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31 YO male w/ hx of endocarditis, IVDU, &homelessness (Patient…
31 YO male w/ hx of endocarditis, IVDU, &homelessness
Endocarditis: infection of endocardial surface of heart, affects heart valves
Pathophysiology: BF w/in heart allows causative organism to infect damaged valves or endothelial surfaces. Infection may spread locally to cause damage to valves and/or supporting structures
Causes
Bacterial, fungal, viral infection
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Can result in
Dysrhythmias, valve dysfunction # #
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ECG, cardiac catherization #
Patient Lab Values
Hgb - 11.4 :red_flag:
Hct - 37.9 :red_flag:
WBC - 5.3
Plt - 391
Na - 137
Ca - 9.0
K - 4.2
Cl - 105
HCO3 - 26
BUN - 16
Cr - 0.95
Gluc - 98
AST - 50 :red_flag:
ALT - 80 :red_flag:
Bili - 0.2
Alk P - 61
Alb - 2.7 :red_flag:
PT - 14.5 :red_flag:
PTT - 36.9
INR - 1.1 #
Interventions
Decreased CO
Recognize primary characteristics of decreased output: fatigue, SOB, edema, orthopnea, PND, increased CVP #
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Patient Medications
Alteplase - thrombolytic drug, treat acute MI and other severe conditions caused by blood clotting by breaking up clots
SE - bleeding, angioedema, embolization, DVT #
Ampicillin - Treat bacterial infection
SE - diarrhea, N/V # # #
Ceftriaxone - Treat bacterial infections
SE - black, tarry stool, chest pain, SOB, cough, fever, chills # #
Cyclobenzaprine - treat pain and stiffness caused by muscle spasms
SE - drowsiness, dry mouth, constipation, fatigue # #
Enoxaparin - anticoagulant, treat/prevent DVT and PE
SE - mild irritation, pain, bruising, redness
Furosemide - treat fluid retention and swelling d/t CHF
SE - dry mouth, dehydration, bleeding, hypokalemia
Hydroxyzine - treat anxiety, N/V
SE - dry mouth, drowsiness, tremors, resp depression #
Lactobacillus acidophilus/casei/mamnasus - probiotic supplement
SE - constipation, gas, bloating, increased thirst
Lorazepam - sedative, treat anxiety
SE - paranoia, impaired memory judgement and coordination # #
MS Contin (morphine) - treat moderate to severe pain
SE - bradycardia, chest pain, drowsiness, nausea #
Naloxone - treat narcotic OD, reverse OD
SE - tachycardia, tremors, N/V, diarrhea #
Nicorette gum - smoking cessation aide, help people quit smoking
SE - chest discomfort, dizziness, tachycardia #
Nystatin - treat fungal infection
SE - diarrhea, mild stomach discomfort, nausea #
Oxycodone - treat moderate to severe pain
SE - risk for dependence, resp distress, anxiety, constipation, stomach pains #
Sennosides - treat constipation, laxative
SE - stomach, abd pain, cramping, N/V, weakness
Patient Lab/Diagnostic Results
MRI - neck/shoulder: herniated C6-7 discitis
ECHO/CT - mitral valve endocarditis
Blood culture - Hep C, HIV # #
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Patient's S/S
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Delirious - psychotic episodes # # #
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