Pulmonic insufficiency (regurgitation)

Definition – pulmonary valve fails to close, so that blood flows back into the right ventricle

Epidemiology

• a birth defect, or a result of pulmonary hypertension
• rarely, result of prolonged use of a pressure-monitoring catheter in the pulmonary artery

Assessment Findings

• dyspnea, fatigue, chest pain and syncope
• peripheral edema may cause discomfort
• if advanced: jaundice with ascites and peripheral edema
• possible malnourished appearance

Management
1. diuretics - to mobilize edematous fluid to reduce pulmonary venous pressure
2. sodium-restricted diet – to control underlying heart disease
3. anticoagulants – to prevent blood clots
4. digitalis – to increase the force or strength of cardiac contractions (inotropic action)
5. surgery for severe cases: valvulotomy or valve replacement

Nursing Interventions

• Apply cardio-care six

THE CARDIO-CARE SIX: A,B,C,D,E,F

1. ADL: Help the client with activities of daily living.
2. Bed rest
3. Commode at bedside (it stresses the heart less than using a bedpan does).
4. Diversions: offer diversions that don’t stress the heart.
5. Elevate head of bed, or sit client up.
6. Feelings: Let clients express concern; reassure when activity will resume.

• monitor the cardio seven
• monitor for findings of heart failure, pulmonary edema, and adverse reactions to drug therapy
• post-op: monitor client for hypotension, arrhythmias and thrombus formation
• provide rest periods
• when client sits, raise legs
• client and family teaching: (same as tricuspid stenosis, tricuspid insufficiency, and pulmonic stenosis)
• client’s dentist must give client prophylactic antibiotics to prevent infection