1-30
1-30. INFECTIVE ENDOCARDITIS
a. Infective (bacterial) endocarditis is a microbial infection of endocardial tissue. The endocardium is the layer of tissue that lines the heart's cavities and covers the flaps of its valves.
b. When an area of endocardium becomes inflamed, a fibrin clot called a vegetation may form. This clot will later form into a mass of scar tissue. The scarred endothelium becomes stiff, thick, and deformed. Vegetations on the valves may eventually cause chronic valvular disease.
c. Endocarditis is categorized as either acute or subacute. This is determined by the virulence of the causative organism.
(1) In acute infective endocarditis, the infecting organism is highly virulent, causing rapid and severe complications.
(2) In subacute infective endocarditis, the infecting organism is of low virulence. Severe complications do not occur until late in the illness, if at all.
d. Because standard medical treatment for infective endocarditis involves intravenous antimicrobial agents for a period of 4-6 weeks, the patient will require nursing intervention to prevent depression and alleviate the boredom that will result from the lengthy hospitalization. As the patient begins to feel better, he will feel confined and restricted by intravenous (IV).
e. Nursing management of patients with endocarditis includes the following:
(1) Obtain a history of allergies prior to the administration of antibiotics.
(2) Ensure patency of IV and prevent the complications of long- term IV therapy.
(3) Observe for signs and symptoms of complications such as CHF, renal failure, or emboli.
(4) Educate the patient about his condition and the need for continued treatment and prophylactic antibiotics.
(5) Teach the patient to recognize the symptoms of endocarditis and to seek medical assistance should symptoms recur.
