Question

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’schest for a pericardial friction rub. Where will the nurse auscultate in order to locate the rub?

Answer 1

1 The best position for the patient with pericardial pain is high fowlers with lean forward. This position reduces the pressure of inflamed sac over the heart. So the load of the heart will reduce. This position will also help to moves the diaphragm and other organs downward by gravity and less undue pressure over the pericardium and at the same time, the rubbing of the outer layer with inner layer will decrease and thus the pain.

2 The main objectives are reducing pain and fever management. These two are very common among people. sometimes the patient might have breathing difficulty, so management of breathlessness should be given. Patients might be anxious related to pain so anxiety should be reduced. Decreased tissue perfusion is a major issue in many people. it should be managed.

3 Pericardial friction rub is a classic objective manifestation. The rub is produced by roughened, inflamed pericardial layers that create s frictionas their surfaces rub together during heart movement. A sratchy, leathery or creky sound that is heardat the third intercostal space left of the sternal border. the sound is best heard when the client is in sitting position and use diaphragm of stethoscope to hear the sound at the best.