Valvular Heart Disease for Progressive Care Certified Nurse (PCCN)
Included In This Lesson
Study Tools For Valvular Heart Disease for Progressive Care Certified Nurse (PCCN)
Outline
Valvular Heart Disease
Definition/Etiology:
- Definition
- Valvular heart disease is an acquired or congenital disorder of a cardiac valve.
Valve disorders include those of stenosis, causing obstruction of forward flow, or regurgitation, allowing backward flow of blood.
- Valvular heart disease is an acquired or congenital disorder of a cardiac valve.
- Etiology
- Rheumatic Fever
- Endocarditis – Vegetation / Damage
- Congenital
- PCCN Focus = Left Sided Heart
- Mitral & Aortic Valve
Pathophysiology:
- Aortic/Mitral Stenosis – Calcified Valve
- Valves don’t open fully
- (less forward flow)
- Murmur heard when valves OPEN
- Aortic/Mitral Regurgitation – Leaky Valve
- valves that don’t close properly
- (Backward flow)
- Murmurs heard when valves CLOSE
Noticing: Assessment & Recognizing Cues:
- Subjective Cues (Heart Failure)
- Shortness of breath
- Orthopnea
- Weakness/ fatigued
- Palpitations
- Objective Cues
- MURMURS
- Systolic (s1) or Diastolic (S2)
- Lub vs Dub
- Auscultate appropriate area
- Aortic – 2nd ICS RSB
- Mitral – 5th ICS MCL
- MURMURS
- Symptoms of both sided heart failure
- Signs of pulmonary edema (frothy, pink sputum)
- Jugular venous distention
- Edema
Interpreting: Analyzing & Planning:
- Labs
- Pre-Op labs if repair/replacement is needed
- Diagnostics
- ECG – Afib is common
- Echocardiogram
- Look at Valves
- non-invasive
- Transesophageal Echocardiogram
- Sees Mitral valve better than traditional
- More invasive (requires at least moderate sedation)
Responding: Patient Interventions & Taking Action:
- ABCs
- Meds and/or Surgery for repair
- Pharmacological Interventions
- Benzos -reduce anxiety
- ACEs/ARBs
- Beta Blockers
- Nitrates
- Digoxin
- Non-Pharmacological
- Valve Repair or Replacement
- Mechanical or Biological
- Completed via Open Heart or Cath Lab (Follow those lessons for specific interventions)
- Valve Repair or Replacement
Reflecting: Evaluating Patient Outcomes:
- Monitor for complications
- Signs/symptoms of heart failure
- AFIB
- Emboli
- If surgery was performed
- See Cath Lab, Open Heart and minimally invasive surgery lesson
- If the valve is replaced, the importance of endocarditis prophylaxis and chronic
anticoagulation is stressed- if the patient does not comply with the follow-up medication regimen, stroke and possibly death are highly likely
Linchpins (Key Points):
- Notice
- Heart Failure Symptoms
- Interpret
- ECHO & TEE
- Respond
- Meds vs Surgery
- Reflect
- Post-Surgical
Transcript
References
- AACN, and Tonja Hartjes. AACN Core Curriculum for
Progressive and Critical Care Nursing. Available from:
Pageburstls, (8th Edition). Elsevier Health Sciences
(US), [Insert Year of Publication]. - Dennison, R. D., & Farrell, K. (2015]). Pass PCCN!.
Elsevier Health Sciences (US). - Kupchik, N. (2020). Ace The Pccn! you can do it!: Study guide. Nicole Kupchik Consulting, Inc.
- Lee, S. (2019). Comprehensive nursing management for
valvular disease. Critical Care Nursing Clinics, 31(1), 31-38.
NCLEX
Concepts Covered:
- Circulatory System
- Emergency Care of the Cardiac Patient
- Cardiac Disorders
- Cardiovascular
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Hematology
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- Upper GI Disorders
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- Newborn Complications
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- Nervous System
- Central Nervous System Disorders – Brain
- Renal
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- Urinary System
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- Noninfectious Respiratory Disorder
- Test Taking Strategies
- Note Taking
- Basics of NCLEX
- Prefixes
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- Medication Administration
- Gastrointestinal Disorders
- Respiratory Disorders
- Pregnancy Risks
- Labor Complications
- Hematologic Disorders
- Fundamentals of Emergency Nursing
- Factors Influencing Community Health
- Delegation
- Perioperative Nursing Roles
- EENT Disorders
- Basics of Chemistry
- Adult
- Emergency Care of the Neurological Patient
- Acute & Chronic Renal Disorders
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Studying
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- Disorders of the Adrenal Gland
- Behavior
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- Preoperative Nursing
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- Communication
- Understanding Society
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- Oncology Disorders
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- Tissues and Glands
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- Renal Disorders
- Eating Disorders
- Prenatal Concepts
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- Depressive Disorders
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- Trauma-Stress Disorders
- Peripheral Nervous System Disorders
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- Neurologic and Cognitive Disorders
- Integumentary Disorders
- Newborn Care
- Basics of Mathematics
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- Labor and Delivery
- Proteins
- Emergency Care of the Trauma Patient
- Hematologic System
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- Developmental Considerations
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- Postpartum Care
- Basic
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- Health & Stress
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- Med Term Basic
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