Valvular Heart Disease Flashcards
How is valvular heart disease defined?
Valve affected & type of dysfunction
Valvular Dysfunction
Stenosis; Regurgitation
Stenosis definition:
Narrowing of the valves
Regurgitation definition:
Incomplete closure of valve leaflets
Mitral valve failed to completely close
Mitral valve regurgitation
Result of mitral valve regurgitation? Particular sign?
Blood is pushed back into the left atrium; see signs of pulmonary edema
Mitral valve leaflets prolapse back into left atrium during systole
Mitral valve prolapse
Most common form of valvular disease in the US?
Mitral valve prolapse
S/S Mitral Valve regurgitation
Fatigue/Dyspnea; loud murmur; decreased cardiac output
Complications of mitral valve prolapse
Heart failure; infective endocarditis; Mitral regurgitation; CVA; Dysrhythmias
S/S Mitral Valve Prolapse
Dysrhythmias (ventricular);
May or may not have chest pain
Result of Aortic Valve Stenosis
Left Ventricular hypertrophy and decrease in cardiac output and heart failure
When do s/s develop with aortic valve stenosis?
When office 1/3 of it’s normal size
S/S of aortic valve stenosis
Symptoms of left ventricular failure (angina; syncope; exertional Dyspnea); Murmur; Symptoms of Heart Failure
Diagnostic Studies for Valvular Heart Disease
H&P Echo CXR ECG Cardiac Cath
When is percutaneous transluminal balloon valvuloplasty used?
When patients are not candidates for surgical valve replacement
What is percutaneous transluminal balloon valvuloplasty used for? What can you expect would be an eventual outcome?
Stenosis; Most would end up w/ some degree of regurgitation
Medical management of valvular heart disease
Prevention of recurrent rheumatic fever;
Prevention of exacerbating of HF and recurrent endocarditis; observe for disease management; prophylactic therapy to prevent infection
Surgical management of valvular heart disease
Percutaneous transluminal balloon valvuloplasty
Valve repair or replacement
Mechanical valve replacement advantage/disadvantage
More durable but requires lifelong anticoagulant therapy; hear clicking sound
Biological valve replacement advantage/disadvantage
Less durable (15-20yr) does not require lifelong anticoagulant therapy
What is one big risk despite what type of valve replacement the patient gets?
Both @ risk of infective endocarditis
Nursing Care Valvular Heart Disease
Assessment (History and Physical);
Decreased Cardiac output; Activity Intolerance; Risk for Bleeding; Risk for Infection; Knowledge Deficit
What should nurse do for valvular heart patient w/ decreased cardiac output
Monitor for s/s heart failure
Daily wt; fluid Restriction; Monitor V/S; Elevate HOB; Rest; Meds; Supplemental Oxygen
What should nurse do for valvular heart patient with activity intolerance?
Watch for Dyspnea w/ exertion;
Create Exercise plan w/ client; Allow for rest periods; Energy Conservation
What should nurse do for valvular heart patient w/ risk for bleeding?
Watch for s/s bleeding when pt on anticoagulants;
Monitor PT/INR; Report INR > 3.5;
Monitor Emesis & Stool
What should nurse do for valvular heart patient w/ risk for infection
Watch for s/s infection;
Monitor WBC & Temp (And other V/S);
Aseptic technique;
Prophylactic Antibiotics
What should nurse teach valvular heart patient to watch out for?
s/s Heart failure, infection, bleeding;
Keep lab and Dr appts;
Prophylactic antibiotics for dental work and invasive procedures
