VALVULAR HEART DISEASE

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Questions and Answers

What occurs when a valve is unable to completely close?

Narrowing

Prolapse

Insufficiency (correct)

Stenosis

Which term describes the thickening of valve tissue that causes narrowing?

Incompetence

Prolapse

Regurgitation

Stenosis (correct)

Which of the following is a common consequence of rheumatic fever?

Aortic regurgitation

Pulmonary valve stenosis

Mitral stenosis (correct)

Tricuspid insufficiency

What structure allows blood to flow from the left ventricle into the aorta?

Aortic semilunar valve Signup and view all the answers

What is the primary effect of valvular heart disease on the heart's workload?

Greater strain on the left side of the heart Signup and view all the answers

Which type of valve disorder occurs when valve leaflets and supporting cords weaken and protrude into the atrium?

Prolapse Signup and view all the answers

How do normal heart valves function?

They open and close in response to blood pressure changes. Signup and view all the answers

Which of the following describes valvular disorders that can occur in various age groups due to congenital conditions?

Congenital valvular disorders Signup and view all the answers

What is a notable factor contributing to the development of valvular disease?

History of rheumatic fever Signup and view all the answers

What major blood vessels are involved in the proper flow of blood through the heart?

Inferior and superior vena cava Signup and view all the answers

Which symptoms should be reported to a health care provider to reduce hospitalization due to exacerbations?

Shortness of breath and fatigue Signup and view all the answers

Why is it important for patients with valvular heart disease to inform their dentist about their condition?

To receive prophylactic treatment to prevent endocarditis Signup and view all the answers

What is the primary focus of nursing interventions for a patient with valvular heart disease?

Assisting with activities of daily living and relieving symptoms Signup and view all the answers

Which action should be prioritized first for a patient with suspected mitral stenosis?

Portable X-ray to identify pulmonary effusion Signup and view all the answers

What should the nurse primarily maintain in a patient with valvular heart disease?

Oxygen saturation levels at or above 94% Signup and view all the answers

Which nursing intervention supports a patient experiencing symptoms of decreased cardiac output?

Educating on dietary sodium restrictions Signup and view all the answers

What is the purpose of administering Lasix to a patient with valvular heart disease?

To decrease preload and relieve heart strain Signup and view all the answers

Which of the following would not typically require prophylactic treatment in a patient with valvular heart disease?

Routine cleaning appointments Signup and view all the answers

What is a potential complication associated with valvular heart disease that requires monitoring?

Endocarditis from dental procedures Signup and view all the answers

Which of the following best describes the appropriate nursing action for maintaining a patient’s SpO2?

Applying oxygen therapy as needed if levels drop Signup and view all the answers

What is the most common cause of aortic stenosis?

Atherosclerosis with degenerative calcification Signup and view all the answers

Which clinical manifestation is directly associated with reduced cardiac output in valvular heart disease?

Lightheadedness and dizziness Signup and view all the answers

Which diagnostic test is NOT typically used to confirm valvular heart disease?

Magnetic resonance imaging (MRI) Signup and view all the answers

When is surgical intervention indicated for a patient with valvular heart disease?

When lifestyle is affected and medical therapy is not relieving symptoms Signup and view all the answers

Which medication is commonly prescribed to help control atrial fibrillation associated with aortic stenosis?

Cardiac glycosides Signup and view all the answers

What type of murmur is typically associated with valvular insufficiency?

Holosystolic murmur Signup and view all the answers

Which symptom indicates that fluid volume excess may be present in a patient with valvular heart disease?

Pitting edema Signup and view all the answers

Which valve replacement option utilizes tissue taken from another species?

Heterograft Signup and view all the answers

What type of patient teaching is essential for those undergoing anticoagulant therapy following valve surgery?

Need for regular prothrombin time or INR monitoring Signup and view all the answers

Which of the following is a nursing intervention to manage activity intolerance in a patient with valvular heart disease?

Balance rest periods with activities Signup and view all the answers

Study Notes

Definitions

Stenosis: Thickening of valve tissue resulting in narrowed openings.
Insufficiency: Inability of a valve to close completely, leading to regurgitation.
Valve Replacement: Surgical procedure to replace dysfunctional valves with bioprosthetic or mechanical alternatives.

Etiology/Pathophysiology

Heart valves ensure unidirectional blood flow through the heart and lungs.
Valves operate passively, influenced by pressure changes within the heart.
Normal blood flow sequence:
- Blood enters the right atrium via the vena cava, then through the tricuspid valve to the right ventricle.
- From the right ventricle, blood moves through the pulmonary semilunar valve into the pulmonary artery towards the lungs.
- Oxygenated blood returns to the left atrium via pulmonary veins, flows through the mitral valve to the left ventricle, and is pumped out through the aorta to the body.
Valvular Heart Disease: Occurs when valves are damaged, compromising their function.
Major conditions include:
- Stenosis: Thickening of valve tissue causing narrowing.
- Insufficiency: Inability for the valve to close properly.
Valvular disorders can stem from congenital abnormalities or a history of rheumatic fever, often following Group A streptococcal infections.
Symptoms may manifest 10-40 years post-rheumatic fever.
Predominantly affects the left-side heart valves (mitral and aortic).

Clinical Manifestations

Symptoms vary depending on the specific valvular disorder and its severity, affecting cardiac output and potentially leading to heart failure (HF).
Staging of valve disorders informs treatment decisions based on disease severity.

Assessment (Recognize the cues)

Subjective Data:
- History of rheumatic fever, ability to perform daily activities without fatigue.
- Chest pain characteristics, lightheadedness, dizziness, and dyspnea indicating inadequate oxygen supply.
Objective Data:
- Auscultation of heart murmurs and abnormal sounds to determine valve involvement.
- Respiratory assessment for crackles and wheezing due to pulmonary congestion.
- Edema assessment indicating heart failure progression.

Diagnostic Tests

Chest Radiograph: Identifies valve calcification.
Echocardiogram: Assesses for valvular regurgitation.
Cardiac Catheterization: Confirms diagnosis of valvular disease.

Medical Management

Activity Limitations: Tailored to the patient's threshold.
Sodium-restricted Diet: Reduces fluid retention.
Medications:
- Diuretics: Alleviate volume overload.
- Cardiac Glycosides: Help control atrial fibrillation associated with aortic stenosis.
- Antidysrhythmics: Manage poorly tolerated arrhythmias.
- Anticoagulants: Used post-operatively in valve replacement.
- Antibiotics: Prophylactic treatment to prevent infective endocarditis.

Surgical Intervention

Indicated when lifestyle is negatively impacted or medical management is ineffective.
Valve Repair: Open commissurotomy is common for mitral stenosis.
Valve Replacement: Options include:
- Porcine (pig) valves, heterografts (cross-species), homografts (same species), and ball-in-cage valves.

Care for Patients with Valvular Heart Disease

Focus on managing decreased cardiac output and symptoms related to this condition.
Nursing Interventions:
- Balance activity with rest to prevent fatigue.
- Administer prescribed medications like Digoxin, diuretics, and oxygen to enhance cardiac output.
- Monitor all vital signs, including respiratory function and fluid retention.
Patient Teaching:
- Importance of medication adherence, dietary restrictions, and activity limitations.
- Explain significance of prophylactic antibiotics for dental procedures to prevent endocarditis.
- Emphasize regular communication with healthcare providers about symptoms and management.

Learning Check

First orders to perform include maintaining SpO2, portable chest X-ray, and administering Lasix for preload reduction.
Nursing interventions primarily focus on assisting with activities of daily living (ADLs), alleviating symptoms of decreased cardiac output, and ensuring patient comfort.

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Description

This quiz covers key concepts related to heart valve disorders, including definitions of stenosis, insufficiency, and valve replacement. It also explores the normal functioning of heart valves and their role in blood flow. Test your understanding of these essential cardiovascular topics.