CHAPTER 1 Cardiovascular System^69
NURSING INTERVENTION
- Place patient in a high Fowler’s position to facilitate breathing.
- After surgery, monitor for:
- Pulmonary edema to look for blood backflowing into lungs.
- Heart failure to assess for a poorly functioning heart.
- Thrombus because of a prosthetic valve.
- Arrhythmias because the heart may be irritated after surgery.
- Arterial Blood Gas (ABG) to check for adequate oxygenation and acid/base
balance.
- Weigh the patient daily to assess for fluid overload.
- Explain to the patient proper recovery from major surgery:
- Schedule rest periods during the day.
- Restrict diet to low-sodium and low-fat.
Tricuspid Insufficiency
WHAT WENT WRONG?
Leakage in the tricuspid valve causes a backflow from the right ventricle into the
right atrium. This results in increased pressure in the atrium and higher resistance
to blood flowing from veins, resulting in enlargement of the right atrium. This may
occur from an anatomic problem, but usually occurs from right ventricular over-
load (in turn caused by left ventricular overload). It may also occur due to an infe-
rior myocardial infarction, or damage from endocarditis.
PROGNOSIS
If the underlying problem can be resolved, the insufficiency may subside. If reso-
lution does not occur, tricuspid valve repair or replacement may be necessary.
HALLMARK SIGNS AND SYMPTOMS
- Difficulty breathing (dyspnea) due to backflow into the lungs
- Fatigue because the heart is working inefficiently
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