1. ENDOCARDITIS
Group three presentation

2. Group members
 Shida mbeye
 Taonga kanyenda
 Panesi white
 Chigomezgo munthali
 Maria kamanga
 Gilly banda

3. BROAD OBJECTIVE
 By the end of the presentation the audience must acquire knowledge
and skills on the condition of endocarditis

4. SPECIFIC OBJECTIVES
 Definition of endocarditis
 Etiology
 Risk factors
 Pathophysiology
 Clinical manifestation
 Diagnostic evaluation
 Nursing assessment
 Nursing diagnosis
 Nursing management
 Medical management
 complications

5.  Introduction
 The heart is a vital organ that pumps blood and it has three layers
which are endocardium, myocardium and pericadium.

6. definition
• Endocarditis is an inflammation of the inner layer of
the heart, the endocardium. it usually involves the
valves and other structures like the intraventricular
and septum.

7. etiology
 Fungus e.g. candida, aspagellus
 Gram negative organisms e.g. pseudomonas
 Bacterias e.g. staphylococci
 Acute rheumatic fever which cause enlarged and
tender lymph nodes, damages the valves
 Congenital heart disease

8. Risk factors
 Previous heart damage
 Dental procedures which lead into the introduction of
bacterias
 Heart surgery
 Intubations
 Procedures involving gastrol intestinal and genitourinaly
tracts e.g.
barium, enemas, sigmoidoscopy, catheterisation and
cytoscopy
 Reproductive conditions like delivery of new
babies, abortions and pelvic inflammatory disease

9. pathophysiology
 Usually in this case the bacterias or any other causing agents
enter the blood stream through invasive procedures like dental
procedures, surgery , urinary catherisation.
 Then they accumulate on the valves of the heart or
endocardium
 Finally they form vegetations or crusters
 These vegetation they lead into damage heart valves by
perforating and deforming the valves leaflets
 This at the end leads to tearing which means there is poor flow
of blood and lead into accumulation of blood in chambers of the
heart hence endocarditis

10. Clinical manifestations
 Loss of vision
 Ischemia
 Fever
 Shortness of breath
 Shock
 Finger clubbing
 Myocardial infarction
 Weight loss
 Malaise
 Chills
 Night sweats
 Chest and abdominal pain
 anorexia

11. Diagnostic evaluation
 Blood culture; helps in testing the presence of microorganisms
 Urinalysis to see microscopic hematuria.
 Doppler echocardiography assist in the diagnosis by
demonstrating a muscle on the valve.
 Computerized tomography rule out heart damage
 Review bun and creatinine levels to evaluate renal function
 Review endocardiography finding if available for valvuler and
ventricular function and presence of vegetation
 Review white blood cell count to evaluate course if infection

12. Nursing assessment
 It includes history taking like;
– Subjective data:
– past medical history: patient asked of signs of the
disease and the onset of the disease and review
with patient history of risk factors like cardiac
failure, shock
– Medication history: has the pt ever taken any
medication, what happened afterwards
– Family history:asked of any case at home of the
similar conditions

13. – Social history: social behaviours that can trigger
the problem
– Surgical history: if ever operated on
– Objective data: assess for temperature
elevations, heart mummer, evidence of cough ,
peripheral edema and embolism, alscultate for
heart sound, monitor arterial blood gas, rapid
purse rate,dyspnea, restlessness and
manifestation of heart failure

14. Nursing diagnoses
 Infective breathing pattern related to inflammation of
heart muscle as evidenced by use of accessory
muscle, dyspnea.
 Impaired gaseous exchange related to fluid
accumulation in the lungs as evidenced by shortness
of breath
 Decreased cardiac output related to valvular
dysfunction as evidenced by poor tissue perfusion
 Imbalanced nutrition less than body requirement
related to anorexia as evidenced by loss of weight.

15.  Altered thermoregulation related to infection as
evidenced by increased body temperature (fever).
 impaired physical mobility related to fatigue
 Ineffective tissue perfusion related to embolisation
 Anxiety related to hypoxia or life threatening situation
as evidenced by patient verbalization
 Altered comfort pain related to use of accessory
muscle as evidenced by patient verbalization

16. Nursing management
 Position the patient at semi fowlers position to help in infective
breathing through providing enough room for lung expansion as
abdominal contents goes down
 Administer oxygen therapy 4-6 l/min to help pt in breathing
effectively through supplementing oxygen
 Monitor arterial blood gas , carbon dioxide, oxygen saturation
hourly and document to monitor signs of respiratory acidosis
 Encourage and provide small frequent meals reach in proteins
helping in repairing worn-out tissues
 Monitor vital signs , heart and lung sound, level of consciousness
to evaluate how effectively the organs like the heart and the lungs
are working

17.  Schedule nursing activities to allow rest
 Encourage and assist pt to cough and deep breath to promote
chest expansion
 provide tepid sponging to reduce raised body temperature by
evaporation and conduction
 Encourage patient on exercises in order to improve patients
mobility through making the body physically fit
 Make yourself available to the patient and nurse with love and
respond well to his/her questions to array pain and anxiety
 Educate the patient on disease process to make pt cope up
with therapy and the condition

18. Medical management
 if the patient is having poor intake of oxygen administer oxygen
therapy 4-6 l/m in helping the patient get supplemented with
enough oxygen
 Administer antibiotic treatment like ampicillin + flucloxacilin
+gentamicin
 Administer pcm 1g tds p.o as analgesic that help in relieving
pain
 Administer inotropic drugs like digoxin that help in increasing
contractility of the heart
 The patient can also be administered with morphine which help
to decrease anxiety

19. complications
 Chronic heart failure
 Shock
 Stroke
 embolism

20. In conclusion
 Endocarditis as explained above it is the inflammation of
endocardium and it brings a lot complications
 Therefore:

21. references
 PAUL ONEILL (2012), MASTER MEDICINE. SECOND
EDITION
 LINTON (2007). INTRO. TO MEDI-SURGE NURSING,4TH
EDITION
•S. Lewis, M. Heitkemper, S. Dirksen, P. Obrien and L.
Bucher (2007) Medical Surgical Nursing; Assessment and
Management of Clinical problems (7th edition)St
Louisi, Mosby.