Reference no: EM133445446

A patient presents to the ED with complaints of chest pain and dizziness after climbing a flight of stairs. He has a past medical history of aortic valve stenosis. The nurse assesses vital signs and connects the patient to cardiac rhythm and pulse oximetry monitoring systems. The following data are available:

• Cardiac rhythm strip interpretation: uncontrolled atrial fibrillation with a ventricular rate of 146 contractions per minute
• Arterial oxygen saturation: 88%
• Mean arterial blood pressure: 70 mmHg
• Respiratory system: rate 32 breaths per minute, labored, crackles auscultated in bilateral, posterior lung fields

1. What is the pathophysiologic basis of chest pain and syncope in this patient?
2. Where is the best anatomic site to auscultate for the murmur of aortic valve stenosis, and where in the cardiac cycle would you expect to hear it?
3. Given these symptoms, it appears that the patient has significant valvular dysfunction. What interventions should the nurse perform?
4. The patient is scheduled to undergo an aortic valve replacement with a mechanical valve. Will this patient require anticoagulation therapy postprocedure?
5. Discuss what information the nurse should include in discharge teaching for this patient.