Cardiac Valvular Disorders Overview

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Questions and Answers

What is the primary cause of the narrowing of the aortic valve in aortic stenosis?

  • High blood pressure
  • Thickening, scarring, calcification, or fusing of the valve's flaps (correct)
  • Increased blood viscosity
  • Pulmonary embolism

In aortic stenosis, the left ventricle contracts less forcefully to compensate for the difficulty in ejecting blood.

False (B)

Name one major cause of aortic stenosis.

Congenital defects or rheumatic heart disease

For patients who are high risk for traditional open-heart surgery, a ______ can be performed instead.

<p>transcatheter aortic valve replacement (TAVR)</p> Signup and view all the answers

Match the aortic stenosis symptom with its description:

<p>Exertional angina = Chest pain during physical activity Exertional dyspnea = Shortness of breath during activity Exertional dizziness = Feeling faint or lightheaded during exertion Systolic murmur = Heart sound that increases after S1 and decreases before S2</p> Signup and view all the answers

Which of these diagnostic tests is commonly used to show enlargement of the left ventricle and left atrium?

<p>ECG (C)</p> Signup and view all the answers

Valvotomy is often used as a first-treatment option for aortic stenosis.

<p>False (B)</p> Signup and view all the answers

What type of murmur is associated with aortic stenosis?

<p>Systolic murmur</p> Signup and view all the answers

Which diagnostic method is used to show valve abnormalities and identify mitral regurgitation?

<p>Echocardiogram with Doppler (D)</p> Signup and view all the answers

MVP always requires surgical repair or replacement of the valve.

<p>False (B)</p> Signup and view all the answers

What lifestyle changes can help prevent symptoms in someone with MVP?

<p>A heart-healthy diet, exercise, stress management, and avoidance of stimulants like caffeine.</p> Signup and view all the answers

Rheumatic fever is the major cause of ______.

<p>mitral stenosis</p> Signup and view all the answers

Which of the following is a treatment option for superficial thrombophlebitis?

<p>Compression stockings (D)</p> Signup and view all the answers

Match the following symptoms with their appropriate conditions:

<p>Mitral Valve Prolapse (MVP) with repair = Reduce heart rate with beta blockers Mitral Stenosis = Thickening of mitral valve flaps General Healthy Heart Advice = Exercise and heart-healthy diet Post-MVP Surgery = Weight gain and job stress</p> Signup and view all the answers

Compression ultrasonography is unreliable for diagnosing suspected DVT.

<p>False (B)</p> Signup and view all the answers

Which of the following symptoms did Mr. Goldfarb report?

<p>Weight gain (B)</p> Signup and view all the answers

In mitral stenosis, the pressure rises in the right ventricle due to increased blood volume.

<p>True (A)</p> Signup and view all the answers

What is the primary goal of treatment for DVTs?

<p>To relieve pain and prevent pulmonary emboli, thrombus enlargement, or development of another thrombus.</p> Signup and view all the answers

What major childhood disease is associated with older adults who develop mitral stenosis?

<p>Rheumatic fever</p> Signup and view all the answers

Early mobilization in patients with a DVT has shown a decrease in ______.

<p>pain and swelling</p> Signup and view all the answers

What diagnostic test is used to assess suspected DVT?

<p>Compression ultrasonography (B)</p> Signup and view all the answers

Anticoagulants are typically required for the treatment of superficial thrombophlebitis.

<p>False (B)</p> Signup and view all the answers

Name a situation in which a venous thrombectomy might be necessary.

<p>To prevent pulmonary emboli or chronic venous insufficiency when anticoagulant therapy cannot be used.</p> Signup and view all the answers

Match the medical terms with their correct descriptions:

<p>Compression ultrasonography = A diagnostic test for DVT Superficial thrombophlebitis = Treated at home with NSAIDs and heat Venous thrombectomy = Surgical removal of a clot Vena cava filter = Traps clots to prevent lung embolism</p> Signup and view all the answers

Which condition is caused by an infection of the endocardium primarily in hearts with artificial or damaged valves?

<p>Infective Endocarditis (D)</p> Signup and view all the answers

Chest pain after cardiac surgery is always from anginal or MI-associated pain.

<p>False (B)</p> Signup and view all the answers

What is the condition called when blood flow erodes the endocardium's resistance to infection?

<p>Infective Endocarditis</p> Signup and view all the answers

Cardiac surgery patients may have a chest tube to monitor drainage. Report amounts above ______ per hour to prevent complications.

<p>200 mL</p> Signup and view all the answers

Match the heart layer with the condition it can develop when inflamed:

<p>Endocardium = Endocarditis Pericardium = Pericarditis Myocardium = Myocarditis</p> Signup and view all the answers

What tools can be used to communicate with an intubated patient?

<p>Simple closed-ended questions (A), Nonverbal gestures (B), Communication boards (C)</p> Signup and view all the answers

Diaphragm elevation can be detected through a chest X-ray.

<p>True (A)</p> Signup and view all the answers

Which group of people is more susceptible to developing infective endocarditis?

<p>Older adults and men</p> Signup and view all the answers

Which of the following symptoms indicate circulatory impairment?

<p>Cool or cold skin (B)</p> Signup and view all the answers

The patient should participate in diversional activities during IV therapy for increased self-esteem.

<p>True (A)</p> Signup and view all the answers

Name two objective data findings that are commonly collected for patients with infective endocarditis.

<p>Fever and tachycardia</p> Signup and view all the answers

An increased erythrocyte sedimentation rate is a common finding in patients with ______.

<p>infective endocarditis</p> Signup and view all the answers

Which diagnostic test is used to identify heart enlargement in patients with potential cardiac issues?

<p>Chest x-ray (A)</p> Signup and view all the answers

Hematuria is a subjective data finding collected for patients with infective endocarditis.

<p>False (B)</p> Signup and view all the answers

List one cardiovascular symptom associated with infective endocarditis.

<p>Chest pain</p> Signup and view all the answers

Match the following conditions with the appropriate symptom or finding:

<p>Infective endocarditis = Positive blood cultures Circulatory impairment = Cyanosis Decreased cardiac output = Fatigue and dyspnea Elevated white blood cell count = Infection indication</p> Signup and view all the answers

What is the recommended therapeutic INR range for a patient on warfarin with a mechanical heart valve?

<p>2.5 to 3.5 (D)</p> Signup and view all the answers

Orthostatic hypertension is a common issue in older adults.

<p>False (B)</p> Signup and view all the answers

Vitamin K plays a crucial role in the blood clotting process.

<p>True (A)</p> Signup and view all the answers

What should be checked for before administering warfarin to ensure patient safety?

<p>Check for bleeding or ecchymosis.</p> Signup and view all the answers

An INR range of ______ to 3 is therapeutic for patients on warfarin who have a blood clot.

<p>2</p> Signup and view all the answers

Which of the following is an essential part of patient education for those at high risk for infective endocarditis?

<p>Prophylactic antibiotics according to AHA guidelines (C)</p> Signup and view all the answers

What is the primary focus when caring for older patients in terms of activity?

<p>Allowing extra time for activities and providing rest intervals.</p> Signup and view all the answers

Match the following nursing considerations with their description:

<p>Monitoring INR = Ensures warfarin is at a safe therapeutic level Patient mobility = Assess if ambulation causes faintness or unsteadiness Vitamin K = Necessary for blood clotting factor activation Orthostatic changes = Monitor for blood pressure adjustments when changing positions</p> Signup and view all the answers

Flashcards

Mitral Valve Prolapse (MVP)

A condition where the mitral valve flaps bulge into the left atrium during contraction.

Symptoms of MVP

MVP can lead to chest pain, fatigue, and arrhythmia in some patients.

Doppler Echocardiogram

An imaging technique using sound waves to visualize heart function and blood flow.

Therapeutic Measures for MVP

Management includes lifestyle changes and medications like beta blockers or antiarrhythmics.

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Mitral Stenosis (MS)

A narrowing of the mitral valve opening due to thickened flaps and shortened chords.

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Causes of Mitral Stenosis

Rheumatic fever is the primary cause, especially in older adults.

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Cardiac Output Reduction

Decreased blood flow from the left ventricle due to right ventricular failure in MS.

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Importance of Lifestyle in MVP

Healthy living can help alleviate MVP symptoms and maintain heart health.

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Geriatric care

Care tailored for older adults, emphasizing safety and time.

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Orthostatic hypertension

A drop in blood pressure upon standing, common in older adults.

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Nursing diagnoses for valvular disorders

Common diagnoses align with heart failure symptoms in patients.

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Patient education in healthcare

Instruction for patients and caregivers about the condition, care, and medications.

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Warfarin monitoring

Regularly checking INR to ensure therapeutic levels for safety.

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Therapeutic INR ranges

The desired INR levels for safe warfarin administration: 2-3 or 2.5-3.5 depending on the condition.

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Vitamin K role

Essential for blood clotting, activating specific clotting factors.

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INR and dietitian consultation

Important for patients on warfarin to manage diet affecting INR levels.

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Chest X-ray Purpose

A chest x-ray checks tube placements and detects issues like pneumothorax.

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Patient Communication

Use closed-ended questions and nonverbal gestures with intubated patients.

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Postoperative Chest Pain

Chest pain post-surgery may arise from incision rather than MI or anginal pain.

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Chest Tube Monitoring

Monitor chest tube drainage; report over 200 mL/hr to prevent complications.

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Heart Layers

The heart has three layers: endocardium, pericardium, and myocardium.

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Infective Endocarditis (IE)

IE is an infection of the endocardium, often in damaged valves or drug users.

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Vegetative Lesion

A vegetative lesion forms when microorganisms attach to eroded endocardium.

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Endocarditis Risk Factors

Risk factors for endocarditis include damaged valves and injection drug use.

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Anticoagulants

Medications used to prevent thromboembolisms.

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Mitral Valve Repair

Preferred over replacement when surgery is needed for mitral issues.

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Aortic Stenosis (AS)

Condition where the aortic valve narrows, obstructing blood flow.

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Compensatory Mechanisms

Body adaptations to maintain cardiac output during AS.

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Symptoms of AS

Early signs include angina, dyspnea, and dizziness; late signs involve heart failure.

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Diagnostic Tests for AS

Tests like echocardiograms that assess aortic valve structure and function.

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Aortic Valve Replacement

The only effective treatment for severe aortic stenosis.

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Transcatheter Aortic Valve Replacement (TAVR)

A minimally invasive option for high-risk patients needing valve replacement.

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Circulatory Impairment Symptoms

Cool skin, cyanosis, or absent peripheral pulses indicating poor blood flow.

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Lower Leg Edema Compression

Use of compression for patients with extensive lower leg swelling.

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DVT Diagnostic Tests

Tests like compression ultrasonography help quickly diagnose DVT.

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Notify HCP

Health care provider should be informed of circulatory impairments immediately.

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Decreased Diversional Activity Engagement

Reduced participation in activities due to restricted mobility from IV therapy.

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Goals of DVT Treatment

Aim to relieve pain and prevent complications like pulmonary emboli.

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Patient Involvement in Activities

Engage patients in planning activities to boost self-esteem during IV therapy.

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Superficial Thrombophlebitis Treatment

Manage at home with heat, analgesics, NSAIDs, and compression.

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Evaluation of Interventions

Success is measured by normal vital signs and active participation in activities.

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Anticoagulants in DVT

Usually not needed for low PE risk; prescribed for 3 months when used.

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Venous Thrombectomy

Procedure to remove a clot to prevent emboli when high risk.

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Subjective Data in Endocarditis

Health history inquiries focusing on infections and cardiac conditions.

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Objective Data Indicators

Signs like fever, heart murmurs, and skin changes related to infective endocarditis.

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Vena Cava Filter

Device placed to trap clots without blocking blood flow.

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Risk Factor Data Collection

Patient history helps assess risk factors for thrombus development.

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Diagnostic Tests for Endocarditis

Tests including blood cultures, echocardiograms, and chest X-rays to confirm infection.

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Study Notes

Cardiac Valvular Disorders

  • Heart valves ensure one-way blood flow
  • Four valves exist: mitral, tricuspid, pulmonic, and aortic
  • Chordae tendineae and papillary muscles secure mitral and tricuspid valves, ensuring tight closure
  • Damage to valves or surrounding structures causes abnormal valvular function
  • Stenosis: Narrowed valve opening, reducing forward blood flow
  • Insufficiency/Regurgitation: Valve doesn't close completely, causing backflow
  • Causes include congenital defects, infections, and rheumatic fever

Rheumatic Fever

  • Autoimmune reaction (2-4 weeks after strep throat)
  • Primarily affects valves of the left side of the heart
  • Occurs between ages 5-15
  • Treatable with penicillin to prevent heart damage
  • Uncommon in the US, but common in developing countries

Mitral Valve Prolapse (MVP)

  • Valve leaflets bulge backward into the left atrium during systole
  • Causes include valve size, chordae tendineae defects, connective tissue disorders, or genetic mutations
  • Often asymptomatic; good prognosis
  • Symptoms include anxiety, atypical chest pain (not exercise-related), arrhythmias, dizziness, syncope, fatigue, and dyspnea.

Valvular Disorders Summary

  • Summarizes various valve disorders with signs, symptoms, tests, and complications

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