NUR 1140 MEDSURG EXAM 2 STUDY GUIDE QUESTIONS
AND ANSWERS BEST GRADED A+ BEST SOLUTIONS NEW
UPDATE 2022
Chapter 28
Management of Patients With Structural, Infectious, and Inflammatory
Cardiac Disorders
● Valvular Disorders
○ Regurgitation: The valve does not close properly, and blood
backflows through the valve (backflow of blood through a
heart valve)
■ The door is open and things are swishing in and out
○ Stenosis: The valve does not open completely, and blood flow
through the valve is reduced (narrowing)
■ Narrowing or obstruction of a cardiac valve’s orifice (opening)
■ Open a certain amount and it doesn't
■ Reduction in blood flow → blockage, obstruction,
ischemia
○ Valve prolapse: The stretching of an atrioventricular valve
NUR 1140 MEDSURG EXAM 2 STUDY GUIDE QUESTIONS
AND ANSWERS BEST GRADED A+ BEST SOLUTIONS NEW
UPDATE 2022 1
,NUR 1140 MEDSURG EXAM 2 STUDY GUIDE QUESTIONS
AND ANSWERS BEST GRADED A+ BEST SOLUTIONS NEW
UPDATE 2022
leaflet into the atrium during diastole
● Valves of the Heart
● Specific Valvular Disorders (both valves have stenosis and
regurgitation but mitral also has prolapse***)
NUR 1140 MEDSURG EXAM 2 STUDY GUIDE QUESTIONS
AND ANSWERS BEST GRADED A+ BEST SOLUTIONS NEW
UPDATE 2022 2
,NUR 1140 MEDSURG EXAM 2 STUDY GUIDE QUESTIONS
AND ANSWERS BEST GRADED A+ BEST SOLUTIONS NEW
UPDATE 2022
○ These valvular disorders may require surgical repair or
replacement of the valve to correct the problem, depending
on the severity of the symptoms
● Vascular disorders is that the increase risk for HF,
dysrhythmias, other symptoms, dizziness and syncope, overlaps
because its cardiac disorders
○ Mitral valve prolapse
■ Valve does not remain closed during systole
● Blood flow from left ventricle to left atrium
■ Usually produces no symptoms
● IF they do → fatigue, SOB,
lightheadedness, dizziness, syncope,
palpitations, chest pain, anxiety, heart
failure symptoms
■ Rarely, it progresses and can result in sudden death
■ The cause is usually an inherited disorder resulting in
enlargement of one or both of the mitral valve leaflets
● Get an echocardiogram if your parents or siblings have it
■ Often the first and only sign of prolapse is identified
when a physical exam of the heart reveals an extra
sound (mitral click)
■ Medical management: control symptoms
● Avoid caffeine and alcohol bc this
disorder may cause dysrhythmias
NUR 1140 MEDSURG EXAM 2 STUDY GUIDE QUESTIONS
AND ANSWERS BEST GRADED A+ BEST SOLUTIONS NEW
UPDATE 2022 3
, NUR 1140 MEDSURG EXAM 2 STUDY GUIDE QUESTIONS
AND ANSWERS BEST GRADED A+ BEST SOLUTIONS NEW
UPDATE 2022
○ Mitral regurgitation
■ Blood flows back from left ventricle into left atrium during
systole
● The valve leaflets are not closing properly bc the
leaflets and chordae tendineae have thickened
and fibrosed, resulting in their contraction
■ Most common cause:
● degenerative changes of the mitral valve (mitral prolapse)
and
ischemia of the left ventricle
■ Can happen from problems with one or more of
the leaflets, the chordae tendineae, the annulus,
or papillary muscles
■ May be asymptomatic, but acute mitral regurg. (from an MI)
usually
manifests as severe congestive heart failure
(dyspnea, fatigue, weakness)
■ May hear a systolic murmur as a high pitched,
blowing sound at the apex
■ TEE provides the best images of the mitral valve
■ Management is the same as that for heart failure →
● afterload reduction, ACE inhibitors, vasodilators,
beta blockers, etc.
○ Could also do a mitral valvuloplasty or valve
NUR 1140 MEDSURG EXAM 2 STUDY GUIDE QUESTIONS
AND ANSWERS BEST GRADED A+ BEST SOLUTIONS NEW
UPDATE 2022 4
AND ANSWERS BEST GRADED A+ BEST SOLUTIONS NEW
UPDATE 2022
Chapter 28
Management of Patients With Structural, Infectious, and Inflammatory
Cardiac Disorders
● Valvular Disorders
○ Regurgitation: The valve does not close properly, and blood
backflows through the valve (backflow of blood through a
heart valve)
■ The door is open and things are swishing in and out
○ Stenosis: The valve does not open completely, and blood flow
through the valve is reduced (narrowing)
■ Narrowing or obstruction of a cardiac valve’s orifice (opening)
■ Open a certain amount and it doesn't
■ Reduction in blood flow → blockage, obstruction,
ischemia
○ Valve prolapse: The stretching of an atrioventricular valve
NUR 1140 MEDSURG EXAM 2 STUDY GUIDE QUESTIONS
AND ANSWERS BEST GRADED A+ BEST SOLUTIONS NEW
UPDATE 2022 1
,NUR 1140 MEDSURG EXAM 2 STUDY GUIDE QUESTIONS
AND ANSWERS BEST GRADED A+ BEST SOLUTIONS NEW
UPDATE 2022
leaflet into the atrium during diastole
● Valves of the Heart
● Specific Valvular Disorders (both valves have stenosis and
regurgitation but mitral also has prolapse***)
NUR 1140 MEDSURG EXAM 2 STUDY GUIDE QUESTIONS
AND ANSWERS BEST GRADED A+ BEST SOLUTIONS NEW
UPDATE 2022 2
,NUR 1140 MEDSURG EXAM 2 STUDY GUIDE QUESTIONS
AND ANSWERS BEST GRADED A+ BEST SOLUTIONS NEW
UPDATE 2022
○ These valvular disorders may require surgical repair or
replacement of the valve to correct the problem, depending
on the severity of the symptoms
● Vascular disorders is that the increase risk for HF,
dysrhythmias, other symptoms, dizziness and syncope, overlaps
because its cardiac disorders
○ Mitral valve prolapse
■ Valve does not remain closed during systole
● Blood flow from left ventricle to left atrium
■ Usually produces no symptoms
● IF they do → fatigue, SOB,
lightheadedness, dizziness, syncope,
palpitations, chest pain, anxiety, heart
failure symptoms
■ Rarely, it progresses and can result in sudden death
■ The cause is usually an inherited disorder resulting in
enlargement of one or both of the mitral valve leaflets
● Get an echocardiogram if your parents or siblings have it
■ Often the first and only sign of prolapse is identified
when a physical exam of the heart reveals an extra
sound (mitral click)
■ Medical management: control symptoms
● Avoid caffeine and alcohol bc this
disorder may cause dysrhythmias
NUR 1140 MEDSURG EXAM 2 STUDY GUIDE QUESTIONS
AND ANSWERS BEST GRADED A+ BEST SOLUTIONS NEW
UPDATE 2022 3
, NUR 1140 MEDSURG EXAM 2 STUDY GUIDE QUESTIONS
AND ANSWERS BEST GRADED A+ BEST SOLUTIONS NEW
UPDATE 2022
○ Mitral regurgitation
■ Blood flows back from left ventricle into left atrium during
systole
● The valve leaflets are not closing properly bc the
leaflets and chordae tendineae have thickened
and fibrosed, resulting in their contraction
■ Most common cause:
● degenerative changes of the mitral valve (mitral prolapse)
and
ischemia of the left ventricle
■ Can happen from problems with one or more of
the leaflets, the chordae tendineae, the annulus,
or papillary muscles
■ May be asymptomatic, but acute mitral regurg. (from an MI)
usually
manifests as severe congestive heart failure
(dyspnea, fatigue, weakness)
■ May hear a systolic murmur as a high pitched,
blowing sound at the apex
■ TEE provides the best images of the mitral valve
■ Management is the same as that for heart failure →
● afterload reduction, ACE inhibitors, vasodilators,
beta blockers, etc.
○ Could also do a mitral valvuloplasty or valve
NUR 1140 MEDSURG EXAM 2 STUDY GUIDE QUESTIONS
AND ANSWERS BEST GRADED A+ BEST SOLUTIONS NEW
UPDATE 2022 4
