D.

Evaluation

1.Clients Daily Progress Chart (From Admission to Discharge)

Days Admissi Day 1 Day 2 Day 3 Day 4 Day Discharge

on 5

Nursing
interventions

1. Anxiety related X X
to major change
as evidenced by
maturational or
situational crisis.

2. Activity
Intolerance X X
Related to
Generalized
weakness as
evidenced by
fatigue and
exceptional
discomfort

3. Acute pain X X
related to
physical injury
agent as
evidenced by
abscess.

4. Anxiety Related X X
to major change
in health status

5. Acute Pain X X
Related to
Physical injury
e.g., abscess

Vital Signs 37.8 ° 37.8° 37.7°

Temperature (c°) 70bpm 74bp 88bp
Pulse Rate (bpm) 20cpm 26cp 20cp
Respiratory Rate (cpm) 120/70 - -
Blood Pressure:
DXC/Lab Procedures
Medical Management
D5O3NaCl 500 * X X
16ggts/min

Drugs X
Lanoxin ).25 mg/1 tab *
4 doses then ½ tab
Diet
Low Sodium X X
Low Fat X X
Activity Exercise
Surgical Mgmt

III. SUMMARY OF FINDINGS

Echocardiography report

 Dilated LV with normal wall motion and contractility. Computed ejection fraction of
72%. No intracardiac thrombus nor effusion noted
 Dilated RV with good wall motion
 Dilated RA with no evidence of thrombus. Normal LA, main pulmonary artery, aortic
root, and proximal ascending aorta dimensions.
 Structurally normal mitral, aortic, tricuspid, and pulmonic valves.
 Color flow and Doppler studies: No abnormal color flow display noted across the valves.
No Doppler evidence of impaired LV relaxation. Normal pulmonary artery pressure by
pulmonary acceleration time.

Radiologic Report
 No active parenchymal infiltrates
 The heart is normal in size. Aorta is unremarkable.
 Hemidiaphragms, constophrenic sulci and visualized bones are intact.

IV. CONCLUSION

Myocarditis is known as inflammation and damage of the heart muscles. It is a condition that
occurs with blood in the heart stops abruptly. What causes the heart to stop is the blockage of one
or multiple arteries. Usually what clogs the arteries are usually fat, cholesterol, and other waste
products. There are many causes of myocarditis that also include viral infections, toxins, and
adverse reactions to medications.

The group has been researching signs and symptoms to this particular disease and is
knowledgeable on the necessary nursing interventions are needed in treating patients that are
suffering from it.

V. RECOMMENDATION
During the case study, our group has attained knowledge about the patient’s condition and would
help the patient, the family and the rest of the health care team.

The following is a list of recommendations made by the group:

For the Student Nurses – It is recommended being prepared with the right knowledge and also
applying the proper interventions and management to provide an efficient nursing care to their
client that has the same condition.

For the Nurse Educators –This study can help the nursing educators by providing in depth
information regarding the condition/disease with their complications. The researchers recommend
health teachings regarding the risk factors that can cause the disease conditions.

For the Health Care Provider – learning never stops in comes to the medical practitioner and
nurses because new innovation are made to improve patient quality of life everyday in health
care. Health care delivery system plays an important role in helping patient with this condition
and that’s why nurses and medical practitioners update themselves in the different new
discoveries with this condition.

IV. Learning Derived

Our case study is about viral myocarditis. I have learned that this type of myocarditis is
common among children and adults. This could be prevented and treated if detected early, thus,
saving lives. I realized again that knowledge deficit is a huge factor that leads to more severe
stages of a disease and eventually death, if left untreated. Appropriate health teachings and good
support system really does help in alleviating and improving the client's condition.
-Julie Banag
“Education is what remains after one has forgotten what one has learned in school.” Albert
Einstein

Viral myocarditis or viral heart disease is a heart condition caused by a virus. The virus
attacks the heart muscle, causing inflammation and disrupting the electrical pathways that signal
the heart to beat properly. This condition can happen to people who seem to be in good health the
infection can go unnoticed. The only sign of viral heart disease is flu-like symptoms which
include all or some of these symptoms: an abnormal heartbeat, chest pain, fatigue, fever, muscle
aches, sore throat, joint or leg pain or swelling and fainting or shortness of breath.

What we learn from these study cases, clinical and lectures and take forward to use either
for our own or patients is very well worth sacrificing for. Impacting one patient or person at a
time will lead to a life of satisfaction and that is more than monetary gratification.
-Roberto Guerra

“Continuous Improvement is better than delayed perfection”

- Mark Twain

What I learned throughout this whole case study is that as nurses we should always be
mindful that there is always new information to attain. With the condition being myocarditis,
there are different types of ways that can cause this disease to occur. With different types of
variables that can affect the patients health, it’s going to be difficult to specify the main problem.
If we stay focused and update ourselves with information each day then we will have a easier
time preventing those types of diseases to occur, and make our work much faster and effectively.
-Adryan Galang

"Prevention and early detection of a disease is better than cure"

Negligence and lack of knowledge of a disease always results in aggravation of it like in

viral myocarditis, if not detected early it will lead to chronic heart failure and eventually death.
What I've learned from this case study is that if you feel ill and you are not 100% healthy, don’t
hesitate to go hospitals even though you don’t have enough money, there are public hospitals like
JBL that caters mostly poor people. You will waste more money if a simple illness will be severe
if not treated early

It is always our health that is important. As a student nurse, we can be a leader towards
our clients by health teachings and make them realize that early detection and treatment of a
disease is vital and it should be taken seriously.

-Carlo Intel Llacer

In this case study, I have learned so much about this one disease. I have learned that there
are about four different types of cardiomyopathy. In our case study, we had the opportunity to
learn about dilated cardiomyopathy. This is the most common type which decreases ventricular
output leading to failure of the left and right heart. Test like the echocardiography can show the
dilation, and this is the most important diagnostic tool for all cardiomyopathies. The treatment
was given through IVF and its very similar to many of the heart failure treatments. One important
factor I did learn as well was the diet and genetics play a big part when encountering a disease
that can be formed on its own.

-Munsayac, Ericka Eunice C

From this case study, I was able to learn about viral myocarditis and how it can lead to
dilated cardiomyopathy. I learned that these heart conditions can possibly lead to further heart
complications if left untreated. Additionally, I learned of the cause of the disease, its
manifestations and nursing interventions for the condition. Despite not having any approved
medical therapies specifically for DCM, I find it interesting that there are people out there who
are currently working to provide something for DCM hearts. Furthermore, I realized the
importance of having a healthy heart in order to reduce risks of future heart complications. It has
reminded me how crucial it is to take care of our hearts and bodies by making a few changes to
our lifestyle.

-Janine Ong

My time in Pedia was short lived compared to my other wards so far. However even with
that little moment, I have learned a great deal of knowledge. For one, it was my first time being
leader. I learned how to conduct orders and how to conduct endorsements properly. Another is it
taught me how to calculate IV fluids. Thirdly, I was taught on the placements of all things in
every ward. Not just pediatrics, but how different IVF set ups work and how to properly check if
the IVF lines were patent or not. Even though my time was limited in Pedia, I can say with full
certainty that it still taught me as much knowledge as the other wards I've been to before.
 -Shanan Santiago

BIBLIOGRAPHY

Books:

Cross. Simon S. Underwood’s Pathology 6th Edition

Woods L Susan Cardiac Nursing 6th Edition

Seeley’s Essentials of Anatomy and Physiology Ninth Edition
Chapter 12 The Heart
p. 318, 319, 320, 321, 322, 323, 324, 325, 326, 327, 328, 329, 330, 347 and 348

Chapter 13 Blood Vessels and Circulation

p. 355

Chapter 15 Respiratory System

pp. 412, 413, 414, 415, 416, 417, 418, 419, 420, 421, 422 and 423

Cites:

https://www.myocarditisfoundation.org/wp-content/uploads/2017/02/MF-
Pediatric16_Proof_2017.pdf

http://www.doh.gov.ph/sites/default/files/publications/2013PHScompressed_0.pdf

http://circres.ahajournals.org/content/118/3/496#ref-22

https://www.myocarditisfoundation.org/about-myocarditis/

http://www.drugdevelopment-technology.com/news/newsmyokardia-begins-dosing-in-phase-i-
trial-of-myk-491-to-treat-dcm-5732247

http://investors.myokardia.com/phoenix.zhtml?c=254211&p=irol-newsArticle&ID=2241662

https://globenewswire.com/news-release/2017/02/02/913351/0/en/First-Subjects-Dosed-in-Phase-
1-Study-of-Dilated-Cardiomyopathy-Candidate-MYK-491.html