Question

He Valsalva maneuver (straining during defecation) involves holding the breath while bearing down on the perineum to pass a stool. Straining to have a bowel movement is to be avoided in clients recently diagnosed with increased intracranial pressure, stroke, or head injury as straining increases intra-abdominal and intrathoracic pressure, which raises the intracranial pressure (Option 1).

The vagus nerve is stimulated when bearing down; this temporarily slows the heart and decreases cardiac output, leading to potential cardiac complications in clients with heart disease (Option 3).

Straining increases intra-abdominal and intrathoracic pressure and should be avoided in clients diagnosed with portal hypertension related to cirrhosis due to the risk of variceal bleeding (Option 5).

The maneuver increases intraocular pressure and is contraindicated in clients with glaucoma and recent eye surgery (Option 6).

(Option 2) The otherwise healthy client recovering from reconstructive augmentation mammoplasty is not at risk for complications related to the Valsalva maneuver.

(Option 4) The client recently diagnosed with pancreatic cancer is not at risk for complications related to the Valsalva maneuver.

Educational objective:
The Valsalva maneuver is contraindicated in the client diagnosed with increased intracranial pressure, stroke, head injury, heart disease, glaucoma, eye surgery, abdominal surgery, and liver cirrhosis.

Answer 1

The Valsalva maneuver increases pressures within the body, which can pose risks for individuals with certain medical conditions. It should be avoided in cases of heart disease, intracranial pressure increases, cirrhosis, glaucoma, and after certain surgeries.

Step-by-step explanation:

The Valsalva maneuver is a voluntary procedure in which a person increases intra-abdominal pressure by contracting their diaphragm and abdominal wall muscles, while closing the glottis.

This maneuver facilitates defecation but can also result in increased intracranial, intraocular, intrathoracic, and intra-abdominal pressures.

It is contraindicated in certain medical conditions like increased intracranial pressure, stroke, head injury, heart disease, portal hypertension related to cirrhosis, glaucoma, recent eye surgery, and certain abdominal surgeries due to potential complications such as variceal bleeding, increased intracranial pressure, or impacts on cardiac output.

During the Valsalva maneuver, other physiological processes occur, such as the stimulation of the vagus nerve, which can temporarily slow the heart and decrease cardiac output.

This makes the Valsalva maneuver a concern for patients with cardiac conditions.

Additionally, increased pressure during this maneuver can affect cerebral blood flow and venous return, which are critical considerations for patients with certain neurological conditions.

Answer 2

The Valsalva maneuver is a voluntary procedure used to increase intra-abdominal pressure by contracting the diaphragm and abdominal wall muscles, and closing the glottis. It should be avoided in certain conditions such as increased intracranial pressure, stroke, head injury, heart disease, glaucoma, and recent eye surgery.

Step-by-step explanation:

The Valsalva maneuver is a voluntary procedure used to increase intra-abdominal pressure by contracting the diaphragm and abdominal wall muscles, and closing the glottis. It is commonly used to facilitate defecation. However, the maneuver should be avoided in certain conditions such as increased intracranial pressure, stroke, head injury, heart disease, glaucoma, and recent eye surgery. It can increase intraocular pressure, raise intracranial pressure, and potentially cause cardiac complications in clients with these conditions.