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PMBrush up on key concepts29Cardiovascular refresher (continued)PERICARDITISKey signs and symptomsAcute pericarditis Pericardial friction rub (grating sound heard as the heartmoves) Sharp and usually sudden pain that usually starts over the sternum and radiates to the neck, shoulders, back, and arms (unlikethe pain of MI, pericardial pain is commonly pleuritic, increasingwith deep inspiration and decreasing when the client sits up andleans forward, pulling the heart away from the diaphragmaticpleurae of the lungs)Chronic pericarditis Pericardial friction rub Symptoms similar to those of chronic right-sided heart failure(fluid retention, ascites, hepatomegaly)Key test results Echocardiography confirms the diagnosis when it shows anecho-free space between the ventricular wall and the pericardium (in cases of pleural effusion).

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Help the client distinguish practices thatare distressing because they dont conformto social norms or personal values from thosethat may place him or others in serious emotional, medical, or legal jeopardy to reinforcethe need to stop behaviors that could harm theclient or others.

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CHRONIC GLOMERULONEPHRITISKey signs and symptoms Edema Hematuria HypertensionKey test results Kidney biopsy identifies the underlying disease and providesdata needed to guide therapy.

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Teaching topics Explanation of the disorder and treatmentplan Medication use and possible adverseeffects Dietary modifications Avoiding aspiration pneumonia Caring for the gastrostomy tube Contacting the American Cancer Societyand local support groupsIn gastriccancer, pain aftereating isnt relievedby antacids andweight loss iscommon.

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Monitoring temperature Recognizing the signs and symptoms ofwound infection Recognizing the signs and symptoms ofulceration Completing skin care daily Contacting the American Cancer Societyand local suport groups265Gastritis isan inflammationof the gastricmucosa thatproduces abdominalcramping, epigastricdiscomfort, andindigestion.

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Nutritional supportDrug therapy Antibiotic therapy according to the sensitivity of the causative organism Antidiarrheals: diphenoxylate with atropine, loperamide Antiemetic: prochlorperazineINTERVENTIONS AND RATIONALES Early intervention with fluid and electrolyte replacement is key because of the risk ofdehydration in young children.

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