NSG 223 Exam 1 Study Guide

NSG 223 Exam 1 Study Guide

Mitral Valve Prolapse: Pathophysiology

(Ans- a portion of one or both mitral valve leaflets balloons back into the atrium during systole.

Mitral Valve Prolapse: Assessment and Diagnostic Findings

(Ans-

• extra heart sound, referred to as a mitral click.

Mitral valve regurgitation: Pathophysiology

(Ans- With each beat of the left ventricle, some blood is forced back into the left atrium, adding to blood flowing in from the lungs

• Lungs become congested
• The volume overload causes ventricular hypertrophy

Mitral valve regurgitation: Assessment and Diagnostic Findings

(Ans-

• A high-pitched systolic murmur, blowing sound at the apex that may

radiate to the left axilla

Mitral valve stenosis: Pathophysiology

(Ans- Obstruction to blood flowing from the left atrium into the left ventricle.Mitral valve narrows and progressively obstructs blood flow into the ventricle

Mitral valve stenosis Cause:

(Ans- rheumatic endocarditis, which thickens mitral valve leaflets and chordae tendineae

• HR increases, diastole is shortened and more blood backs up into

pulmonary veins

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Mitral valve stenosis: Clinical Manifestations

(Ans-

• The first symptom of mitral stenosis often is dyspnea on exertion (DOE)

Mitral valve stenosis: Assessment and Diagnostic Findings

(Ans-

• atrial fibrillation
• low-pitched, rumbling diastolic murmur is heard at the apex
• Echocardiography diagnosis
• An episode of loss of consciousness may be a sign that the aortic

stenosis is becoming worse and not enough blood flow to brain

Aortic Regurgitation: Pathophysiology

(Ans- Blood from the aorta returns to the left ventricle during diastole.

Aortic Regurgitation: Clinical Manifestations

(Ans-

• Heart palpitations feel in the neck and head
• Visible carotid or temporal arteries

Aortic Regurgitation: Assessment and Diagnostic Findings

(Ans-

• Auscultate for a high-pitched, blowing diastolic murmur at the 3rd or 4th

intercostal space at the left sternal border

• Wide pulse pressure (difference between sys & dis)
• ECHO- every 6 months

Aortic Stenosis: Pathophysiology

(Ans- The heart's aortic valve narrows which reduces or blocks blood flow from your heart, into the aorta, and to the rest of the body.

Aortic Stenosis: Clinical Manifestations

(Ans-

• patients usually first have exertional dyspnea 2 / 3

• Angina pectoris is a frequent symptom
• Pulse pressure may be low (30 mm Hg or less) because of diminished

blood flow.

Aortic Stenosis: Assessment and Diagnostic Findings

(Ans- a loud, harsh systolic murmur may be heard over the aortic area, right second intercostal space, and may radiate to the carotid arteries and apex of the left ventricle.

Mitral Valve Prolapse: Medical Management

(Ans-

• Medical management is directed at controlling symptoms.
• the patient is advised to eliminate caffeine and alcohol from the diet and

to stop the use of tobacco products.

• antiarrhythmic medications.
• Prophylactic antibiotics are not recommended prior to dental or invasive

procedures

• calcium channel blockers or beta-blockers to control chest pains and

palpitations

Mitral valve regurgitation: Medical Management

(Ans- benefit from afterload reduction (arterial dilation) by treatment with:

• angiotensin-converting enzyme (ACE) inhibitors such as captopril,

enalapril lisinopril

• angiotensin receptor blockers (ARBs) such as losartan or valsartan
• beta-blockers such as carvedilol

Mitral valve stenosis: Medical Management

(Ans-

• anticoagulants to decrease the risk of developing atrial thrombus
• If atrial fibrillation develops, cardioversion is attempted to restore normal

sinus rhythm. If unsuccessful, the ventricular rate is controlled with beta- blockers, digoxin, or calcium channel blockers;

• Patients with mitral stenosis are advised to avoid strenuous activities,

competitive sports, and pregnancy,

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