Immunosuppression, IV drug abuse, prosthetic valve placement, surgical/invasive procedures.
• Signs and symptoms include fever, anorexia, fatigue, weight loss, Osler nodes, Janeway lesions, and/or splinter hemorrhages.
• Management involves IV antibiotic therapy for a prolonged period and possibly, surgical interventions.

Angina

• Chest pain resulting from an imbalance between oxygen supply and demand in the heart muscles.
• Types: Stable (predictable) and unstable (unpredictable) angina
• Treatment goals are to provide relief and prevent complications like a heart attack.

Pericarditis

• Inflammation of the pericardium (the sac surrounding the heart).
• Common symptoms include chest pain, fever, and/or shortness of breath

Pulmonary Edema

• Buildup of fluid in the lungs.
• Common symptoms include shortness of breath, cough, and/or chest pain
• May present with high ventilation/low perfusion mismatch
• Requires immediate treatment to improve oxygenation.

Laryngeal Cancer

• Malignant tumor of the larynx.
• Risk factors include smoking, alcohol use, and certain occupational exposure(e.g., to radiation)
• Signs/Symptoms: hoarseness, persistent sore throat, change in voice, trouble swallowing, and/or difficulty breathing

Cardiac Biomarkers

• Troponin: a protein that increases in serum when the heart muscles are damaged. It's useful in diagnosing heart attacks.
• CK-MB: Isoenzyme of creatine kinase, primarily found in cardiac muscle tissue. Elevated CK-MB suggests muscle damage

Pulmonary Embolism (PE)

• Occurs when a blood clot (thrombus) travels to the lungs and blocks a pulmonary artery..
• Common risks: Previous blood clots, extended immobility, cancer, surgical procedures.
• Symptoms: shortness of breath, chest pain, and/or coughing up blood (hemoptysis).

Chest Trauma

• Blunt trauma: injury from impact or compression
• Penetrating trauma: injury by an object penetrating the chest
• Assess for respiratory distress and/or cardiovascular compromise.
• Initial interventions: Ensure an airway, give high-flow supplemental oxygen, and consider chest tubes if needed.

Test your knowledge on pericarditis related to myocardial infarction. This quiz covers incidence rates, symptoms, diagnostic findings, and ECG changes associated with pericarditis. Enhance your understanding of this common cardiac condition.