Mr.

Nathaniel is a 46 year-old man who has developed symptoms of acute pericarditis

secondary to viral infection. Diagnosis was based on characteristic sign of a friction rub and
pain over the pericardium. (20 points)
1. He patient is experiencing pericardial pain. To alleviate this discomfort, what position
could the nurse assist the patient with maintaining?
- Advice bed rest or chair rest in a sitting-upright and leaning-forward position.
2. When planning Mr. Nathaniel’s care, what should the nurse understand are the objectives
of pericarditis management?
 When planning Mr. Nathaniel’s care, the major goal for the patient may include
relief of pain and absence of complication.
Objective for Pericarditis Mangement:
 Observe for pericardial effusion, which can lead to cardiac tamponade:
arterial pressure falls; systolic pressure falls while diastolic pressure remains
stable; pulse pressure narrows; heart sounds progress from being distant to
imperceptible.
 Observe for neck vein distention and other signs of rising CVP.
 Notify physician immediately upon observing any of the above symptoms,
and prepare for diagnostic echocardiography and pericardiocentesis. Reassure
patient and continue to assess and record signs and symptoms until physician
arrives.
3. The nurse is auscultating Mr. Nathaniel’s chest for a pericardial friction rub. Where will
the nurse auscultate in order to locate the rub?
 The most characteristic sign of pericarditis is a creaky or scratchy friction rub
heard most clearly at the left lower sternal border.