Primary Nursing Diagnosis

Activity intolerance related to imbalance between oxygen supply and demand

OUTCOMES. Endurance; Energy conservation; Self-care; Ambulation: Walking; Circulation status; Cardiac pump effectiveness; Rest; Respiratory status; Symptom severity; Nutritional status: Energy

INTERVENTIONS. Activity therapy; Energy management; Circulatory care; Exercise therapy: ambulation; Oxygen therapy; Self-care assistance; Nutrition management

90 Aortic Valve Insufficiency

^ PLANNING AND IMPLEMENTATION Collaborative

MEDICAL. Medical management focuses initially on treating the underlying cause, such as endocarditis or syphilis. Patients are encouraged to limit strenuous physical activity. Fluid restrictions and diuretics may be ordered to reduce pulmonary congestion. Supplemental oxygenation will enhance oxygen levels in the blood to decrease labored breathing and chest pain.

SURGICAL. Most patients can be stabilized with medical treatment, but early elective valve surgery should be considered because the outlook for medically treated symptomatic disease is poor. Surgical repair or replacement is the most common treatment of AI.

The incompetent valve can be replaced with a synthetic or biologic valve, such as a pig valve. The choice of valve type is based on the patient's age and potential for clotting problems. The biologic valve usually shows structural deterioration after 6 to 10 years and needs to be replaced. The synthetic valve is more durable but also more prone to thrombi formations.

Pharmacologic Highlights

Medication or Drug Class

Dosage

Description

Rationale

Digoxin

0.25 mg PO qd

Cardiotonic

Increases force of contraction in

0 0

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