Valvular Heart Disease

Question 1

How is valvular heart disease defined?

Answer 1

Valve affected & type of dysfunction

Question 2

Valvular Dysfunction

Answer 2

Stenosis; Regurgitation

Question 3

Stenosis definition:

Answer 3

Narrowing of the valves

Question 4

Regurgitation definition:

Answer 4

Incomplete closure of valve leaflets

Question 5

Mitral valve failed to completely close

Answer 5

Mitral valve regurgitation

Question 6

Result of mitral valve regurgitation? Particular sign?

Answer 6

Blood is pushed back into the left atrium; see signs of pulmonary edema

Question 7

Mitral valve leaflets prolapse back into left atrium during systole

Answer 7

Mitral valve prolapse

Question 8

Most common form of valvular disease in the US?

Answer 8

Mitral valve prolapse

Question 9

S/S Mitral Valve regurgitation

Answer 9

Fatigue/Dyspnea; loud murmur; decreased cardiac output

Question 10

Complications of mitral valve prolapse

Answer 10

Heart failure; infective endocarditis; Mitral regurgitation; CVA; Dysrhythmias

Question 11

S/S Mitral Valve Prolapse

Answer 11

Dysrhythmias (ventricular);

May or may not have chest pain

Question 12

Result of Aortic Valve Stenosis

Answer 12

Left Ventricular hypertrophy and decrease in cardiac output and heart failure

Question 13

When do s/s develop with aortic valve stenosis?

Answer 13

When office 1/3 of it’s normal size

Question 14

S/S of aortic valve stenosis

Answer 14

Symptoms of left ventricular failure (angina; syncope; exertional Dyspnea); Murmur; Symptoms of Heart Failure

Question 15

Diagnostic Studies for Valvular Heart Disease

Answer 15

H&P
Echo
CXR
ECG
Cardiac Cath

Question 16

When is percutaneous transluminal balloon valvuloplasty used?

Answer 16

When patients are not candidates for surgical valve replacement

Question 17

What is percutaneous transluminal balloon valvuloplasty used for? What can you expect would be an eventual outcome?

Answer 17

Stenosis; Most would end up w/ some degree of regurgitation

Question 18

Medical management of valvular heart disease

Answer 18

Prevention of recurrent rheumatic fever;
Prevention of exacerbating of HF and recurrent endocarditis; observe for disease management; prophylactic therapy to prevent infection

Question 19

Surgical management of valvular heart disease

Answer 19

Percutaneous transluminal balloon valvuloplasty

Valve repair or replacement

Question 20

Mechanical valve replacement advantage/disadvantage

Answer 20

More durable but requires lifelong anticoagulant therapy; hear clicking sound

Question 21

Biological valve replacement advantage/disadvantage

Answer 21

Less durable (15-20yr) does not require lifelong anticoagulant therapy

Question 22

What is one big risk despite what type of valve replacement the patient gets?

Answer 22

Both @ risk of infective endocarditis

Question 23

Nursing Care Valvular Heart Disease

Answer 23

Assessment (History and Physical);

Decreased Cardiac output; Activity Intolerance; Risk for Bleeding; Risk for Infection; Knowledge Deficit

Question 24

What should nurse do for valvular heart patient w/ decreased cardiac output

Answer 24

Monitor for s/s heart failure

Daily wt; fluid Restriction; Monitor V/S; Elevate HOB; Rest; Meds; Supplemental Oxygen

Question 25

What should nurse do for valvular heart patient with activity intolerance?

Answer 25

Watch for Dyspnea w/ exertion;

Create Exercise plan w/ client; Allow for rest periods; Energy Conservation

Question 26

What should nurse do for valvular heart patient w/ risk for bleeding?

Answer 26

Watch for s/s bleeding when pt on anticoagulants;
Monitor PT/INR; Report INR > 3.5;
Monitor Emesis & Stool

Question 27

What should nurse do for valvular heart patient w/ risk for infection

Answer 27

Watch for s/s infection;
Monitor WBC & Temp (And other V/S);
Aseptic technique;
Prophylactic Antibiotics

Question 28

What should nurse teach valvular heart patient to watch out for?

Answer 28

s/s Heart failure, infection, bleeding;
Keep lab and Dr appts;
Prophylactic antibiotics for dental work and invasive procedures