12 Nursing Diagnosis for Mitral Stenosis

12 Nursing Diagnosis for Mitral Stenosis

Nursing Diagnosis and Interventions   October 14, 2013

Nursing Care Plan for Mitral Stenosis

Mitral stenosis is a narrowing of the mitral valve in the heart. This restricts the flow of blood through the valve. Back pressure which builds up behind the narrowed valve can cause various problems and symptoms. The more severe the narrowing, the more serious the problems.

Mitral stenosis (MS) is characterized by obstruction to left ventricular inflow at the level of mitral valve due to structural abnormality of the mitral valve apparatus. The most common cause of mitral stenosis is rheumatic fever.

Symptoms can include:

• Shortness of breath. This tends to occur on exercise at first, but occurs at rest if the stenosis becomes worse. This symptom is due to the congestion of blood and fluid in the lungs.
• Fainting, dizziness or tiredness. If the amount of blood getting through to the ventricle is reduced, the output of blood from the left ventricle to the body is then reduced.
• Chest pains (angina). This may develop if there is a reduced blood flow to the coronary arteries (the arteries that take blood to the heart muscle).
• Chest infections. These are common.
• Coughing up blood-stained sputum. This may occur due to the congestion of blood and fluid in the lungs.

If rheumatic fever is the cause then, typically, symptoms start between the ages of 20 and 50. (That is, 10-20 years after having have had an episode of rheumatic fever as a child.)


12 Nursing Diagnosis for Mitral Stenosis

1. Ineffective individual coping
related to :

• Situational crisis;
• Inadequate support systems;
• Ineffective coping methods.

2. Deficient Knowledge (learning needs)
related to :

• Lack of knowledge;
• Misinterpretation of information;
• Cognitive limitations;
• Deny the diagnosis.

3. Risk for Fluid Volume Excess
related to :

• The displacement of the pressure on the congestive pulmonary vein;
• Decrease in perfusion organ (kidney);
• Increased retention of sodium / water;
• Increased hydrostatic pressure, or decreased plasma protein (absorbs liquid in the interstitial area / tissue).

4. Risk for Impaired gas exchange
related to :

• Alveolar - capillary membrane changes (displacement of fluid into the interstitial area / alveoli).

5. Ineffective breathing pattern
related to:
decreased lung expansion.

6. Anxiety
related to:

• Threat of loss / death;
• Situational crisis;
• Threats to self-concept (self-image).

7. Ineffective Tissue perfusion
related to:

• Decrease in peripheral blood circulation;
• Cessation of arterial-venous flow;
• Decrease in activity.

8. Decreased cardiac output
related to:

• Obstruction of blood flow from the left atrium into the left ventricle,
• Presence of ventricular tachycardia,
• Shortening of the diastolic phase.

9. Imbalanced Nutrition: less than body requirements
related to:

• Shortness of breath.

10. Impaired Urinary Elimination
related to:

• Decreased glomerular perfusion;
• Decrease in cardiac output.

11. Risk for Fluid Volume Deficit
related to:

• Decrease in cardiac output;
• Decline in glomerular filtration.

12. Activity intolerance
related to:

• Decreased cardiac output,
• Congestive pulmunal.