Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 1 Cardiovascular System^63



  • heparin

  • warfarin

  • enoxaparin


NURSING DIAGNOSES



  • Anxiety

  • Decreased cardiac output

  • Activity intolerance


NURSING INTERVENTION



  • Place patient in a high Fowler’s position to facilitate breathing.

  • Oxygen.

  • Pain management.

  • Monitor for:

    • Pulmonary edema because of backflow to the lungs.

    • Thrombus because a foreign object (valve) is in place, and may cause
      clotting.

    • Arrhythmias because the heart may be irritable secondary to surgery.



  • Weigh the patient daily to be aware of fluid overload.

  • Explain to the patient:

    • Schedule rest periods during the day.

    • Restrict diet to low-sodium and low-fat foods.




Mitral Insufficiency


WHAT WENT WRONG?


Leakage of the mitral valve causes blood to flow back from the left ventricle into
the left atrium. As a result, blood might flow back into the lungs. Mitral regurgi-
tation is due to an incompetent valve, damaged from rheumatic fever, CAD, or
endocarditis.


24

Free download pdf