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NCP - 4 Nursing Diagnosis for Endocarditis

Nursing Care Plan for Endocarditis

Endocarditis is an infectious disease caused by microorganisms in the endocardium or heart valve. Endocarditis infections usually occur in the heart that has been damaged. The disease is preceded by endocarditis, usually in the form of congenital heart disease, and acquired heart disease. Formerly the endocardial infection often caused by bacteria that are called bacterial endokariditis. Now the infection is not caused by bacteria, but can be caused by other microorganisms, such as fungi, viruses, and others.

Endocarditis is not only happening in the endocardium and valves that have been damaged, but also on the endocardium, and a healthy valve, for example; through intravenous drug abuse or chronic disease. Course of the disease can be; acute, sub-acute, and chronic, depending on the virulence of microorganisms and patient endurance. Subacute infection is almost always fatal, whereas hyperacute / acute, clinically never existed, because the patient died prior due to sepsis.

Most endocarditis caused by viridans streptococci are microorganisms that live in the upper airway. Prior to the discovery of antibiotics, then 90-95% endocarditis is an infection caused by viridans streptococci, but since discovered antibiotics, viridans streptococci 50% cause of infective endocarditis which is 1/3 of the source of infection. Another cause of infective endocarditis more pathogens, namely; Staphylococcus aureus causes infections subacute endocarditis. Other causes of fecal streptococci, staphylococci, gram-negative aerobic / anaerobic, fungal, viral, yeast and candida.

Predisposing factors beginning with diseases of heart abnormalities can be rheumatic heart disease, congenital heart disease, prosthetic heart valves, sclerotic heart disease, mitral valve prolapse, post cardiac surgery, hypertrophic obstructive cardiomyopathy.

Endocarditis infections often occur in rheumatic heart disease with fibrillation and heart failure. Infection often the mitral valve and aortic valve. Congenital heart disease, endocarditis is a congenital heart disease without ciyanosis, the valve deformity and tetralogy fallop. If there are organic abnormalities of the heart, then a predisposing factor for infectious endocarditis is due to the use of immunosuppressive drugs or cytostatic, hemodialysis or peritonial dialysis, liver cirrhosis, diabetes mellitus, chronic obstructive pulmonary disease, kidney disease, lupus erythematosus, gout, and intravenous drug abuse .
Precipitating factors endocarditis infection is tooth extraction or other action on the teeth and mouth, urinary tract catheterization, action obstretrik gynecologic and respiratory tract inflammation.


4 Nursing Diagnosis for Endocarditis

1. Risk for Ineffective Tissue perfusion related to thromboembolism or secondary damage to the valves in endocarditis.
2. Risk for activity intolerance related to imbalance between myocardial oxygen supply needs.
3. Anxiety related to the fear of death, a decline in health status, crises and threats or health changes.
4. Ineffective individual coping related to the prognosis of the disease, which is one of self-image, and change roles.

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