As you monitor J.F. throughout the day, what other signs and symptoms of embolization will you watch for?

Question

Also explain the diagnostic criteria for infectious endocarditis.

Answer 1

• Cerebral embolization manifesting with changes in level of consciousness (LOC), visual changes,
headache, transient ischemic attacks (TIAs), and stroke
• Embolization to the extremities manifesting with decreased absent arterial pulses, cool fingers and
toes with delayed capillary refill, and cyanosis
• Coronary artery embolization manifesting with signs of angina, MI, heart failure (HF), or cardiac
dysrhythmias
• Embolization to the bowel manifesting with abdominal pain, cramping, and N/V

Positive blood cultures: These are the prime diagnostic test result, even though definitive results
might take a few weeks to obtain if the organisms are slow growing.
Cardiac murmurs: Turbulent blood flow through the damaged valves produces murmurs. In J.F.'s
case, the holosystolic murmur is caused by blood being forced through the stenotic aortic
valve during systole, and the diastolic murmur by backflow of blood from the aorta into the left
ventricle through the incompetent aortic valve during diastole (aortic regurgitation). The best
way to evaluate these murmurs is through cardiac echocardiography—the transesophageal
echocardiogram.
Fever: Inflammatory mediators, released in response to the infectious organisms, produce fever.