Hemodynamic goals for a patient with valvular heart disease involve consideration of what five cardiac parameters? (1) Heart rate, (2) rhythm, (3) preload, (4) afterload (determined by SVR), and (5) contractility. Dopamine may be used for inotropic support. Phenylephrine, with its predominant alpha actions, will serve to increase blood pressure and SVR while decreasing heart rate (reflexively) to allow better flow through the stenotic opening. How is this treated? Maintenance of cardiac output is desired. A patient with mitral valve stenosis presents with: HR of 100 blood pressure 80/50 PCWP, 18 and CVP, 12. Hence, there is a diastolic murmur (aortic regurgitation) and a systolic murmur (mitral regurgitation). With severe and prolonged aortic regurgitation, the dilation of the ventricle (eccentric hypertrophy) may be associated with a secondary mitral regurgitation. The very low diastolic pressure and wide pulse pressure suggest aortic regurgitation as the primary problem. With both a systolic and a diastolic murmur if the patient has a heart rate of 100 and a blood pressure of 135/45? Aortic regurgitation. What valve problem (aortic stenosis, aortic regurgitation, mitral stenosis, There is often a faint diastolic murmur of minimal aortic regurgitation. With aortic stenosis, there is a midsystolic ejection murmur that peaks in late systole. With both a systolic and a diastolic murmur? Aortic stenosis. What monitoring is indicated for managing the patient with a history ofĬongestive heart failure secondary to diastolic dysfunction? The use of invasive monitoring such as central venous pressure (CVP) or pulmonary artery catheter (PAC) may be indicated in managing the patient with a history of congestive heart failure secondary to diastolic dysfunction. The best indicator of diastolic dysfunction is a decrease in left ventricular compliance. How is diastolic function of the left ventricle assessed? What is the BEST indicator of left ventricular diastolic dysfunction? Diastolic function of the left ventricle is assessed by examining left ventricular compliance. Three factors that promote left ventricular eccentric hypertrophy are (1) excessive intravascular volume, (2) aortic regurgitation, and (3) mitral regurgitation. The chamber enlarges and can accommodate a larger volume of blood. Volume overload (chronically increased preload) stimulates the ventricular wall to dilate. If you are interested in donating to the Golden Valley Memorial Hospital Foundation, please contact Sarah Duncan, Foundation Director, at promotes eccentric hypertrophy? What happens to the size of the left ventricular chamber when there is eccentric hypertrophy? Identify three factors that will promote left ventricular eccentric hypertrophy. “This scholarship provides opportunities to nurses in our community to advance their careers and ensures our patients will receive the highest quality of care.” “We sincerely appreciate the generosity of the Meyer’s family to honor Dolores,” said Sarah Duncan, Foundation Director. Once she completes the program, Stilson plans to do her clinical work locally and then become a Family Nurse Practitioner at GVMH. Stilson is taking online classes through United States University to pursue a Master of Science in Nursing. She works in the Outpatient Treatment Center as an Oncology Nurse and has been with GVMH for 10 years. The recipient of the Dolores Meyer scholarship is Erin Stilson, RN. Meyer was very passionate about nursing and helping patients. To honor her memory, Meyer’s family made a donation to the Foundation to establish a scholarship to help a nursing student further their education. She was a registered nurse (RN) and held the position of Assistant Director of Nurses when she retired. Meyer was employed at GVMH from 1973-2002. 25, 2021) – Golden Valley Memorial Hospital Foundation is delighted to announce that it recently received a donation to establish a scholarship for nursing students from the family of Dolores Meyer, a former Golden Valley Memorial Healthcare (GVMH) employee.
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