PRESENTATION ON HEART BSN 1st PROFE.pptx

This presentation is all about heart structure and function

1. MADAM SHUMAILA TARIQ ALI RAZA KHAN HASNAIN AHMAD MUHAMMAD BILAL

2. OBJECTIVES After attending this session students will be able to : Understand the anatomy and physiology Define pericarditis myocarditis endocarditis Explain the types Identify the causes and risk factors Explain the pathophysiology Know the clinical manifestations Know how to asses and diagnosis Know the Medical M anagement Know the Nursing Management Complications Make NANDA nursing diagnosis

3. Anatomy and Physiology of Heart Walls PERICARDIUM: It is a outermost membrane of the heart. Which is double membranous sac The outer sac is fibrous pericardium and inner sac is serous pericardium. MYOCARDIUM: Myocardium is composed of cardiac muscles found only in heart The ends of cells are closed contact with adjacent cells. These joints or Intercalated discs are thicker darker lines. When an impulse is initiated it spread from cell to cell via these discs. ENDOCARDIUM: It is the inner most layer of the heart.it surrounds the chambers of the heart.

4. INTRODUCTION PERICARDITIS: It is the swelling and irritation of thin sac like tissues surrounding the heart. It often causes sharp chest pain occurred by the layers of pericardium rub against each other. MYOCARDITIS: It is an inflammatory process involving the myocardium, can cause heart dilation, thrombi on the heart wall, Infiltration of circulating blood cells around the coronary vessels and between the muscle fibres. ENDOCARDITIS: It is the inflammation of the inner lining of the heart chambers and walls, and usually caused by the infection from blood stream and attach to damage area of the heart.

5. TYPES PERICARDITIS MYOCARDITIS ENDOCARDITIS ACUTE PERICARDITIS ACUTE MYOCARDITIS INFECTIVE ENDOCARDITIS RECURRENT PERICARDITIS CHRONIC MYOCARDITIS RHEUMATIC ENDOCARDITIS CHRONIC CONSTRICTIVE PERICARDITIS LYMPHOCYTIC MYOCARDITIS ACUTE ENDOCARDITIS CHRONIC ENDOCARDITIS

6. VIRAL INFECTION: Coxasackie virus A&B strands , Poliomyelitis, influenza virus, Rubella, Odeno virus, HIV, Covid-19 BACTERIAL INFECTION: Diphtheria, Tuberculosis, Typhoid Fever, Tetanus, Staphylococcal, Pneumococcal, streptococcus, E coli PARASITIC AND FUNGAL: Trapanosome, Candida CONNECTIVE TISSUE DISEASE: Lupus rheumatoid arthritis DRUG & CHEMICAL POISONING: Penicillin, sulphonamides, anti-seizures, cocaine RADIATION THERAPY: Large doses of radiation to chest AUTOIMMUNE DISORDERS: Rheumatoid arthritis TUMOR OR CANCER: Metastasis from breast CAUSES OF INFLAMATION

7. PATHOPHYSIOLOGY

8. CLINICAL MANIFESTATIONS Chest pain Fever, Chills Tachycardia Fatigue Dyspnea Syncope Palpitations Discomfort in chest and upper abdomen Flue like symptoms like headache ,body aches ,joint pain ENDOCARDIUM: Valvular damage Rapture of cordhae tandinae Pulmonary Embolism Heart Block

9. Assessment and Diagnostic Findings Patient history Physical examination Heart sounds WBC count C Reactive Protein test Leucocyte count Erythrocyte Sedimentation R ate ( ESR ) Ct Scan Magnetic Resonance Imaging ( MRI ) Endo Myocardial Biopsy Stool and Throat culture Blood test for Heart muscle enzymes(Troponin and CK levels)

10. PREVENTION Avoid close contact with people Avoid Alcohol Quit Smoking Reduce Sodium Diet Reduce Stress Do not eat unhealthy food Do not awake more ( have proper sleep )

11. MEDICAL MANAGEMENT Antibiotics(Penicillin) Analgesics and anti inflammatory Angiotensin Converting Enzymes Inhibiters ( ACEIs ) captopril , enalapril ,lisinopril Angiotensin 2 Receptor blockers : Losartan , Valsartan Beta Blockers : metaprolol , carvadelol Diuretics : Furosemide Corticosteroids : Prednisone.

12. SURGICAL MANAGMENT Pericardialcentesis Extra Carporal Membrane Oxygenation ( ECMO ) Heart Transplant Open Heart Surgery

13. NURSING MANAGEMENT NURSING INTERVENTION RATIONALS Assess the vital signs and characteristics of heart beat, every 2-hours. To assist in creating accurate diagnosis. Assess the breath sounds via auscultation Breath sounds are important sign of fluid overload and myocarditis Administer the antibiotics and other medication as per order To alleviate the symptoms of infectious disease. Provide bed rest to patient It reduces the myocardial oxygen demand Administer supplemental oxygen as prescribed To increase oxygen level and achieve an SPO2 as in target rang

14. Elevate the head of the bed to semi-fowlers position Head elevation help improve the expansion of lungs. Prepare the patient for ventricular assist device by consent This help the ventricles of heart to pump more blood supply In ineffective breathing situation check the ABG level. It helps to identify the level of O2 and CO2 Evaluate the patients response to pharmacological treatment In order to compare the response with patients therapy goal Encourage to take adequate oral fluids as prescribed In order to prevent from dehydration

15. COMPLICATIONS Pericardial Effusion Cardiac Temponade Cardiomyopathy Heart Failure Irregular Rhythms Pulmonary Embolism Cerebral Hemorrhage

16. NURSING DIAGNOSIS Acute pain related to inflammation as evidence by hyperthermia Decrease cardiac output related to impaired cardiac contractility as evidence by arrhythmia Activity intolerance related to oxygen imbalance as evidence by fatigue and breathing difficulty Ineffective breathing pattern related to decrease expansion of lungs as evidence by productive cough D eficient knowledge related to disease as evidence by patients questions about the condition

17. 1: Which of following test is criterion standard for diagnosis of Myocarditis? a: ECHOCARDIOGRAPHY C: ENDOMYOCARDIAL BIOPSY B: SCINTIGRAPHY D: ELECTROCARDIOGRAM 2: which of the following result in left ventricular hypertrophy except : A : Aortic stenosis c : systemic hypertension B: mitral stenosis d : coarctation of aorta 3: Which of these is most commonly responsible for myocardial infarction : A : Aneurysm c : heart failure B : coronary artery thrombosis d : Renal failure 4 : The following commonly cause myocarditis : A: dengue fever c: malaria B: Trypanosome cruzi d : radiations Post Activity Questions

18. REFERENCES BRUNNER & SUDDARTH MEDICAL –SURGICAL NURSING 13 th Edition LAKHWINDER KAUR &SUKHWINDER KAUR MEDICAL –SURGICAL NURSING 4 th Edition www.nclex.edu