Page | 1
NUR 1140 MEDSURG EXAM 2 STUDY GUIDE
QUESTIONS AND ANSWERS BEST GRADED A+
BEST SOLUTIONS NEW UPDATE 2025-2026
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,
1
, ischemia
○ Valve prolapse: The stretching of an atrioventricular
Page | 2
valve leaflet into the atrium during diastole
● Valves of the Heart
● Specific Valvular Disorders (both valves have stenosis and
regurgitation but mitral also has prolapse***)
2
, ○ These valvular disorders may require surgical repair or
replacement of the valve to correct the problem,
depending on the severity of the symptoms
Page | 3
● 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
○ Mitral regurgitation
3
, ■ Blood flows back from left ventricle into left atrium
during systole
● The valve leaflets are not closing properly
Page | 4 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
replacement
○ Mitral stenosis
■ Obstruction of blood flowing from the left atrium to the
4
NUR 1140 MEDSURG EXAM 2 STUDY GUIDE
QUESTIONS AND ANSWERS BEST GRADED A+
BEST SOLUTIONS NEW UPDATE 2025-2026
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,
1
, ischemia
○ Valve prolapse: The stretching of an atrioventricular
Page | 2
valve leaflet into the atrium during diastole
● Valves of the Heart
● Specific Valvular Disorders (both valves have stenosis and
regurgitation but mitral also has prolapse***)
2
, ○ These valvular disorders may require surgical repair or
replacement of the valve to correct the problem,
depending on the severity of the symptoms
Page | 3
● 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
○ Mitral regurgitation
3
, ■ Blood flows back from left ventricle into left atrium
during systole
● The valve leaflets are not closing properly
Page | 4 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
replacement
○ Mitral stenosis
■ Obstruction of blood flowing from the left atrium to the
4
