Acute Decompensated Heart Failure.docx

Water hammer pulse a strong quick beat that collapses

  • No School
  • AA 1
  • 15

This preview shows page 11 - 14 out of 15 pages.

“Water-hammer” pulse (a strong, quick beat that collapses immediately) if severe Soft or absent S 1 S 3 or S 4 Murmur Tricuspid Valve Stenosis Occurs in patients with RF and IVDA Right atrial enlargement and systemic venous pressure Clinical manifestations Peripheral edema Ascites Hepatomegaly Murmur Pulmonic Valve Stenosis Almost always congenital Causes right ventricular hypertension and hypertrophy Clinical manifestations Fatigue Loud murmur Valvular Heart Disease Diagnostic Studies Patient’s history/physical exam CT scan of chest Echocardiogram Chest x-ray ECG Heart catheterization Interprofessional Care Conservative Management Prophylactic antibiotic therapy to prevent recurrent RF and IE Dependent on valve involved and disease severity Prevent exacerbations of HF, pulmonary edema, thromboembolism, and recurrent endocarditis Drugs to treat/control HF Vasodilators (e.g., nitrates, ACE inhibitors) Positive inotropes (e.g., digoxin) Diuretics β-blockers Sodium restriction Anticoagulation therapy Anti-dysrhythmic drugs Percutaneous transluminal balloon valvuloplasty Split open fused commissures
Image of page 11

Subscribe to view the full document.

For mitral, tricuspid, and pulmonic stenosis Balloon-tipped catheter inserted via femoral artery Inflated to separate valve leaflets Surgical Therapy Valve repair Surgical procedure of choice Lower mortality May not restore total valve function Valve replacement Valve repair Commissurotomy (valvulotomy) Closed Open (more common) Valvuloplasty Open Minimally invasive Annuloplasty Valve replacement Mechanical (artificial) Last longer Risk of thromboembolism Require long-term anticoagulation Biologic (tissue) Bovine, porcine, and human No anticoagulation required Less durable Types of Prosthetic Valves
Image of page 12
A , Starr-Edwards caged ball valve; B , St. Jude bi-leaflet valve; C , Carpentier-Edwards porcine; D, CoreValvetranscatheter aortic valve. Nursing Assessment Subjective Data Past medical history IV Drug Abuse, fatigue Palpitations, weakness, activity intolerance, dizziness, fainting Dyspnea on Exertion, cough, hemoptysis, orthopnea, Paroxysmal nocturnal dyspnea Angina or atypical chest pain Objective Data Fever Diaphoresis, flushing, cyanosis, clubbing, peripheral edema Crackles, wheezes, hoarseness S 3 and S 4 Dysrhythmias or in pulse pressure; hypotension Water-hammer or thready peripheral pulses Hepatomegaly, ascites Weight gain Nursing Diagnoses Decreased cardiac output Excess fluid volume Activity intolerance Deficient knowledge Planning Patient Goals Normal cardiac function Improved activity tolerance Understanding of the disease process and health maintenance measures Nursing Implementation Health Promotion Diagnosing and treating streptococcal infection Prophylactic antibiotics for patients with history Encourage compliance Teach patient when to seek medical treatment
Image of page 13

Subscribe to view the full document.

Image of page 14
  • Fall '19
  • Cardiology, mitral valve, Mitral valve prolapse, Valvular heart disease

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern