Here are some nursing interventions for this nursing diagnosis:- Provide education on the disease process, treatment plan, medication management and importance of follow up. - Teach about signs and symptoms of worsening condition like increased swelling, shortness of breath etc and when to seek medical help.- Demonstrate proper techniques for activities of daily living like bathing, dressing, toileting with limitations. - Educate on diet management, fluid restriction, weight monitoring and exercise plan.- Counsel on stress management, energy conservation, rest periods and pacing of activities.- Teach about infection prevention like hand washing, wound care, dental hygiene etc. - Provide written instructions and contact information
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The document discusses tricuspid valve stenosis and insufficiency. It defines the conditions as a narrowing or stiffening of the tricuspid valve opening (stenosis), or the valve not closing tightly enough to prevent leakage (insufficiency). Causes can include rheumatic fever, infections, congenital malformations, and tumors. Risks include right heart failure and liver congestion. Diagnosis involves physical exams, echocardiograms, and cardiac catheterization. Treatment options include medications, valve repairs such as annuloplasty or valvuloplasty, and valve replacements. Complications include heart failure, endocarditis, and liver cirrhosis.
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Similar to Here are some nursing interventions for this nursing diagnosis:- Provide education on the disease process, treatment plan, medication management and importance of follow up. - Teach about signs and symptoms of worsening condition like increased swelling, shortness of breath etc and when to seek medical help.- Demonstrate proper techniques for activities of daily living like bathing, dressing, toileting with limitations. - Educate on diet management, fluid restriction, weight monitoring and exercise plan.- Counsel on stress management, energy conservation, rest periods and pacing of activities.- Teach about infection prevention like hand washing, wound care, dental hygiene etc. - Provide written instructions and contact information
Similar to Here are some nursing interventions for this nursing diagnosis:- Provide education on the disease process, treatment plan, medication management and importance of follow up. - Teach about signs and symptoms of worsening condition like increased swelling, shortness of breath etc and when to seek medical help.- Demonstrate proper techniques for activities of daily living like bathing, dressing, toileting with limitations. - Educate on diet management, fluid restriction, weight monitoring and exercise plan.- Counsel on stress management, energy conservation, rest periods and pacing of activities.- Teach about infection prevention like hand washing, wound care, dental hygiene etc. - Provide written instructions and contact information (20)
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Here are some nursing interventions for this nursing diagnosis:- Provide education on the disease process, treatment plan, medication management and importance of follow up. - Teach about signs and symptoms of worsening condition like increased swelling, shortness of breath etc and when to seek medical help.- Demonstrate proper techniques for activities of daily living like bathing, dressing, toileting with limitations. - Educate on diet management, fluid restriction, weight monitoring and exercise plan.- Counsel on stress management, energy conservation, rest periods and pacing of activities.- Teach about infection prevention like hand washing, wound care, dental hygiene etc. - Provide written instructions and contact information
- 1. TRICUSPID VALVE STENOSIS AND INSUFFICIENCY
- 2. INTRODUCTION TRICUSPID VALVE Known as RIGHT ATRIOVENTRICULAR VALVE Consists of the three flaps or cups Situated between the right atrium and right ventricle. Acts as valve to prevent backflow of the blood.
- 3. DEFINITION Narrowing or stiffening of the opening in the valve stenosis. TRICUSPID VALVE STENOSIS
- 5. DEFINITION The valve does not close tightly TRICUSPID enough to prevent REGURGITATION leakage TRICUSPID VALVE TRICUSPID VALVE INSUSFFICIENCY INCOMPETENCE
- 7. RHEUMATIC FEVER INFECTION CAUSES ACCOMPANIED BY VALVULAR DISEASES CONGESTION HEART FAILURE CONGENITAL HEART DISEASES TUMOUR
- 8. RISK FACTOR • Rheumatic fever • Infection ( endocarditis) • Congenital malformation • Tumor (rare) • Diet medication called “Fen-Phen (phentermine and fenfluramine) or dexfenfluramine
- 9. PATHOPHYSIOLOGY BLOOD FLOW TO THE RIGHT ATRIUM TRICUSPID VALVE RIGHT VENTRICLES
- 10. PATHOPHYSIOLOGY BACKFLOW TO THE RIGHT ATRIUM HIGHER PRESSURE RIGHT ATRIUM, ENLARGEMENT, AND HYPERTROPHY HEPATOMEGALY SYSTEMIC VENOUS RETURN CONGESTION ASCITES
- 11. CLINICAL MANIFESTATION Asymptomatic Fatigue Palpitation Increased jugular vein distension Peripheral edema Dyspnea Hypotension Diastolic – mumbling murmur Pain at upper right abdomen
- 12. INVESTIGATION LABORATORY TEST RADIOLOGY INVESTIGATION
- 13. INVESTIGATION LABORATORY TEST RESULT Polycythemia result FULL BLOOD COUNT (FBC) Leukocytosis indicate ineffective endocarditis Mild elevation of LIVER FUNCTION TEST (LFT) aminotransferases may present secondary to chronic hepatic venous congestion. BLOOD CULTURES Positive infective endocarditis.
- 14. INVESTIGATION • Physical examination • Pulse ▫ Abnormal pulse elevated in the jugular vein of the neck. • Auscultation with a stethoscope. ▫ The result is abnormal heart sounds and heart murmur.
- 15. INVESTIGATION
- 16. INVESTIGATION Transesophageal CT - Scan echocardiogram Chest X-ray Ultrasound 12 lead ECG MRI Stress test cardiac Echocardiogram catheterization
- 17. CHEST X-RAY RIGHT ATRIUM ENLARGEMENT
- 18. 12 LEAD ECG
- 19. ECHOCARDIOGRAM
- 21. ULTRASOUND
- 22. CT SCAN
- 23. MRI SCAN
- 25. STRESS TEST
- 26. TREATMENT SURGICAL TREATMENT MEDICAL TREATMENT
- 27. MEDICAL TREATMENT • Mild- no symptoms no require treatment. • Medication as prescribed to relief the symptoms only . • Types of medication prescribed depends on the condition of patient. Antibiotics Diuretics Anticoagulants Antiplatelets Vasodilators Cardiac glycosides
- 28. MEDICATION GROUP EXAMPLE ACTION ANTIBIOTICS PENICILLIN G Inhibit cell wall POTASSIUM synthesis in (PFIZERPEN) susceptible organism cell death. ANTICOAGULANTS WARFARIN SODIUM Prevent thrombosis (COUDIUM) and prolong clotting time CARDIAC GLYCOSIDES DIGOXIN Increasing cardiac (LANOXIN) output by slowing heart rate and increase the force contraction.
- 29. MEDICATION GROUP EXAMPLE ACTION ANTIPLATELETS TICLOPIDINE Reduces the clot HYDROCHLORIDE production by (TICLID) interfering with platelets aggregation. VASODILATORS GTN To vasodilators the ISORDIL blood vessels. DIURETICS FRUSEMIDE To reduce the (LASIX) edema.
- 30. SURGICAL TREATMENT Annuloplasty Valvuloplasty Replacement heart valve Commissurotomy
- 31. ANNULOPLASTY • Procedure to reduce the an enlarged annulus (fibrous ring) surrounding the valve. • Prosthetic ring sutured into the circumference of tricuspid annulus and the stitches are pulled towards to prosthesis .
- 32. ANNULOPLASTY
- 33. VALVULOPLASTY • Involves direct repair to torn leaflets by open surgery.
- 34. COMMISSUROTOMY • Incision of stenos valve leaflets at their borders. OPEN Performed median COMMISSUROTOMY sternotomy CLOSED Insert finger through a small COMMISSUROTOMY incision
- 35. OPEN CLOSED COMMISSUROTOMY COMMISSUROTOMY
- 36. REPLACEMENT HEART VALVE • Replacement valve can replace to overcome the congenital or obstructive of valvular disorders. • Types of replacement valve • Natural valve • Modified natural valves (animal donors) • Artificial or mechanical valve
- 37. MODIFIED NATURAL VALVE PIG TISSUE VALVE PORCINE VALVE COW VALVE
- 38. MECHANICAL VALVE
- 40. COMPLICATION OF TRICUSPID VALVE STENOSIS AND INSUFFICIENCY
- 41. COMPLICATION CHRONIC HEART FAILURE ENDOCARDITIS LIVER CIRHOSIS
- 43. HEALTH TEACHING
- 44. HEALTH TEACHING
- 46. NCP 1 NURSING DIAGNOSIS : DECREASED OF CARDIAC OUTPUT RELATED TO THE TRICUSPID VALVE STENOSIS AND INSUFFICIENCY. EXPECTED OUTCOME: CARDIAC OUTPUT WILL ELEVATED AND MAINTAIN.
- 47. NURSING INTERVENTION NURSING INTERVENTION RATIONALE Monitor vital signs , hemodynamic To report any changes /abnormality parameters, cardiac rhythm. reading. Monitor intake and output chart. To detect loss of function of the renal perfusion or renal failure. Weight daily. To evaluate the elevation of weight due to fluid retention. Restrict the fluid as ordered. To reduce cardiac workload. Monitor oxygen saturation and ABG To allow the assessment of oxygenation. results. Administer oxygen as ordered. To improve alveolar ventilation and oxygenation. Encourage rest on the bed. To decrease cardiac workload. Administer medication as prescribed. To reduce fluid volume and cardiac work Elevate the head of the bed. To promote breathing mechanism.
- 48. NCP 1 EVALUATION CARDIAC OUTPUT INCREASING , THE HEART RATE, BLOOD PREESSURE AND URINE OUTPUT WITHIN THE NORMAL RANGE.
- 49. NCP 2 NURSING DIAGNOSIS: ACTIVITIY INTOLERANCE RELATED TO THE TRICUSPID VALVE STENOSIS AND INSUFFICIENCY EXPECTED OUTCOME : CLIENT WILL TOLERATE ACTIVITY WITHOUT DYSPNEA OR TACHYCARDIA
- 50. NURSING INTERVENTION NURSING INTERVENTION RATIONALE Monitor vital signs before and during To report any abnormalities reading. activity. Encourage self-care and gradually To improve client self-esteem and increasing activities as a lower and sense of power. tolerated. Provide assistance as needed. To reducing the energy expenditure to help maintain a balance oxygen balance. Consult with cardiac rehabilitation , To improve the strength and promote physical therapy for in-bed exercise good circulation. and activity plan. Discuss ways to conserve the energy. To maintain oxygen level in the body.
- 51. NCP 2 EVALUATION CLIENT MANAGE SELF-CARE AND MODERATE ACTIVITY WITHOUT BECOMING DYSPNEA AND MAINTAIN HEART RATE.
- 52. NCP 3 NURSING DIAGNOSIS: RISK FOR INFECTION RELATED TO THE TRICUSPID VALVE STENOSIS AND INSUFFICIENCY EXPECTED OUTCOME : CLIENT WILL FREE OF INFECTION
- 53. NURSING INTERVENTION NURSING INTERVENTION RATIONALE Use aseptic technique for all invasive To prevents infection. procedures. Assess the wound and catheter sites To reduce the risk of infection. for redness, swelling, warmth, pain . Administer antibiotics as ordered. To treat and prevent the infection. Monitor WBC and TWDC results. To notify the leukocytosis and leucopenia. EVALUATION: CLIENT FREE FROM NOSOCOMIAL INFECTION
- 54. NCP 4 NURSING DIAGNOSIS: DEFICIT KNOWLEDGE OF SELF-CARE RELATED TO THE TRICUSPID VALVE SYENOSIS AND INSUFFICIENCY EXPECTED OUTCOME : CLIENT WILL ACCURATEKY DESCRIBE DISCHARGE INSTRUCTION
- 55. NURSING INTERVENTION NURSING INTERVENTION RATIONALE Completely explain all treatment. To improve the understanding disease process. Consult the physician about To prevent infection. prophylactic antibiotics therapy before or invasive treatment. Avoid vigorously activities and To reduces cardiac workload. competitive sports. Avoid caffeine and over-the –counter To reduce the high risk of congestion medications cardiac failure. EVALUATION: CLIENT MORE UNDERSTANDING AND KNOWLEGEABLE.
- 56. CONCLUSION • Tricuspid valve stenosis and insufficiency are the heart valvular disease. • Both of them caused by the rheumatic heart diseases. • It can be corrected by the repairment of the valve and replacement of the valve for good circulation of blood in the body and improve breathing process.
- 57. REFERENCES • http://www.nlm.nih.gov/medlineplus/en cy/article/000169.htm • http://emedicine.medscape.com/article /158484-followup#showall • http://heart_emedtv.com/tricuspid- stenosis/tricuspid-stenosis.html • http://www.tricuspidvalvestenosis.com/ • http://www.mayoclinic.org/tricuspid- valve-disease/
- 58. REFERENCES • Luckmann and sorenser’s Medical surgical nursing ( A Psychophysiology approach) fourth edition, JOYCE M.BLACK & ESTHER MATASSARIN (1234&1235) • PEARSON INTERNATIONAL EDITION (2008),Medical- surgical nursing critical thinking in client care.(Fourth edition),PRISCILLA LEMONE AND KAREN BURKE,(2008) • Lippincott Williams and Wilkins, Introduction medical surgical nursing (ninth edition), BARBARA R.TIMBY & NANCY E.SMITH.