Credits to Mr. Jefferson Ramos

1. ALTERED OXYGENATION:
CARDIOVASCULAR

2. DISTURBANCES IN OXYGEN
TRANSPORT MECHANISM
Structural Cardiac
Disorders

3. HEART VALVES

4. MITRAL VALVE

5. MITRAL VALVE PROLAPSE

6. MITRAL VALVE PROLAPSE
• Directed at controlling the symptoms
• Nitrates
• Calcium-channel blockers
• Beta-blockers
• For heart failure, it is treated as it
would be for any other heart with
heart failure

7. MITRAL REGURGITATION

8. MITRAL REGURGITATION
• Systolic murmur
• Dyspnea
• Fatigue
• Palpitations
• Shortness of breath on exertion
• Cough due to pulmonary congestion

9. MITRAL STENOSIS

10. MITRAL STENOSIS
• Dyspnea on exertion = 1st
symptom
• Progressive fatigue
• Hemoptysis
• Repeated respiratoty infections

11. MITRAL STENOSIS
• Antibiotic prophylaxis
• Anticoagulants
• Valvuloplasty
• Percutaneous transluminal
valvuloplasty
• Mitral valve replacement
Colleen C. Flores, RN

12. AORTIC REGURGITATION

13. AORTIC REGURGITATION
• Asymptomatic
• Clients may be aware of forceful heartbeats (head
& neck)
– Visible or palpable on carotid or temporal arteries
• Exertional dyspnea followed by fatigue
• Diastolic murmur
• Widened pulse pressure
• Water-hammer pulse
• Breathing difficulties (Progressive signs and
symptoms)

14. AORTIC STENOSIS

15. AORTIC STENOSIS
• Asymptomatic
• Exertional dyspnea
• Dizziness and syncope
• Rough systolic murmur

16. Surgical Management
• Valvuloplasty

17. Surgical Management
• Valvuloplasty

18. Surgical Management
• Valve Repair and Replacement:

19. Surgical Management
• Valve Repair and Replacement:

20. NURSING MANAGEMENT
• Education on diagnosis (it may be
hereditary), symptoms that may develop
• Need for prophylactic antibiotics before any
invasive procedure
• Diet :

21. DISTURBANCES IN OXYGEN
TRANSPORT MECHANISM
Infectious Disorders

22. Rheumatic Heart Disease

23. Rheumatic Heart Disease
Strep Throat S/Sx Rheumatic Fever S/Sx
• sudden onset of sore • fever
throat • painful, tender, red swollen
joints
• pain on swallowing
• pain in one joint that
• fever, usually 101–104°F migrates to another one
• headache • heart palpitations
• red throat/tonsils • chest pain, SOB
• abdominal pain, nausea • skin rashes
and vomiting may also • fatigue
occur, especially in • small, painless nodules under
children the skin

24. Rheumatic Heart Disease
• Best defense = prevent rheumatic fever
from occurring
• Treat strep throat with penicillin or other
antibiotics
• People with history of rheumatic fever
are more susceptible to recurrent attacks
and heart damage.

25. Infective Endocarditis
(Bacterial Endocarditis)

26. • Manifestations:
– Remittent fever (high or low) accompanied by chills*
– Malaise, fatigue, anorexia, weight loss
– Headache & musculoskeletal complaints (arthralgia)
– Murmurs
– Petichiae (conjunctiva), splinter hemorrhages (dark red
lines) under the nails, Painful finger or toe tip (Osler’s
node – pea-sized nodules)
• Dx: blood culture – at least 6 (taken during chills or at height
of fever), ECG, CBC
• Tx: antimicrobials – depend on organism involved (Penicillin
& Streptomycin commonly used)
– IV 4-6wks
– Prosthetic heart valves may need to be replaced
Colleen C. Flores, RN

27. Splinter Hemorrhages

28. Osler’s nodes

29. Roth’s Spots

30. Myocarditis

31. Pericarditis

32. Manifestations & Management:
1. Acute: chest pain exacerbated with respirations
– Pericardial friction rub (classic sign)
– MGT: tx of underlying cause, NSAID (ASA), morphine, provide
reassurance on temporary nature of disease
2. Cardiac tamponade: narrow pulse pressure
– Tachycardia (compensatory) → shock & death
– Hypotension, jugular vein distention, cyanosis, muffled heart
sounds, paradoxic pulse
– MGT: pericardiocentesis; prompt intervention needed to
prevent shock & death
3. Constrictive: RV failure & ↓cardiac output
– Fatigue on exertion, dyspnea, low pulse pressure, distended
neck veins, delayed capillary refill time
– leg edema, ascites
– MGT: digitalis, diuretics, Na+ restriction; pericardiectomy
Colleen C. Flores, RN

33. DISTURBANCES IN OXYGEN
TRANSPORT MECHANISM
Vascular and
Peripheral Disorders
Colleen C. Flores, RN

34. Vascular System

35. Aortic Aneurysm

36. Clinical Manifestation
Thoracic Aortic Aneurism May be asymptomatic
Pain is usually constant and boring
(when patient is supine)
Dyspnea, brassy cough, hoarseness
of voice
Abdominal Aortic Aneurism Feels that heart is beating in the
(AAA) abdomen while lying down
May feel abdominal mass or
abdominal throbbing
Dissecting Aneurism of the Sudden severe and persistent pain
Aorta described as tearing or ripping in
the anterior chest or back and
extends to the shoulders, epigastric
area or abdomen

37. Buerger’s Disease

38. Raynaud’s Disease

39. Raynaud’s Disease

40. Management

42. Veins Cause/s Clinical Manifestations
Superficial Varicose veins, IVs Tender, indurated,
(Thrombo- injections, visible, & palpable
phlebitis) Buerger’s, cancer, vein; ovoid nodules in
- Saphenous blood dyscrasias skin
- Median cephalic
& basilic
Deep Vein (DVT) Immobility, CHF, cancer, (+)Homan’s sign,
blood dyscrasias, tenderness, warmth,
- Femoral, iliac,
fracture, dislocation, superficial venous
tibial, popliteal obesity, oral distention, cyanosis
contraceptives (severe occlusion)

43. Pharmacological Management
• Anti-coagulants - prevents clot
formation
–Heparin (Liquaemin)
–Warfarin (Coumadin
• Thrombolytics = Streptokinase -
dissolves clot

44. Surgical Management
Venous Thrombectomy
Umbrella Procedure

45. Nursing Management
• Superficial thrombophlebitis – local
measures (i.e. warm pack, extremity
elevation); sometimes anti-inflammatory
meds are required
• DVT – CBR until local signs of
inflammation subsides; after 7-15days =
ambulate with elastic stockings

46. Colleen C. Flores, RN