ERA COLLEGE OF NURSING

LESSON PLAN
ON

“RIGHT VENTRICULAR HYPERTROPHY”

SUBMITTED TO- SUBMITTED BY-

MS. GODHULI GOSH DEEPANSHI MASIH

ASSISTANT PROFESSOR M.Sc. NURSING 2ND YR

ERA COLLEGE OF NURSING ERA COLLEGE OF NURSING

LUCKNOW LUCKNOW
TOPIC- RIGHT VENTRICUALR HYPERTROPHY
UNIT- 10
STUDENT TEACHER- Ms.Deepanshi Masih
EVALUATOR- Ms. Godhuli Gosh (Assistant professor)
GROUP INVOLVEMENT- 2ND Year M.Sc. Nursing
DATE-
TIME- 45 minutes
A.V.AIDS USED- power point, white board
PREVIOUS KNOWLEDGE- Students have little bit previous knowledge regarding right ventricular hypertrophy.
GENERAL OBJECTIVES-: At the end of the teaching the students will be able to gain in depth knowledge regarding right ventricular
hypertrophy and develop favourable attitude towards clients with right ventricular hypertrophy.

SPECIFIC OBJECTIVES-: At the end of the class, students will be able to-
1. Define right ventricular hypertrophy
2. Understand epidemiology of right ventricular hypertrophy
3. Overview the etiological factors of right ventricular hypertrophy
4. Explain the pathophysiology of right ventricular hypertrophy
5. Discuss clinical manifestation of right ventricular hypertrophy
6. Explain the diagnostic evaluation of right ventricular hypertrophy
7. Describe medical management of right ventricular hypertrophy
8. Understand pharmacological management of right ventricular hypertrophy
9. Discuss nursing management of right ventricular hypertrophy
10. Enlist nursing diagnosis and theory application for right ventricular hypertrophy
11. Overview nursing implementation for right ventricular hypertrophy
12. Enlist nursing evaluation for right ventricular hypertrophy
13. Point out the related research input related to right ventricular hypertrophy
14. Summary of the topic
15. Conclude the topic
SR. TIME SPECIFIC CONTENT TEACHING LEARNING AV. EVALUATION
NO OBJECTIVES ACTIVITY ACTIVITY AIDS
1 1 min Define right Right ventricular hypertrophy is a pathologic Lecture cum students will Power What is meant
ventricular increase in muscle mass of the right ventricle discussion listen point by RVH?
hypertrophy in response to pressure overload. attentively
2 1 min Understand Epidemiology of right ventricular Lecture cum students will Power What is
epidemiology of hypertrophy depends on the underlying cause, discussion listen point epidemiology of
right ventricular with an estimated prevalence ranging from 10 attentively right ventricular
hypertrophy to 52 cases per million adults worldwide. hypertrophy?
3 2 min Overview the There are many different causes within these Lecture cum students will Power What are the
etiological factors categories including- discussion listen point etiological
of right  COPD attentively factors of right
ventricular  Pulmonary emboli ventricular
hypertrophy  Chronic lung disease, such as sarcoidosis hypertrophy?
and pulmonary fibrosis.
 Cardiac fibrosis
 Sickle cell anaemia
 Chronic anaemia, such as iron deficiency,
folate or B12 deficiency or thalassemia
 Sleep apnea
Problems with the structure or function of the
heart that can cause right ventricular
hypertrophy include-
 Arterial septal defect
 Pulmonary valve stenosis
 Tricuspid valve regurgitation
 Tetralogy of Fallot
 Ventricular septal defect
4 2 min Explain the  The deoxygenated blood flow from the right Lecture cum students will Power What is
pathophysiology atrium into the right ventricle discussion listen point pathophysiology
of right  Due to narrowing of the pulmonary artery attentively of right
 ventricular  Pressure increases in the infundibulum of ventricular
hypertrophy the right ventricle hypertrophy?
 The blood flow is reduced to the pulmonary
outflow tract
 Resulting in right ventricle to work harder
 Leading to right ventricle hypertrophy
 The pressure increases in right side of the
heart
 Deoxygenated blood crosses over into the
left atrium
 Mixing of the blood occurs causing
cyanosis and arrhythmia
5 2 min Discuss clinical These include- Lecture cum students will Power What is clinical
manifestation of  Difficulty in breathing on exertion discussion listen point manifestation of
right ventricular  Chest pain on exertion attentively right ventricular
hypertrophy  Fainting episodes hypertrophy?
 General fatigue/lethargy
 Dizziness
 Feeling of fullness in the upper abdominal
area
 Discomfort or pain in the right upper
abdomen
 Reduced appetite
 Swelling of the legs, ankles or feet
 Racing heart beat (palpitations)
6 2 min Explain the 1. Proper history taking and physical Lecture cum students will Power What are the
diagnostic examination discussion listen point diagnostic
evaluation of right 2. Proper medical history should be taken from attentively evaluation of
ventricular the parents whose child shows signs of the right ventricular
hypertrophy condition hypertrophy?
3. Chest x-ray
 4. Electrocardiogram
5. Echocardiogram
6. Cardiac magnetic resonance
7 4min Describe medical Specific treatment for right ventricular Lecture cum students will Power What is medical
management of hypertrophy will be determined by the discussion listen point management of
right ventricular physician based on: attentively right ventricular
hypertrophy  The child’s age, overall health and medical hypertrophy?
history.
 Extent of the condition
 The child’s tolerance for specific
medications, therapies.
 Expectations for the courses of the
condition.
 The family’s opinion or preference.
8 5 min Understand Ace inhibitors Lecture cum students will Power What is
pharmacological Angiotensin ii receptor blockers discussion listen point pharmacological
management of Beta blockers attentively management of
right ventricular Digoxin right ventricular
hypertrophy Diuretics hypertrophy?
9 2 min Discuss nursing  Obtain through nursing history of the Lecture cum students will Power What is nursing
management of child. discussion listen point management of
right ventricular attentively right ventricular
 Perform through physical examination
hypertrophy hypertrophy?
of the child with review of all systems.
 Examine cardiovascular systems
thoroughly by palpation, auscultation
and inspection.
 Observe and record child’s level of
exercise tolerance.
10 2 min Enlist nursing Impaired gas exchange related to altered Lecture cum students will Power What is nursing
diagnosis and pulmonary blood flow or oxygen deprivation. discussion listen point diagnosis and
theory application Imbalance nutrition: less than body attentively theory
 for right requirements related to the excessive energy application for
ventricular demands required by increased cardiac right ventricular
hypertrophy workload. hypertrophy?
Risk for imbalanced fluid volume related to
fluid retention secondary to improper
functioning of the kidneys
Activities intolerance related to imbalance
between oxygen supply and demand
secondary to generalized weakness
Decreased cardiac output related to specific
anatomic defect
Developmental delay related to decreased
energy, inadequate nutrition, physical
limitations and social isolated.
11 2 min Overview nursing  Improve cardiac outcome by Lecture cum students will Power What are
implementation monitoring peripheral perfusion by discussion listen point nursing
for right checking peripheral pulses, noting attentively implementation
ventricular temperature, colour changes and for right
hypertrophy capillary refill time. ventricular
hypertrophy?
 Improve respiration by determining
degree of respiratory distress. Position
child at 45 degree angle to decrease
pressure of the viscera on the
diaphragm and increase lung volume
and provide oxygen therapy as
needed.
 Improve activity tolerance: reduce the
workload of the heart since decreased
activity and expenditure of energy will
decrease oxygen requirements.
 Provide adequate nutritional and fluid
 intake to maintain the growth and
developmental needs of the child.
 Prevent infection by preventing
exposure to communicable diseases
and provide optimum nutrition.
12 2 min Enlist nursing  The child demonstrates adequate Lecture cum students will Power What is nursing
evaluation for cardiac output as evidenced by no discussion listen point evaluation for
right ventricular cyanosis, warm extremities and attentively right ventricular
hypertrophy capillary refill time less than 2 sec. hypertrophy?

 The child exhibits normal breathing

pattern.
 The child demonstrates appropriate
weight gain and normal growth.
 The child remains free from infection.
 The child engages in activities within
normal limits without any
complications.
13 4 min Point out the A study conducted by Cesare Cuspidi.et.al. Lecture cum students will Power
related research (2020) which aimed an experimental and discussion listen point
input related to clinical evidence supports the view that right attentively
right ventricular ventricular hypertrophy may parallel left
hypertrophy ventricular hypertrophy in systemic
hypertension. The literature articles in the last
three decades reporting studies in adult
hypertensive individuals were considered.
Total of 13 studies, including 1290 untreated
and treated hypertensive patients and 259
normotensive controls, were considered.
Overall in hypertensive patients right
ventricular wall was thicker than in
 normotensive counterparts right ventricular
hypertrophy prevalence consistently varied
among studies with an average of 28.6% in
the pooled population. The research
concluded that clinical studies indicate that
RVH is common cardiac phenotype in
systemic hypertension.
14 2 min Summary of the Right ventricular hypertrophy is a condition Lecture cum students will Power
topic defined by an abnormal enlargement of the discussion listen point
cardiac muscle surrounding the right attentively
ventricle. The right ventricle is one of the four
chambers of the heart. It is located towards
the lower end if the heart and it receives blood
from the right atrium and pumps blood into
the lungs. Since RVH is an enlargement of
muscle. It arises when the muscle is required
to work harder.
15 2 min Conclude the Right ventricular hypertrophy is the Lecture cum students will Power
topic enlargement of heart’s right ventricle. Right discussion listen point
ventricular hypertrophy is considered to be attentively
one of the rare disorders of the heart. Right
ventricular hypertrophy doesn’t always cause
symptoms, which means it often isn’t
discovered until it later stages. If left
untreated, it can lead to some serious
complications, including heart failure. Once
diagnosed, right ventricular hypertrophy
usually responds well to medication, lifestyle
changes, surgery, or a combination of all
three.
BIBLIOGRAPHY

1. Joyce M. Black, Jane H. Howks, A textbook of Medical Surgical Nursing Clinical Management fir the Positive Outcome, Philadelphia:
Sounders Elsevier 2009, Page no.- 2115-24
2. Chintamani Lewis et.al, A Textbook of Medical Surgical Nursing Assessment and Management of Clinical Problems, New Delhi,
Elsevier, 2011, page no.- 722-728
3. Linton, Introduction to Medical Surgical Nursing, 5th edition, Elsevier Publications, Page no.- 654-655
4. Katherine Marengo, diet and health basics in RVH, updated on 2020 January; [available online]: https://www.healthline.com
5. PT. Bhattacharya (2021); right ventricular hypertrophy; [available online]: https://www.ncbi.nlm.nih.gov
6. Right ventricular hypertrophy an overview; Science Direct; [available online]: https://www.sciencedirect.com