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NURS 3512 - Class 1-6 > Week 4 - Valvular Heart Disease > Flashcards

Week 4 - Valvular Heart Disease Flashcards

1
Q

what are 2 functional disorders r/t heart valves

A
  • stenosis

- regurgitation

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2
Q

what is stenosis

A
  • what the valve opening is narrowed = impeded forward blood flow thru the valve
  • d/t scar tissue or infection
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3
Q

what is regurgitation

A
  • when the valve fails to close completely = backward flow of blood
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4
Q

what side of the heart do valve disorders occur more frequently in

A
  • left side of the heart
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5
Q

symptoms of valvular heart disease depend on? (2)

A
  • what the problem is

- how severe

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6
Q

what are often heard with valvular heart disease

A
  • murmurs
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7
Q

what is mitral valve stenosis

A
  • obstruction of blood flow from the left atrium to left ventricle
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8
Q

what does mitral valve stenosis cause (3)

A
  • back up of blood into the L atrium and the lungs
  • atrial enlargement/hypertrophy
  • pulmonary congestion
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9
Q

what are symptoms of mitral valve stenosis (9)

A
  • exertional dyspnea
  • SOB
  • fatigue
  • palpitations (afib)
  • hoarseness (atrial enlargement pressing the larygneal nerve)
  • hemopytisis (pulm HTN)
  • chest pain (decreased CO)
  • seizures
  • stroke
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10
Q

how can mitral stenosis lead to the formation of emboli

A
  • develops in the L atrium due to stasis of the blood (bc cannot move forward)
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11
Q

what is aortic valve stenosis

A
  • narrowing or stricture of the aortic valve which leads to obstruction of blood flow between the left ventricle and aorta
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12
Q

what does aortic valve stenosis cause (3)

A
  • left vent. hypertrophy
  • increased myocardial O2 consumption (bc increased myocardial mass)
  • decreased CO
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13
Q

when do symptoms of aortic valve stenosis occur

A
  • when the valve opening becomes approx 1/3 of its normal size
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14
Q

what are symptoms of aortic valve stenosis (3)

A
  • angina
  • syncope
  • exertional dyspnea
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15
Q

what is contraindicated in the treatment of aortic valve stenosis? why?

A
  • nitro

- bc ot decreases preload, and preload is necessary to help open the stiffened valve

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16
Q

what mitral valve regurgitation

A
  • when incomplete valve closure during systole allows blood to flow backward from the L ventricle to the L atrium
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17
Q

what does mitral regurg cause (3)

A
  • decreased ventricular filling = decreased CO
  • ventricular hypertrophy
  • both ventricle & atrium work harder to preserve CO
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18
Q

describe symptoms of mitral regurg

A
  • often asymptomatic until development of left ventricular failure
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19
Q

what are symptoms of mitral regurg (6)

A
  • thready peripheral pulse
  • cool, clammy extremities
  • dyspnea
  • shock
  • signs of left ventricular failure
  • pulm edema
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20
Q

what are signs of L ventricular failure (6)

A
  • weakness
  • fatigue
  • palpitations
  • dyspnea
  • orthopnea
  • peripheral edema
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21
Q

what is aortic regurg

A
  • incomplete valve closure which leads to blood backing up from the aorta to the L ventricle
22
Q

what does aortic regurg cause

A
  • L ventricular hypertrophy = ineffective pump = low CO
23
Q

what are signs of aortic regurg (5)

A
  • low CO
  • shock
  • profound dyspnea
  • hypotension
  • chest pain
24
Q

what is the most common form of valve disease

A
  • mitral valve prolapse
25
Q

what is mitral valve prolapse

A
  • abnormallity of the mitral valve leaflets & papillary muscle that allows the leaflets to collapse or buckle up into the L atrium during systole
26
Q

what can mitral valve prolapse lead to

A
  • mitral valve regurg
27
Q

what can cause mitral valve prolapse (2)

A
  • CT disorder

- genetic

28
Q

describe symptoms of mitral valve prolapse(2)

A
  • often asymptomatic

- broad spectrum of severity

29
Q

list symptoms of mitral valve prolapse (8)

A
  • murmur
  • clicks heard during systole
  • dysrhythmias
  • palpitations
  • light-headedness & syncope
  • dizziness
  • chest pain
  • dyspnea
30
Q

what can be used to diagnose valvular heart disease (6)

A
  • history
  • phys exam
  • echo
  • cardiac catheterization
  • chest xray
  • ECG
31
Q

treatment for valvular heart disease depends on..

A
  • valve involved

- severity

32
Q

what are types of treatment done for valvular heart disease

A
  • conservative therapy

- procedural or surgical valve replacement or repaier

33
Q

what is the goal of conservative therapy for valvular heart disorders (4)

A

prevent exacerbations of:

  • HF
  • pulm edema
  • thromboembolism
  • recurrent endocarditis
34
Q

if symptoms of HF develop during valvular heart disease, what meds are gievn (5)

A
  • vasodilators
  • positive intotropes
  • beta blockers
  • diuretics
  • low sodium diet
35
Q

what meds are given for valvular heart disease (3)

A
  • anticoag
  • antidysrhythmia
  • digoxin
36
Q

what are 2 types of procedures done for valve replacement or repair

A
  • open surgery

- percutaneous

37
Q

what determines what procedure is done for valve replacement or repair? what is preferred?

A
  • clinical state of pt
  • pt ability to tolerate procedure/surgery
  • valve repair preferred
38
Q

what does percutaneous valvuloplasty involve

A
  • threading a balloon tipped catheter from the femoral artery to the stenotic valve so the balloon can be inflated to attempt to separate the valve leaflets
39
Q

what are 2 types of percutaneous procedures done for valve repair/replacement

A
  • percutaneous aortic valve replacement

- percutaneous transluminal balloon valvuloplasty

40
Q

what is percutaneous aortic valve replacement

A
  • involves inserting a bioprosthetic valve using a femoral arterial approach
41
Q

what are 2 types of valves to consider for valve replacement

A
  1. mechanical

2. biologic

42
Q

what are mechanical valves

A
  • valves manufactured from artifical materials

ex. metal alloys, carbon, dacron

43
Q

what are biologic valves

A
  • valves constructed from animal or human tissues + some artifical tissue
    ex. bovine, porcine, and human cardiac tissue
44
Q

what is the benefit to mechanical valves

A
  • durable

- last longer than biologic (~20 years)

45
Q

what is the con to mechanical valves

A
  • increased risk of thromboembolism = life long anticoag therapy and frequent monitoring of blood
46
Q

what is the pro to biologic valves

A
  • do not necessitate anticoag therapy
47
Q

what is a con to biologic valves (4)

A
  • less durable
  • can calcify
  • can cause stiffening of leaflets
  • can cause tissue degeneration
48
Q

what is the overall goal for pts with valvular heart disease (3)

A
  • normal cardiac function
  • improved activity tolerance
  • understanding of the disease process and health maintenance measures
49
Q

what should you teach a pt with valvular disease (11)

A
  • must adhere to meds
  • develop an approp exercise plan to increase cardiac tolerance
  • restrict activities that regularly produce fatigue and dsypnea
  • smoking cessation
  • avoid strenuous physical activity
  • if mechanical valve, need anticoag for rest of life
  • monitor for S&S of excess fluid volume (S&S of HF)
  • restrict salt
  • avoid caffeine
  • admin O2 as ordered
  • need prophylactic antibiotics before all invasive surgical or diagnostic procedures & the dentist ***
50
Q

why should a pt wit valvular disease avoid strenuous physical activity

A
  • valve cannot handle the required increase in CO
51
Q

what are some signs of excess fluid volume (3)

A
  • weight gain
  • periperal edema
  • crackles to lung
52
Q

why should a pt with valvular disease avoid caffeine?

A
  • increased risk of dysrhythmias

NURS 3512 - Class 1-6 (47 decks)

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