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Exam (elaborations)

Nsg 2282 Ch 24 Test With Complete Solutions

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NSG 2282 CH 24 TEST WITH COMPLETE SOLUTIONS ...

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NSG 2282 CH 24 TEST WITH
COMPLETE SOLUTIONS

T/F Mitral valve prolapse occurs twice as frequently in women than in men - ANSWER
TRUE

What is mitral valve prolapse? - ANSWER a portion of one or both mitral valve leaflets
balloons back into the atrium during systole causing blood to regurgitate from the left
ventricle to the left atrium.

T/F It is impossible for mitral valve prolapse to result in heart enlargement, a fib,
pulmonary HTN, or heart failure - ANSWER FALSE. Although rare these conditions can
occur

What are some possible symptoms that patients may report? - ANSWER Fatigue,
shortness of breath, lightheadedness, dizziness, syncope, palpitations, chest pain, or
anxiety.

What is most often the only sign of mitral valve prolapse? - ANSWER An extra heart
sound, referred to as the "mitral click" that occurs during systole. The nurse may hear a
murmur if there is regurgitation of blood.

What test is used to diagnose and determine the extent of mitral valve prolapse? -
ANSWER Echocardiogram

How is MVP managed medically? - ANSWER Aimed at treating symptoms. Patients may
be prescribed antiarrhythmic medications , nitrates for chest pain, calcium channel
blockers, or betablockers

What can the nurse do for the patient with MVP? - ANSWER Educate the patient that the
condition is possibly hereditary and that they should tell all first-degree relatives to be
checked. Encourage the patient to read product labels so that they may stay away from
stimulants and medications with ephedrine in them. Explore the patients diet and
lifestyle factors.

What are the most common reasons why a patient would have mitral regurgitation? -
ANSWER Degeneration of the mitral valve for whatever reason and ischemia of the left
ventricle in developed countries, and rheumatic heart disease in developing countries

What can cause mitral regurgitation? - ANSWER Problems with one or more leaflets,
chordae tendineae, the annulus, or the papillary muscles.

What can occur in the long term due to mitral regurgitation? - ANSWER Excess blood
backs up into the atrium , as a result causes blood to back up in the lungs causing

, pulmonary HTN and congestion. Then during diastole, the excessive amount of blood
from the atria fills the ventricle and causes it to dilate and hypertrophy

What are some symptoms of acute mitral regurgitation? - ANSWER Severe and sudden
dyspnea, fatigue, weakness, palpitations, and cough from pulmonary congestion

What sound would mitral regurgitation make when auscultating heart sounds? -
ANSWER A systolic murmur characterized by a blowing sound at the apex of the heart

How is mitral regurgitation treated? - ANSWER Those who develop pulmonary
congestion are prescribed medications used in heart failure (ACEs, ARBs, direct
vasodilators, betablockers)

T/F Just because a patient has heart failure does not mean surgery is indicated -
ANSWER FALSE. Patients with symptoms of HF with mitral regurgitation should
consider surgical intervention

What most often causes mitral stenosis? - ANSWER Rheumatic endocarditis. Gradually
thickens the mitral valve, leaflets, and chordae tendineae, causing leaflets to fuse
together

Symptoms of mitral stenosis include - ANSWER Dyspnea of exertion* caused by
pulmonary HTN, progressive fatigue, Dry cough or wheezing caused by enlarged left
atrium, possible hemoptysis, orthopnea, paroxysmal nocturnal dyspnea, repeated
respiratory infections. Atrial arrhythmias due to hypertrophy.

What sound is characteristic of mitral stenosis? - ANSWER Low-pitched rumbling
diastolic murmur, best heard at the apex.

T/F Symptoms of mitral stenosis may not appear until the valve is blocked and reduced
to 1/2 - 1/3 of its original size - ANSWER TRUE

What can cause aortic regurgitation? - ANSWER Congenital valve abnormalities,
inflammatory lesions that deform leaflets, or dilation of the aorta rheumatic
endocarditis, syphilis, blunt chest trauma.

What happens in aortic regurgitation? - ANSWER Over time blood is pushed back into
the ventricle during diastole and hypertrophy occurs. This causes the ventricle to
contract with above normal force resulting in increased systolic pressure. Arteries
attempt to vasodilate to compensate for increased pressure causing a reduction in
diastolic pressure.

How might a patient with aortic regurgitation feel? - ANSWER They might notice a
pounding or forceful heartbeat especially in the head or neck area. May have visible or
palpable arterial pulsation at the carotid or temporal arteries. As it gets worse HF
symptoms may appear

What sound would aortic regurgitation make on auscultation? - ANSWER A high-pitched
blowing diastolic murmur is found at the fourth or fifth intercostal space.

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