2. INTRODUCTION TRICUSPID VALVE Known as RIGHT
ATRIOVENTRICULARVALVE Consists of the three flaps or cups Situated
between the right atrium and rightventricle. Acts as valve to
prevent backflow of theblood. 3. DEFINITION Narrowing orstiffening
of theopening in the valvestenosis.TRICUSPIDVALVESTENOSIS 4.
TRICUSPIDVALVE STENOSIS 5. DEFINITIONThe valve does not close
tightly TRICUSPIDenough to preventREGURGITATION
leakageTRICUSPIDVALVETRICUSPID VALVE INSUSFFICIENCY INCOMPETENCE 6.
TRICUSPID INSUFFICIENCY 7. RHEUMATICFEVERINFECTION CAUSES
ACCOMPANIED BY VALVULAR DISEASESCONGESTIONHEART FAILURE
CONGENITALHEART DISEASES TUMOUR 8. RISK FACTOR Rheumatic fever
Infection ( endocarditis) Congenital malformation Tumor (rare) Diet
medication called Fen-Phen(phentermine and fenfluramine)
ordexfenfluramine 9. PATHOPHYSIOLOGYBLOOD FLOW TO THE
RIGHTATRIUMTRICUSPID VALVE RIGHT VENTRICLES 10.
PATHOPHYSIOLOGYBACKFLOW TO THE RIGHT ATRIUM HIGHER PRESSURE RIGHT
ATRIUM, ENLARGEMENT, AND HYPERTROPHYHEPATOMEGALYSYSTEMIC VENOUS
RETURN CONGESTIONASCITES 11. CLINICAL MANIFESTATION
AsymptomaticFatiguePalpitationIncreased jugular vein distension
Peripheral edema DyspneaHypotensionDiastolic mumbling murmurPain at
upper right abdomen 12. INVESTIGATIONLABORATORY TEST
RADIOLOGYINVESTIGATION 13. INVESTIGATIONLABORATORY TEST RESULT
Polycythemia resultFULL BLOOD COUNT (FBC) Leukocytosis indicate
ineffective endocarditisMild elevation ofLIVER FUNCTION TEST (LFT)
aminotransferases maypresent secondary to chronichepatic venous
congestion.BLOOD CULTURES Positive infective endocarditis. 14.
INVESTIGATION Physical examination Pulse Abnormal pulse elevated in
the jugular vein of the neck. Auscultation with a stethoscope. The
result is abnormal heart sounds and heart murmur. 15. INVESTIGATION
16. INVESTIGATIONTransesophageal CT - ScanechocardiogramChest
X-rayUltrasound12 lead ECGMRI Stress test cardiac
Echocardiogramcatheterization 17. CHEST X-RAYRIGHT
ATRIUMENLARGEMENT 18. 12 LEAD ECG 19. ECHOCARDIOGRAM 20.
CARDIACCATHETERIZATION 21. ULTRASOUND 22. CT SCAN 23. MRI SCAN 24.
TRANSESOPHAGEALECHOCARDIOGRAM 25. STRESS TEST 26. TREATMENT
SURGICALTREATMENT MEDICALTREATMENT 27. MEDICAL TREATMENT Mild- no
symptoms no require treatment. Medication as prescribed to relief
thesymptoms only . Types of medication prescribed depends onthe
condition of patient. Antibiotics Diuretics Anticoagulants
Antiplatelets Vasodilators Cardiac glycosides 28.
MEDICATIONGROUPEXAMPLE ACTIONANTIBIOTICSPENICILLIN GInhibit cell
wall POTASSIUM synthesis in (PFIZERPEN) susceptible organism cell
death.ANTICOAGULANTS WARFARIN SODIUM Prevent thrombosis (COUDIUM)
and prolong clotting timeCARDIAC GLYCOSIDES DIGOXIN Increasing
cardiac (LANOXIN) output by slowing heart rate and increase the
force contraction. 29. MEDICATIONGROUP EXAMPLE ACTIONANTIPLATELETS
TICLOPIDINE Reduces the clotHYDROCHLORIDE production
by(TICLID)interfering withplateletsaggregation.VASODILATORSGTN To
vasodilators theISORDIL blood vessels.DIURETICS FRUSEMIDE To reduce
the(LASIX) edema. 30. SURGICAL TREATMENT Annuloplasty
ValvuloplastyReplacement heart valve Commissurotomy 31.
ANNULOPLASTY Procedure to reduce the an enlargedannulus (fibrous
ring) surrounding thevalve. Prosthetic ring sutured into
thecircumference of tricuspid annulusand the stitches are pulled
towards toprosthesis . 32. ANNULOPLASTY 33. VALVULOPLASTY Involves
direct repair to torn leaflets by opensurgery. 34. COMMISSUROTOMY
Incision of stenos valve leaflets at theirborders.OPENPerformed
median COMMISSUROTOMY sternotomy CLOSEDInsert finger through a
small COMMISSUROTOMY incision 35. OPENCLOSEDCOMMISSUROTOMY
COMMISSUROTOMY 36. REPLACEMENT HEART VALVE Replacement valve can
replace to overcomethe congenital or obstructive of
valvulardisorders. Types of replacement valve Natural valve
Modified natural valves (animal donors) Artificial or mechanical
valve 37. MODIFIED NATURAL VALVEPIG TISSUE VALVEPORCINE VALVE COW
VALVE 38. MECHANICAL VALVE 39. COMPLICATION OF TRICUSPID VALVE
STENOSIS ANDINSUFFICIENCY 40. COMPLICATIONCHRONIC HEART
FAILUREENDOCARDITISLIVER CIRHOSIS 41.
COMPLICATIONHEPATOMEGALYASCITES 42. HEALTHTEACHING 43. HEALTH
TEACHING 44. NCP 1NURSING DIAGNOSIS :DECREASED OF CARDIAC OUTPUT
RELATED TOTHE TRICUSPID VALVE STENOSIS ANDINSUFFICIENCY.EXPECTED
OUTCOME:CARDIAC OUTPUT WILL ELEVATED ANDMAINTAIN. 45. NURSING
INTERVENTIONNURSING INTERVENTION RATIONALEMonitor vital signs ,
hemodynamicTo report any changes /abnormalityparameters, cardiac
rhythm.reading.Monitor intake and output chart. To detect loss of
function of the renal perfusion or renal failure.Weight daily.To
evaluate the elevation of weight due to fluid retention.Restrict
the fluid as ordered. To reduce cardiac workload.Monitor oxygen
saturation and ABGTo allow the assessment of
oxygenation.results.Administer oxygen as ordered.To improve
alveolar ventilation and oxygenation.Encourage rest on the bed. To
decrease cardiac workload.Administer medication as prescribed. To
reduce fluid volume and cardiac workElevate the head of the bed. To
promote breathing mechanism. 46. NCP 1EVALUATIONCARDIAC OUTPUT
INCREASING , THE HEART RATE, BLOOD PREESSUREAND URINE OUTPUT WITHIN
THENORMAL RANGE. 47. NCP 2NURSING DIAGNOSIS: ACTIVITIY INTOLERANCE
RELATED TO THETRICUSPID VALVE STENOSIS AND INSUFFICIENCYEXPECTED
OUTCOME : CLIENT WILL TOLERATE ACTIVITY WITHOUTDYSPNEA OR
TACHYCARDIA 48. NURSING INTERVENTIONNURSING
INTERVENTIONRATIONALEMonitor vital signs before and during To
report any abnormalities reading.activity.Encourage self-care and
gradually To improve client self-esteem andincreasing activities as
a lower andsense of power.tolerated.Provide assistance as needed.
To reducing the energy expenditureto help maintain a balance
oxygenbalance.Consult with cardiac rehabilitation , To improve the
strength and promotephysical therapy for in-bed exercisegood
circulation.and activity plan.Discuss ways to conserve the
energy.To maintain oxygen level in the body. 49. NCP 2
EVALUATIONCLIENT MANAGE SELF-CARE AND MODERATE ACTIVITY WITHOUT
BECOMING DYSPNEA ANDMAINTAIN HEART RATE. 50. NCP 3 NURSING
DIAGNOSIS: RISK FORINFECTION RELATED TO THETRICUSPID VALVE STENOSIS
AND INSUFFICIENCY EXPECTED OUTCOME : CLIENT WILL FREE OF INFECTION
51. NURSING INTERVENTIONNURSING INTERVENTION RATIONALEUse aseptic
technique for all invasive To prevents infection.procedures.Assess
the wound and catheter sitesTo reduce the risk of infection.for
redness, swelling, warmth, pain .Administer antibiotics as ordered.
To treat and prevent the infection.Monitor WBC and TWDC results.To
notify the leukocytosis and leucopenia. EVALUATION: CLIENT FREEFROM
NOSOCOMIAL INFECTION 52. NCP 4 NURSING DIAGNOSIS:DEFICIT KNOWLEDGE
OF SELF-CARE RELATEDTO THE TRICUSPID VALVE SYENOSIS AND
INSUFFICIENCYEXPECTED OUTCOME : CLIENT WILL ACCURATEKY
DESCRIBEDISCHARGE INSTRUCTION 53. NURSING INTERVENTIONNURSING
INTERVENTION RATIONALECompletely explain all treatment.To improve
the understanding disease process.Consult the physician aboutTo
prevent infection.prophylactic antibiotics therapybefore or
invasive treatment.Avoid vigorously activities andTo reduces
cardiac workload.competitive sports.Avoid caffeine and over-the
counter To reduce the high risk of congestionmedicationscardiac
failure.EVALUATION:CLIENT MORE UNDERSTANDINGAND KNOWLEGEABLE. 54.
CONCLUSION Tricuspid valve stenosis and insufficiencyare the heart
valvular disease. Both of them caused by the rheumatic
heartdiseases. It can be corrected by the repairment of thevalve
and replacement of the valve for goodcirculation of blood in the
body and improvebreathing process. 55. REFERENCES
http://www.nlm.nih.gov/medlineplus/ency/article/000169.htm
http://emedicine.medscape.com/article/158484-followup#showall
http://heart_emedtv.com/tricuspid-stenosis/tricuspid-stenosis.html
http://www.tricuspidvalvestenosis.com/
http://www.mayoclinic.org/tricuspid-valve-disease/ 56. REFERENCES
Luckmann and sorensers Medical surgical nursing( A Psychophysiology
approach) fourth edition,JOYCE M.BLACK & ESTHER
MATASSARIN(1234&1235) PEARSON INTERNATIONAL EDITION
(2008),Medical-surgical nursing critical thinking in
clientcare.(Fourth edition),PRISCILLA LEMONE ANDKAREN BURKE,(2008)
Lippincott Williams and Wilkins, Introductionmedical surgical
nursing (ninth edition), BARBARAR.TIMBY & NANCY E.SMITH.
