Myocardial Infarction & Peripheral Vascular Diseases Q 41 - Gyan Darpan : Learning Portal
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Sunday 24 April 2022

Myocardial Infarction & Peripheral Vascular Diseases Q 41

A client has been admitted to the hospital with a diagnosis of suspected bacterial endocarditis. The complication the nurse will constantly observe for is:
     A. Presence of heart murmur
     B. Systemic emboli
     C. Fever
     D. Congestive heart failure

Correct Answer: B. Systemic emboli

Emboli are the major problem; those arising in the right heart chambers will terminate in the lungs and left chamber emboli may travel anywhere in the arteries. Complications include conduction disease (first-degree atrioventricular block, bundle branch block, or complete heart block), ischemia (emboli to the coronary arteries), embolic stroke, intracerebral hemorrhage, brain abscess, septic emboli leading to infarction of the kidneys, spleen, lungs and other organs, hematogenous spread of infection leading to vertebral osteomyelitis, septic arthritis, or psoas abscess and systemic immune reaction such as glomerulonephritis.

Option A: Cardiac murmurs are observed in about 85% of patients. Heart murmurs may be present, but do not indicate a problem with emboli.
Option C: Fever is the most common symptom. It can be associated with chills, night sweats, anorexia, weight loss, loss of appetite, malaise, headache, myalgias, arthralgias, abdominal pain, dyspnea, cough, and pleuritic pain.
Option D: CHF may be a result, but this is not as dangerous an outcome as emboli. Congestive heart failure develops in 30% to 40% of patients usually due to valvular dysfunction. Other signs include cutaneous manifestations such as petechiae or splinter hemorrhages (non-blanching linear reddish-brown lesions under the nail bed).

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