Question

A patient presents to the clinic with fever, chills, and malaise. Physical examination reveals a new onset of murmur, subungual hemorrhages, and painful Osler nodes What diagnosis does the nurse practitioner suspect based on these findings?

a. Right-sided congestive heart failure
b. Left-sided congestive heart failure
c. Bacterial endocarditis
d. Viral endocarditis

Answer 1

Based on symptoms such as fever, heart murmur, and Osler nodes, the nurse practitioner suspects bacterial endocarditis, an infection of the heart's endocardial surface.

Step-by-step explanation:

A patient presenting with fever, chills, and malaise, along with a new onset of heart murmur, subungual hemorrhages, and painful Osler nodes, is most likely suspected of having bacterial endocarditis by the nurse practitioner. Bacterial endocarditis is an infection of the heart's endocardial surface, typically involving the heart valves and leads to the formation of bacterial vegetations. Damage to the heart, often requiring valve replacement, can occur and be identified by signs like a heart murmur and Osler nodes, which are indicative of this condition.

In contrast, right-sided or left-sided congestive heart failure is less likely given the presentation of signs more specific to infection as well as heart valve involvement, which is more characteristic of endocarditis. Viral endocarditis is rare compared to bacterial causes, especially given the presence of identifiable bacterial risk factors, though it remains in the differential diagnosis until proven otherwise.