1. Valvular Heart Disease NR40

2. Valvular Heart Disease Stenosis Regurgitation (Insufficiency) Prolapse

3. Causes of Valvular Disease Endocarditis Congenital Defects Inflammation STD Rheumatic Fever Myocardial Infarction

4. Forms of Valvular Disease MVP- Mitral Valve Prolapse Blood regurgitates from LV to LA during systole One leaflet doesn’t close correctly. More common in women. Clinical Manifestations Tx and Nsg Management

5. Mitral Stenosis Blood flow obstruction from LA to LV. Mitral valve thickens, usually viral cause (rheumatic fever) Clinical Manifestations Tx and Nsg Management

6. Mitral Valve Regurgitation Valve doesn’t close properly during systole, blood flow back from LV to LA Tx and Nsg Management

7. Aortic Stenosis Blood flow obstruction between LV and aorta. Causes afterload and eventual LVH Clinical Manifestations Tx and Nsg Management

8. Aortic Regurgitation Back flow of blood from aorta back into LV during diastole, because valve doesn’t close properly. Clinical Manifestations Tx and Nsg Management

9. Nursing Diagnoses Activity Intolerance Anxiety Decreased cardiac output

10. Surgical Valve Repair Valvuloplasty Valve replacement - Mechanical valve - Xenograft - Homograft/allograft - Autograft

11. Anticoagulants Parenteral: Heparin Lovenox Fragmin Labtest: aPTT Norm: ________ DVT Prophylaxis: aPTT_______________ Antidote:____________ Oral: Coumadin Labtests: PT/ INR Norm PT:___________ Norm INR:__________ DVT Prophylaxis: PT ________________ INR _______________ Antidote:____________

12. Antiplatelets Action: Ticlopidine (Ticlid) Clopidogrel ( Plavix) ASA Glycoprotein IIb/IIIa inhibitors

13. Hemorrheologics Action: Pentoxfylline (Trental)

14. Thrombolytics Action: Streptokinase T-PA Retavase

15. Nursing Intrventions Assessment and monitoring Assess for bleeding Patient teaching and followup: Coumadin: blood work medi alert bracelet Limit ETOH to 2 drinks/day Limit foods high in Vitamin K (broccoli, dk green leafy veggies,spinach, kale)