Exam 1: Chapter 33 - Valvular Heart Disease

Question 1

What is an abnormality or dysfunction of any of the hearts four valves?

Answer 1

Valvular heart disease

Question 2

What valves are on the left side of the heart?

Answer 2

Mitral and aortic valves

Question 3

What valves are on the right side of the heart?

Answer 3

Tricuspid and pulmonic valves

Question 4

What valve dysfunction occurs secondary to endocarditis or IV illicit drug use and is rare?

Answer 4

Tricuspid valve dysfunction

Question 5

What does valve dysfunction affect?

Answer 5

the efficiency of the heart as a pump and reduced stroke volume

Question 6

What can valve dysfunction lead to overtime?

Answer 6

remodeling of the heart itself (hypertrophy) and heart failure

Question 7

What is health promotions and disease prevention for valvular heart disease?

Answer 7

• prevent/treat bacterial infections
• consume diet low in Na and follow fluid restrictions to prevent heart failure
• control chronic illness
• increase activity/exercise to boost HDL levels

Question 8

What are the two classifications for valvular heart disease?

Answer 8

• stenosis: narrowed opening impedes blood moving forward
• insufficiency/improper closure: some blood flows backwards (regurgitation)

Question 9

What is congenital valvular heart disease?

Answer 9

can affects all four valves and cause either stenosis or insufficiency

Question 10

What is acquired valvular heart disease?

Answer 10

can be classified as either:
- degenerative disease
- rheumatic disease
- infective endocarditis

Question 11

What is acquired degenerative valvular heart disease?

Answer 11

due to damage over time from mechanical stress, atherosclerosis, and hypertension and most common in developed countries

Question 12

What is acquired rheumatic valvular heart disease?

Answer 12

gradual fibrotic changes, calcification if valve cusps and most common in developing countries

Question 13

What is acquired infective endocarditis?

Answer 13

infectious organisms destroy the valve. streptococcal infections are a common cause

Question 14

what is a primary risk factor for mitral stenosis and insufficiency?

Answer 14

rheumatic fever

Question 15

what is marfan syndrome?

Answer 15

a connective tissue disorder that affects the heart and other areas of the body

Question 16

in older adults, what is the predominant cause of valvular heart disease?

Answer 16

degenerative calcification and atherosclerosis, papillary muscle dysfunction, and infective endocarditis

Question 17

T/F: clients who have valvular heart disease often do not have manifestations until late in the progression of the disease

Answer 17

true

Question 18

What helps to determine what valve is involved/damaged?

Answer 18

• a murmur
• echocardiogram

Question 19

What does a chest x-ray show in terms of valvular damage?

Answer 19

chamber enlargement with stenosis and insufficiencies, and pulmonary congestion

Question 20

What does a 12-lead EKG show in terms of valvular damage?

Answer 20

chamber hypertrophy

Question 21

What does a transesophageal echocardiogram (TEE) show in terms of valvular damage?

Answer 21

provided visualization of the mitral and aortic valves and can be used intraoperatively during valve replacement and repair

Question 22

What test assesses the impact of the valve problem on cardiac functioning during stress?

Answer 22

Exercise tolerance testing/stress echocardiography

Question 23

What test determines ejection fraction during activity and rest of the heart?

Answer 23

radionuclide studies

Question 24

what test is used to evaluate the coronary arteries and the degree of atherosclerosis?

Answer 24

angiography

Question 25

What might the heart rhythm appear to be in a pt with valvular heart disease?

Answer 25

irregular, bradycardic, w/ murmur

Question 26

What medications are used for valvular heart disease?

Answer 26

• diuretics
• afterload-reducing agents
• inotropic agents
• anticoagulants

Question 27

Why are afterload-reducing agents given to pts with valvular heart disease?

Answer 27

they help the heart pump more easily by alternating the resistance to contraction
- ace inhibitors
- beta blockers
- calcium channel blockers

Question 28

Why are inotropic agents given to pts with valvular heart disease?

Answer 28

they increase contractility and thereby improve cardiac output
- digoxin

Question 29

What is post surgery care for any type of procedure for valvular heart disease?

Answer 29

• care for eternal incision
• limit activity for 6 weeks
• report fever

Question 30

What are therapeutic procedures for valvular heart disease?

Answer 30

• percutaneous balloon valvuloplasty
• valve replacement
• miscellaneous surgical management

Question 31

What is the goal of surgery for valvular heart disease?

Answer 31

Improve quality of life rather than prolong life

Question 32

What consists of a percutaneous balloon valvuloplasty?

Answer 32

opens up aortic or mitral valves affected by stenosis

Question 33

What does a valve replacement consist of?

Answer 33

replacement of damaged heart valves,
mechanical valves require lifelong anticoagulant therapy,
and tissue valves need to be replaced every 7-10 years

Question 34

When should pt report to the provider who has valvular heart disease?

Answer 34

gain of 3lb in one day or 5lb in one week

Question 35

What is the main complication for valvular heart disease?

Answer 35

Heart failure