Question

Jane Smith a 21 year old client is admitted with infective endocarditis the client has a history of meat rail valve prolapse and a recent strep throat infection when she started when she felt better she stopped taking the antibiotic she presents to the telemetry unit with ostler Noah's presents on the path of her fingers and toes and Janeway lesions on the palms of her hands and soles of her feet she has splinter hemorrhages present on her fingernails the nurse knows that the spleen is enlarged and tender during palpation the client is lethargic and stated she has no appetite and has lost 5 lb in the past week and 10 pounds in 2 weeks before because she has no appetite she complains of muscle aches in her lower back and thighs and joint pain everywhere the vital signs are temp 102 blood pressure 90 over 50 heart rate 110 a minute what nursing management is needed for the client

Answer 1

Infective endocarditis is an inflammation of the heart lining and the valves secondary to bacterial infection . It is often associated with untreated Strept throat infection. The Streptococcus gain entry to the heart causing this inflammation . The other mode of entry is IV drug abuse.

Nursing management of the patient with Infective endocarditis :

• Assess for the heart sounds to check for any murmurs.
• Assess for oral hygiene and guide her to brush her teeth twice a day.
• Assess the level of knowledge and guide her regarding the disease condition and necessary use of antibiotics and significance to complete a course of antibiotics and not to stop the antibiotic once you start feeling better.
• Administer IV antibiotics as prescribed.
• Administer anticoagulant as ordered as the client is at risk of thrombus formation which may result in stroke.
• Educate regarding the side effects of anticoagulant therapy. A soft tooth brush can be used to prevent bleeding of gums.
• Also , observe for signs and symptoms of thrombus formation like pain in one of the lower extremity.
• Educate the client regarding oral hygiene and its link to endocarditis.
• Proper handwashing technique has to be taught to the patient.
• Ask the patient to eat nutritious food.
• Eat small frequent meals with increased fruits and vegetables .
• Inform the patient regarding the prophylactic antibiotics that she has to take even after she is discharged from hospital and the importance of not missing a single dose and completion of the antibiotic course.
• Avoid dental procedures for a period of six months after treatment is advised.

Thank you.