Question

Consider the scenario and answer the following questions:

Mr. Nathaniel is a 46 year-old man who has developed symptoms of acute pericarditis secondary to viral infection. Diagnosis was based on characteristic sign of a friction rub and pain over the pericardium.

1. The patient is experiencing pericardial pain. To alleviate this discomfort, what position could the nurse assist the patient with maintaining?

2. When planning Mr. Nathaniel’s care, what should the nurse understand are the objectives of pericarditis management?

3. The nurse is auscultating Mr. Nathaniel’s chest for a pericardial friction rub. Where will the nurse auscultate in order to locate the rub?

Answer 1

The nurse should assist the patient to maintain an upright position with the head of the bed elevated at 45 degrees because this position helps to provide pain relief. Bed rest may also help relieve pain in patients with acute pericarditis.

Nurse should make sure to provide oxygen support to the patient. At the same time, nurse also should arrange cardiac monitor to monitor cardiac activities of the client. Moreover, rule out other life-threatening causes of chest pain, such as myocardial infarction or aortic dissection. Evaluate for evidence of hemodynamic instability. Other than this nurse should frequently assess the client status, monitor hemodynamics ( Pulse, HR, BP, PR ), assess neurological status, provide psychological support etc.

The best position to auscultate is over the left lower sternal edge or apex during end expiration with the patient sitting up and leaning forward.