Bacterial Endocarditis

RAGASA, MARIA THERESE S.

Reference: Maternal and Child Health Nursing 6 th Edition – Adele Pillitteri
 Definition
● ENDO: Internal
● CARD: Heart
● ITIS: Inflammation
● Endocarditis is
inflammation and
infection of the inner
lining of the heart
(Endocardium). Mainly
the chambers and valves
of the heart.
 2 TYPES

ENDOCARDITIS

INFECTIVE NON INFECTIVE

Caused by Not caused

bacteria or by bacteria
fungi or fungi
● Staphylococcus
● Streptococcus
Who is the culprit?

Viridans Streptococci
 Steptococcal infection
● Tends to invade the body during oral surgery.
● Enter from a urinary tract infection or a skin infection.
● As the disease progresses, vegetation (abnormal growth)
composed of bacteria, fibrin, and blood appears on the
endocardium of the valves and heart chambers.

● Over a period of time, the invading process destroys the

endocardial lining of the heart, underlying muscle and
valves
 Assessment
● Insidious (gradual with harmful effects) onset
● Arthralgia (pain in joints)
● Malaise, chills, periods of sweating
● Audible heart murmurs
 Assessment (cont.)
● C – Clots in heart and body
● L – Lung fluid (crackles) ; Le quadrant abdominal pain
from infarction of spleen

● O – Overheating (fever) body’s response to fight infection

● T – too little OXYGEN from decreased C.O.
➢ Pale, Anorexia and Weight loss
➢ Petechiae of conjunctiva or oral mucosa
4 CLASSICAL SIGNS AND SYMPTOMS
> Splinter hemorrhages (or haemorrhages) are tiny blood
clots that tend to run vertically under the nails

>Roth's spots are retinal hemorrhages with white or pale

centers composed of coagulated fibrin including platelets,
focal ischemia, inflammatory infiltrate, infectious organisms,
or neoplastic cells

>Osler’s nodes - small, raised, red, painful nodes on the pads

of the fingers or toes

>Janeway lesions (small, painless, red-blue macular lesions

on palms and soles
 Laboratory Studies
● Proteinuria
● Hematuria
● Normochromic , normocytic anemia
● Leukocytosis
● Increased ESR
● ECG = Vegetative growths on heart valves
● BLOOD CULTURE : Confirmatory test (reveals presence of
invading organism)
 Therapeutic Management
1. Prophylactic administration of antibiotic before ear, nose,
throat, tonsil or mouth surgery (prior childbirth)

2. Therapy towards underlying infection

3. Drug of choice: Penicillinase-resistant penicillin such as
nafcillin (Unipen) via IV through central venous access
device

4. Long-term follow-up care

 Nursing Implications
1. Be precautious to the signs and symptoms of Bacterial
Endocarditis.
2. A child with a known congenital heart defect should be
evaluated.
3. Prophylactic use of antibiotics before procedures such as
invasive dental procedures should be observed and
followed
4. Provide long-term and continued follow-up care to
monitor the child’s condition
5. Have the child on bed rest.
Central Venous Access
THANK YOU!