NSG 223 Exam 3 Questions With Correct Solutions
Mitral Valve Prolapse: Pathophysiology
a portion of one or both mitral valve leaflets balloons back into the atrium during systole.
Mitral Valve Prolapse: Assessment and Diagnostic Findings
- extra heart sound, referred to as a mitral click.
Mitral valve regurgitation: Pathophysiology
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
- A high-pitched systolic murmur, blowing sound at the apex that may radiate to the left
axilla
Mitral valve stenosis: Pathophysiology
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:
,rheumatic endocarditis, which thickens mitral valve leaflets and chordae tendineae
- HR increases, diastole is shortened and more blood backs up into pulmonary veins
Mitral valve stenosis: Clinical Manifestations
- The first symptom of mitral stenosis often is dyspnea on exertion (DOE)
Mitral valve stenosis: Assessment and Diagnostic Findings
- 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
Blood from the aorta returns to the left ventricle during diastole.
Aortic Regurgitation: Clinical Manifestations
- Heart palpitations feel in the neck and head
- Visible carotid or temporal arteries
Aortic Regurgitation: Assessment and Diagnostic Findings
- 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
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
- patients usually first have exertional dyspnea
- 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
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
- 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
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
- 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,
Prevention: Mitral valve stenosis:
- Long term antibiotics
- Antibiotic prophylaxis for recurrent rheumatic fever with rheumatic carditis may require 10 or
more years of antibiotic coverage
Aortic Regurgitation: Medical management
Prevention:
Mitral Valve Prolapse: Pathophysiology
a portion of one or both mitral valve leaflets balloons back into the atrium during systole.
Mitral Valve Prolapse: Assessment and Diagnostic Findings
- extra heart sound, referred to as a mitral click.
Mitral valve regurgitation: Pathophysiology
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
- A high-pitched systolic murmur, blowing sound at the apex that may radiate to the left
axilla
Mitral valve stenosis: Pathophysiology
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:
,rheumatic endocarditis, which thickens mitral valve leaflets and chordae tendineae
- HR increases, diastole is shortened and more blood backs up into pulmonary veins
Mitral valve stenosis: Clinical Manifestations
- The first symptom of mitral stenosis often is dyspnea on exertion (DOE)
Mitral valve stenosis: Assessment and Diagnostic Findings
- 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
Blood from the aorta returns to the left ventricle during diastole.
Aortic Regurgitation: Clinical Manifestations
- Heart palpitations feel in the neck and head
- Visible carotid or temporal arteries
Aortic Regurgitation: Assessment and Diagnostic Findings
- 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
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
- patients usually first have exertional dyspnea
- 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
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
- 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
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
- 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,
Prevention: Mitral valve stenosis:
- Long term antibiotics
- Antibiotic prophylaxis for recurrent rheumatic fever with rheumatic carditis may require 10 or
more years of antibiotic coverage
Aortic Regurgitation: Medical management
Prevention:
