Aortic insufficiency (regurgitation)

Posted on Monday, 13 July 2009 by Site Admin

Definition:blood flows back into the left ventricle during diastole overloading the ventricle
and causing it to hypertrophy.
:extra blood also overloads the left atrium and, eventually, the pulmonary system.

Epidemiology

by itself, most common among males
with mitral valve disease, more common among females
may accompany Marfan’s syndrome, ankylosing spondylitis, syphilis, essential hypertension or a defect of the ventricular septum

Assessment Findings

uncomfortable awareness of heartbeat
palpitations along with a pounding head
dyspnea with exertion
paroxysmal nocturnal dyspnea, with diaphoresis, orthopnea and cough
fatigue and syncope with exertion or emotion
anginal chest pain unrelieved by sublingual nitroglycerin
heartbeat that seems to jar the client’s entire body
client’s nailbeds appear to be pulsating
if nail tip is pressed, the root will flush and then pale (Quincke’s sign)
if left ventricle fails, client may show ankle edema and ascites
pulsus biferiens

Management

digitalis - increases the heart’s contractility (inotropic action)
diuretics – to mobilize edematous fluids and to reduce pulmonary venous pressure
sodium-restricted diet – to prevent fluid retention
anticoagulant agents – to prevent blood clots
surgical – valve replacement. however, aortic insufficiency often damages the ventricle before it is detected.

Nursing interventions

same as all other valve disorders – the cardio-care six except don’t need to elevate head unless pulmonary problems have begun.
monitor the cardio seven
monitor for signs of heart failure, pulmonary edema, and drug reactions.
post-op: monitor client for hypotension, arrhythmias and clots.
client and family teaching
same as all other valve disorders – the cardio five
emphasize the need for prophylactic antibiotics during dental care
ADL: Help the client with activities of daily living.
Bed rest
Commode at bedside (it stresses the heart less than using a bedpan does).
Diversions: offer diversions that don’t stress the heart.
Elevate head of bed, or sit client up.
Feelings: Let clients express concern; reassure when activity will resume.
instruct client to raise legs when sitting