Medical Surgical Endocarditis #2

Question

The nurse is assigned five clients on the medical floor of the hospital. The hospital’s infection control committee is creating a proactive program to identify clients at risk for hospital acquired infective endocarditis. Which of the five clients would be most at risk for hospital-acquired infective endocarditis?

Answers

  1. Clients with kidney failure and receiving in-hospital dialysis.
    • Rationale:

      This answer is correct because infective endocarditis in clients receiving hemodialysis is significantly more common and causes greater morbidity and mortality than in other populations. This is due to the risk of bacteria, particularly staph, strep, and enterococcus bacteria, that can enter the bloodstream during repeated vascular access during the dialysis.

  2. Oncology clients who just received immunotherapeutic agents.
    • Rationale:

      This answer is not correct because although an oncology client may be at risk for some infections, bacterial (infective) endocarditis occurs due to an infection that enters the bloodstream. Infective endocarditis in clients receiving hemodialysis is significantly more common and causes greater morbidity and mortality than in other populations. This is due to the risk of bacteria, particularly staph, strep, and enterococcus bacteria, that can enter the bloodstream during repeated vascular access during the dialysis.

  3. Clients out of the Intensive Care Unit who were treated with thrombolytics
    • Rationale:

      This answer is not correct because a client who has just been treated with thrombolytics has had limited sticks due to the risk of bleeding. The IV site for thrombolytics is not used as many times or as often as a client taking dialysis. Infective endocarditis in clients receiving hemodialysis is significantly more common and causes greater morbidity and mortality than in other populations. This is due to the risk of bacteria, particularly staph, strep, and enterococcus bacteria, that can enter the bloodstream during repeated vascular access during the dialysis.

  4. All pediatric clients being treated with IV antibiotics.
    • Rationale:

      This answer is not correct because treatment with antibiotics decreases the risk of acquiring bacterial (infective) endocarditis. Infective endocarditis in clients receiving hemodialysis is significantly more common and causes greater morbidity and mortality than in other populations. This is due to the risk of bacteria, particularly staph, strep, and enterococcus bacteria, that can enter the bloodstream during repeated vascular access during the dialysis.

Overview

Clients with kidney failure and receiving in-hospital dialysis are at a higher risk of acquiring hospital acquired bacterial (infective) endocarditis.

Explanation

Learning Outcomes

Bacterial (infective) endocarditis is an infection that can be caused by bacteria which enters the bloodstream and attaches itself to the heart valve or cardiac blood vessel. This vegetation which grows within the heart valve or vessel and can result in serious heart damage or death related to emboli. Infective endocarditis in clients receiving hemodialysis is significantly more common and causes greater morbidity and mortality than in other populations. This is due to the risk of bacteria, particularly staph, strep, and enterococcus bacteria, that can enter the bloodstream during repeated vascular access during the dialysis.

Test Taking Tip

Watch description words that make all the difference in a question’s correct response. “Hospital acquired” infective endocarditis will require a different response than just “infective carditis.”

Video Rationale