D.Y.

Patil Education Society (Institution deemed to be university)

D.Y. Patil College of Nursing, Kolhapur

LESSON PLAN
ON
AORTIC STENOSIS
Submitted by :
Mrs. Susmita Dhanawade
MSc Nursing 1ST Year
Submitted to :
Mrs. Dr. suchitarani rathod,
Professor, HOD Of Medical Surgical Nursing

Submitted on:
Name of the student Teacher : Mrs. Susmita Mark Dhanawade
Subject : Medical Surgical Nursing
Topic : Aortic Stenosis
Group : B. Sc Nursing 2rd year
No. of Students 100
Date :
Time :
Name of the evaluator : Dr. Suchitrarani Rathod.
Method of instruction : English
Teaching method : Lecture-cum-discussion
Duration : 45 mins
Venue : B.sc (N) 2rd year Classroom. D.Y. Patil
College of Nursing
Previous Knowledge of the students: Student had some knowledge about
Pericarditis

A.V. Aids : Chalk Board, Roller board,

Handouts, PPT, Hangouts, Booklet
General objective: At the end of the topic students will be able to have in depth
knowledge about heart.

Specific Objectives:
At the end of this session, the student will be able to

1. Explain The Anatomy And Physiology Of Aortic Stenosis.

2. Definition Of Aortic Stenosis.
3. Describe The Causes Of Aortic Stenosis.
4. Explain The Clinical Features Of Aortic Stenosis.
5. List Out The Diagnostic Evaluation Of Aortic Stenosis.
6. Describe The Medical management of aortic stenosis.
7. Explain the Surgical management of aortic stenosis.
8. Explain Nursing management of aortic stenosis.
Bibliography:

1. LEWIS’S Medical Surgical Nursing, Assessment And Management

Of Clinical Problems, Mariann M.Harding,Jeffery Kwong, Debra
Hagler, Reinsich;11th Edition, Pg. No.5514-516

2. Joyce M. Black, Jane Hokanson Hawks Medical Surgical Nursing

And Clinical Management For Positive Outcomes, Black And
Hawks; 7th Edition, Thomson Press (India) Ltd.2007 (Vol 2), Pg. No.
1630-1632

3. PHIPPS’ medical surgical nursing, health and illness perspectives,

Monahan, sands, neighbours, marek and nigro;8th edition, replica
press pvt ltd.2009, pg. no. 812-815

4. Ross and Wilson anatomy and physiology, in health and illness, anne
Waugh, Allison grant; 11th edition, Churchill Livingstone; pg. no.63-
65

5. Brunner & Suddarth’s Textbook of Medical-Surgical Nursing,

Surgical Management of Aortic stenosis, Lippincott Williams &
Wilkins; 10th edition, Wolters Kluwer Pvt. Ltd. India, pg. no. 1780

6. M.P. Sharma, Aortic stenosis, Comprehensive Textbook of Medical

Surgical Nursing ,AITBS publisher, India:(1) 2016,pg no.228-230.

7. Williams l, hopper p, Understanding medical surgical nursing.5th ed.

Philadelphia: f.a. Davis company; 2011.
Sr.no. Time Specific Content Teacher’s Student’s AV aids Evaluation
Objectives Activity Activity
1. 2 min Self SELF INTRODUCTION
introducetion Good morning, everybody. Myself Mrs. Susmita
Dhanawade, student of 1styr. M.Sc. (N). As a part of my
nursing education curriculum, I will be engaging your class

Explain The
today.
4 min Explaining Listening
Anatomy And
Anatomy and physiology and
Physiology Of Aortic valve stenosis — or aortic stenosis — is a type of heart valve answering
Aortic disease (valvular heart disease). The valve between the lower left heart
Stenosis. chamber and the body's main artery (aorta) is narrowed and doesn't open
fully. This reduces or blocks blood flow from the heart to the aorta and to
the rest of the body.
The aortic valve is a semilunar valve (diameter of about 20 mm) that
generally has three leaflets. Common congenital differences include a
bicuspid valve. More rarely, unicuspid valves can be present. The valve can
be visualized via ultrasound. The valve divides one of the highest pressure
differentials of the cardiopulmonary system and, as such, is subject to wear
and tear injury. The leaflets of the aortic valve connect to the aortic root via
the aortic annulus. They are also suspended by fibrous structures called
commissures.
2. 3 min Definition Of DEFINITION Explaining Listening Roller
Aortic stenosis is an obstruction to flow occurs the aortic and board
Aortic
answering
Stenosis. valve during systolic, this obstruction to flow creates a
resistance to ejection and increased in the left ventricle.
Sr.no. Time Specific Content Teacher’s Student’s AV aids Evaluation
Objectives Activity Activity
-B. Venkatesan
3. 6 min Describe The CAUSES OF AORTIC STENOSIS Explaining Listening PPT
and
Causes Of 1. Infants, children, adolescents answering
Aortic  Congenital aortic stenosis
Stenosis.
 Congenital subvalvular aortic stenosis
 Congenital supravalvular aortic stenosis

2. Young adults to middle-aged

 Calcification and fibrosis of congenitally bicuspid
aortic valve
 Rheumatic aortic stenosis

3. Middle-aged to elderly
 Senile degenerative aortic stenosis
 Calcification of bicuspid valve
 Rheumatic aortic stenosis
4. 5 min Explain The CLINICAL FEATURES OF AORTIC STENOSIS Explaining Listening Pamphl
and ets
Clinical  Symptoms: answering
Features Of
1 Mild or moderate aortic stenosis is usually
Aortic
asymptomatic
Stenosis.
Sr.no. Time Specific Content Teacher’s Student’s AV aids Evaluation
Objectives Activity Activity
2 Exertional dyspnoea

3 Angina

4 Exertional syncope

5 Sudden death

6 Episodes of acute pulmonary oedema

 Signs:

1. Ejection systolic murmur

2. Slow-rising carotid pulse

3. Narrow pulse pressure

4. Thrusting apex beat (LV pressure overload)

5. Signs of pulmonary venous congestion (e.g.

crepitations)

7 4 min List Out The DIAGNOSTIC EVALUATION OF AORTIC Explaining Listening Hand
Diagnostic and outs
Evaluation Of STENOSIS answering
Aortic
Stenosis. History collection

Physical examination
ECG
Sr.no. Time Specific Content Teacher’s Student’s AV aids Evaluation
Objectives Activity Activity
 Left ventricular hypertrophy (usually)

 Left bundle branch block

Chest X-ray

 May be normal. Sometimes enlarged left ventricle and

dilated ascending aorta on PA view, calcified valve on
lateral view

Echo

 Calcified valve with restricted opening, hypertrophied

LV

Doppler

 Measurement of severity of stenosis

 Detection of associated aortic regurgitation

Cardiac catheterisation

 Mainly to identify associated coronary artery disease

 May be used to measure gradient between LV and aorta

8 5 min Describe The MANAGEMENT Explaining Listening PPT

and
Sr.no. Time Specific Content Teacher’s Student’s AV aids Evaluation
Objectives Activity Activity
Medical  In symptomatic state, prophylactic antibiotic to prevent, answering
management bacterial endocarditis
of aortic
stenosis.  In patient with a suspected rheumatic basis for the aortic
stenosis rheumatic prophylactic should be continued
until the age of 35

 Nitrates should be used for exertional chest discomfort

 Diastolic and diuretics for left ventricular failure and it

will not help in or stenosis because of mechanical
obstruction to outflow will not be reduced

 Beta blockers will used become they can depress

myocardial function

 Cardiac dysrythimas should be treated

pharmacologically

9 3 Min Explain the SURGICAL MANAGEMENT Explaining Listening PPT

and
Surgical  It should be considered when the pressure gradient is answering
management greater than 50 mm hg or the valve orifice is less than
of aortic
Sr.no. Time Specific Content Teacher’s Student’s AV aids Evaluation
Objectives Activity Activity
stenosis. 0.8 cm

 Commissurotomy in care of congenital aortic valvular

stenosis. valve replacement are mechanical prosthesis, Explaining Listening
and tissue prosthesis and PPT
Explain the
6 min answering
nursing
management
of aortic Nursing management
stenosis.
1. Assist The Patient In Bathing, If Necessary.
2. Provide A Bedside Commode Because Using A Commode Puts
Less Stress On The Heart Than Using A Bedpan.
3. Offer Diversional Activities That Are Physically Undemanding.
4. Alternate Periods Of Rest To Prevent Extreme Fatigue And
Dyspnea.
5. To Reduce Anxiety, Allow The Patient To Express His Concerns
About The Effects Of Activity Restrictions On His Resposibilities
And Routine.
6. Keep The Patient’s Legs Elevated While He Sits In A Chair To
Improve Venous Return In The Heart.
7. Place The Patient In An Upright Position To Relieve Dyspnea.
8. Administer Oxygen As Needed To Prevent Tissue Hypoxia.
9. Keep The Patient In A Low Sodium Diet. Consult With A Dietitian
To Ensure That The Patient Receives Foods That He Likes While
Adhering To The Diet Restrictions.
10. Allow The Patient To Express His Fears And Concerns About The
Sr.no. Time Specific Content Teacher’s Student’s AV aids Evaluation
Objectives Activity Activity
Disorder, It’s Impact On His Life, And Any Impending Surgery.
11. Monitor The Patient’s Vital Signs, Weight, And Intake And Output
For Signs Of Fluid Overload.
12. Evaluate Patient’s Activity Tolerance And Degree Of Fatigue.
13. Monitor The Patient For Chest Pain That May Indicate Cardiac
Ischemia.
14. Regularly Assess The Patient’s Cardiopulmonary Function.
15. Observe The Patient For Complications And Adverse Reactions To
Drug Therapy.

10 Summary:
Today we learned about Aortic stenosis that is unable to conceive. We
learned about its definition, its causes, clinical features and Diagnostic
Evaluation, Medical, surgical management.

11 ASSIGNMENT: write dawn the nursing care plan on aortic stenosis