· - Acute pericarditis
- physical examination.
- General examination
- HEENT/Neck
- Heart
- Lungs
- Abdomen
- Extremities
- Skin
- results:
- Order 1:
- Pulse oximetry, stat
- Oxygen inhalation, stat
- IV access, stat
Cardiac monitor, stat - Results:
- Order 2:
- Aspirin, oral, stat, one time
- 12 lead EKG, stat
- CBC with a differential, stat
- BMP, stat (elevated BUN or creatinine may reveals the underlying uremia as the cause of acute pericarditis.)
- Chest X-ray, PA and lateral, stat
CK-MB, stat and repeat in 8 hours x 2 - Troponin I, stat and repeat in 8 hours x 2
- ESR, stat
Blood cultures, stat - results:
- If unknown etiology order 3:
- ANA
- Tuberculin skin test
- HIV serology
- Order 4
- Echo if
- OrdEr 5:
- Admit to floor
Regular diet
Ambulate at will - Vitals Q 4 hours
- Echocardiogram, stat
Telemetry - D/C Oxygen
- Indomethacin, oral, continuous
- Order 6
- Tapping is indicated in
- Once the echo is clear (small fluid) i.e. no evidence of tamponade
- Order 7:
- Reassurance
- Patient counseling
No smoking
No alcohol
Seat belt use
Safe sex
Regular exercise - D/C to home
- Follow up appointment in two weeks
