Infective Endocarditis: NCLEX Priorities
Endocarditis recognition: fever + new murmur, Janeway, Osler, Roth, blood cultures.
Endocarditis is infection of the heart valves. NCLEX tests classic peripheral findings and risk groups.
Classic findings
Fever, new heart murmur, Janeway lesions (painless palmar/plantar), Osler nodes (painful fingertip), Roth spots (retinal), splinter hemorrhages, petechiae.
Risk groups
IV drug users (right-sided, tricuspid), prosthetic valves, structural heart disease, recent dental work without prophylaxis.
Diagnostics
Blood cultures × 3 from separate sites. TEE preferred over TTE for vegetations.
Treatment
IV antibiotics 4-6 weeks based on organism. Vancomycin + ceftriaxone empiric. Valve surgery if HF, severe regurgitation, persistent infection.
Prophylaxis
Antibiotic prophylaxis before dental procedures only for high-risk: prosthetic valve, prior endocarditis, certain congenital heart disease.
Frequently asked
Right-sided endocarditis, typical patient?
IV drug user. Tricuspid valve.
Blood cultures before antibiotics?
Yes, critical. Always.
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