Heart Valve Disorders

mlinnie's version from 2018-11-09 22:20


Question Answer
Mitral Stenosismitral valve thickens and gets narrower, blocking blood flow from the left atrium to left ventricle
Most cases of mitral stenosis caused byrheumatic fever
Symptoms for Mitral Stenosismoderate to severe: dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, weakness, fatigue, palpitations, jugular vein distention, Ascites with (severe pulmonary hypertension or tricuspid stenosis), edema, hepatomegaly, diastolic thrill at cardiac apex, loud S1 or opening snap and diastolic murmur at the apex
Nursing InterventionCardio Care Six, monitor for heart failure, pulmonary edema, if surgery was done montior for hypotension, arrhythmias,& thrombus formation, Monitor EKG for changes of left atrial enlargement and right ventricle enlargement
Managementantiarrhythmics, if meds fail atrial fibriallation is treated with cardioversion, low-sodium diet prevent retention,
Mitral insufficiency or regurgitationa damaged mitral valve allows blood from the left ventricle to flow back into the left atrium during systole. to handle the backflow, the atrium enlarges; the left ventricle also enlarges, in part to make up for its lower output of blood.
Causes of Mitral insufficiencyfollows birth defects like transposition of the great arteries, in elderly the mitral annulus may become calcified
Assessment Finding for Mitral insufficiencyorthopnea, dyspnea, fatigue, weakness, weight loss, chest pain, palpitations, JVD, Peripheral edema
Management of Mitral insufficiencylow sodium diet; O2; Antibiotics; Prophylactic Antibiotics or surgery
Nursing Interventions for Mitral insufficiencyCardio care six; Monitor Cardio seven; monitor for left-sided heart failure, pulmonary edema, adverse reactions to drug therapy and cardia dysrhythmias especially atrial and V-fib
Diagnostic findings for Mitral insufficiencyEKG for arrythmias, echocardiogram to visualize regurgitant jets and flair chordae/leaflets; cardiac catheterization will show regurgitation of blood from left ventricle to left atrium
Tricuspid Stenosisnarrowing of the tricuspid valve between right atrium and right ventricle; caused by rheumatic fever
Assessment Finding for Tricuspid Stenosisdyspnea, fatigue, syncope, peripheral edema, jaundice with severe peripheral edema and ascites, may appear malnourished, JVD
Nursing Interventions for Tricuspid StenosisCardio care six; monitor the cardio seven; post valve surgery, monitor for hypotension, arrhythmias, & thrombus formation; when client sits, elevate legs to prevent dependent edema
Teaching for Tricuspid StenosisTeach cardio five; compliance with long-term antibiotic; need for prophylactic antibiotic during dental care
Tricuspid insufficiency or regurgitationtricuspid valve lets blood leak from the right ventricle back into the right atrium. results from dilation of the right ventricle and tricuspid valve ring. most common in late stages of heart failure from rheumatic or congenital heart disease
Assessment Finding for Tricuspid insufficiency dyspnea, fatigue, weakness, syncope, peripheral edema may cause discomfort
Managementsurgical - valve replacement
Nursing Interventionsame as Tricuspid Stenosis


Question Answer
Pulmonic Stenosisobstructed right ventricular outflow resulting in right ventricular hypertrophy; usually congenital, often with other birth defects such as tetralogy of Fallot; may result from rheumatic fever
Assessment Finding for Pulmonic Stenosisdyspnea, fatigue, weakness, syncope, peripheral edema may cause discomfort
Management for Pulmonic Stenosis surgical - replace the valve via balloon and cardiac catheter
Pulmonic insufficiency pulmonary valve fails to close, so that blood flows back into the right ventricle. a birth defect, or a result of pulmonary hypertension
Management for Pulmonic insufficiency diuretics - to mobilize edematous fluid to reduce pulmonary venous pressure; sodium-restricted diet - to control underlying heart disease; anticoagulants - to prevent blood clots; digitalis - to increase the force or strength of cardiac contractions (inotropic action) digitalis - to increase the force or strength
Aortic Stenosisaortic valve narrows. Left ventricle must work harder, so needs more oxygen, and may suffer ischemia and heart failure. most significant valvular lesion seen among elderly people. It usually leads to left-sided heart failure. incidence increases with age
Assessment Finding for Aortic Stenosisclassic triad: dyspnea, syncope, angina, palpitations, left-sided heart failure may bring on orthopnea, paroxysmal nocturnal dyspnea, and peripheral edema
Management for Aortic Stenosisnitroglycerin to relieve chest pain, low-sodium diet - to prevent fluid retention, diuretics - to mobilize edematous fluid and to reduce pulmonary venous pressure ; digitalis - to increase the force or strength of cardiac contractions (inotropic action) ; oxygen - to prevent hypoxia ; surgery - percutaneous balloon valvuloplasty, then valve replacement
Nursing Interventions Same as others
Aortic insufficiencyblood flows back into the left ventricle during diastole overloading the ventricle and causing it to hypertrophy. Extra blood also overloads the left atrium and, eventually, the pulmonary system.
Aortic insufficiency may accompany what disorders Marfan's syndrome, ankylosing spondylitis, syphilis, essential hypertension or a defect of the ventricular septum
Assessment Findings for Aortic insufficiencyuncomfortable awareness of heartbeat ; palpitations along with a pounding head; dyspnea with exertion; paroxysmal nocturnal dyspnea, with diaphoresis, orthopnea and cough; anginal chest pain unrelieved by sublingual nitroglycerin ; client's nailbeds appear to be pulsating; if nail tip is pressed, the root will flush and then pale (Quincke's sign); bisferiens pulse (A pulse marked by two systolic peaks on the pulse waveform.)
Management of Aortic insufficiencysame as above