Santos, Zaki Delfin E.

BSN 3-YA-18
NCMB 312: MS1 COURSE TASK CU1

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) The patient is experiencing pericardial pain. To alleviate this
discomfort, what position could the nurse assist the patient with maintaining? When planning Mr.
Nathaniel’s care, what should the nurse understand are the objectives of pericarditis
management? The nurse is auscultating Mr. Nathaniel’s chest for a pericardial friction rub.
Where will the nurse auscultate in order to locate the rub?

1. The patient is experiencing pericardial pain. To alleviate this discomfort, what position
could the nurse assist the patient with maintaining?

- To alleviate discomfort from pericardial pain in a patient with acute pericarditis,

the nurse can assist the patient in maintaining a semi-Fowler's position. The
semi-Fowler's position involves elevating the head of the bed to a 30 to
45-degree angle.

2. When planning Mr. Nathaniel’s care, what should the nurse understand are the
objectives of pericarditis management?

When planning the care of a patient like Mr. Nathaniel, who has acute pericarditis
secondary to a viral infection, the nurse should understand the objectives of pericarditis
management. The primary goals of managing pericarditis include:

I. Relief of Pain and Discomfort

- The most immediate objective is to alleviate the chest pain and discomfort typically
associated with pericarditis. Pain management is crucial and may involve the use of
nonsteroidal anti-inflammatory drugs (NSAIDs) or other pain relief medications as
prescribed.

II. Resolution of Inflammation

- Pericarditis is characterized by inflammation of the pericardium (the sac surrounding
the heart). The aim of treatment is to reduce and resolve this inflammation. NSAIDs,
colchicine, or corticosteroids may be prescribed for this purpose, depending on the
underlying cause and severity of the condition.

III. Prevention of Complications

- Pericarditis can lead to complications such as pericardial effusion (accumulation of
fluid in the pericardial sac) or cardiac tamponade (compression of the heart due to
excessive fluid accumulation). Management should aim to prevent or promptly address
these complications if they arise.
IV. Management of Underlying Cause
- If pericarditis is secondary to an underlying cause (such as a viral infection,
autoimmune disease, or myocardial infarction), the healthcare team will work to address
and treat the root cause. This may involve antiviral medications, antibiotics, or treatment
for the underlying condition.

V. Monitoring for Recurrence

- Pericarditis can recur in some cases. The healthcare team should monitor the patient
for any signs of recurrence and adjust the treatment plan accordingly.

VI. Preventing Secondary Cardiac Issues

- Patients with pericarditis may be at risk of other cardiac issues, such as arrhythmias.
Monitoring and managing these potential complications is essential.

VII. Patient Education

- Providing the patient with education about the condition, its causes, and the
importance of compliance with the prescribed treatment plan is crucial. This includes
educating the patient about the potential side effects of medications and when to seek
medical attention.

VIII. Psychosocial Support

- Addressing the emotional and psychological impact of pericarditis is important. The
nurse should provide emotional support, encourage open communication, and offer
resources for coping with stress and anxiety related to the diagnosis and treatment.

IX. Follow-Up and Recovery

- Ensure that the patient receives appropriate follow-up care and monitoring to assess
treatment effectiveness and prevent complications. This may involve periodic
echocardiograms and clinical evaluations.

X. Return to Normal Activities

- As the patient's condition improves, the goal is to gradually return to normal daily
activities and exercise, while following the healthcare provider's guidance.

XI. Adherence to Medications and Lifestyle Modifications

- Reinforce the importance of taking prescribed medications as directed and making
necessary lifestyle modifications (such as dietary changes or smoking cessation) to
manage and prevent pericarditis.

XII. Patient and Family Satisfaction

- Assess the patient and family's satisfaction with the care provided, addressing any
concerns, questions, or issues they may have.
 These objectives are essential in managing pericarditis effectively and promoting
the patient's recovery and well-being.

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?

I. Left Lower Sternal Border (LLSB):

● Place the stethoscope diaphragm or bell over the left lower sternal border, which is the
area where the lower edge of the sternum (breastbone) meets the ribs. This is a
common location for pericardial friction rubs to be heard.
II. Apex of the Heart (Apical Area):
● Move the stethoscope slightly downward and to the left to the apex of the heart. This is
the point of maximal impulse (PMI) and is typically located in the fifth intercostal space at
or just medial to the midclavicular line on the left side of the chest. Auscultate this area
as well.
III. Left Upper Sternal Border (LUSB):
● It's also advisable to listen over the left upper sternal border, which is higher on the
chest, as pericardial rubs can sometimes be heard in this area.