A 67-year-old patient will be undergoing a mitral valve replacement for severe mitral valve stenosis. When reviewing the patient's chart, which of these infectious diseases would likely to be present in this patient's history?

Meningitis

Haemophilus influenzae

Rheumatic fever

Varicella

Answer and Explanation

The Correct Answer is C

A.   Meningitis is an infection of the protective membranes covering the brain and spinal cord (meninges). It is not directly related to mitral valve stenosis or other valvular heart diseases.
B.   Haemophilus influenzae is a bacterium that can cause respiratory tract infections and other diseases such as meningitis, particularly in children. However, it is not a common cause of rheumatic fever or valvular heart disease.
C.   Rheumatic fever is a serious complication of untreated or inadequately treated Group A Streptococcal pharyngitis (strep throat). It can cause inflammation in various parts of the body, including the heart. Rheumatic fever is a known cause of rheumatic heart disease, which can lead to mitral valve stenosis or regurgitation.
D.   Varicella, commonly known as chickenpox, is a viral infection caused by the varicella-zoster virus. While it is important to manage and prevent viral infections, varicella is not associated with the development of mitral valve stenosis or other valvular heart diseases.

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Correct Answer is B

Explanation

A. Hepatomegaly, or enlargement of the liver, is more commonly associated with right-sided heart failure. When the right side of the heart fails, it can lead to systemic venous congestion, which causes blood to back up in the liver and results in hepatomegaly.
B. Crackles (or rales) heard on lung auscultation are a hallmark of left-sided heart failure. This is due to the accumulation of fluid in the alveoli and interstitial spaces of the lungs, which occurs when the left side of the heart is unable to effectively pump blood forward.
C. Peripheral edema, or swelling of the extremities, is typically associated with right-sided heart failure rather than left-sided heart failure.
D. Distended neck veins are a sign of right-sided heart failure, not left-sided heart failure. This occurs when there is elevated pressure in the systemic venous system due to the right side of the heart being unable to effectively pump blood into the pulmonary circulation.

A. Administer digoxin B. Continue to monitor the client. C. Defibrillate the client. D. Prepare for transcutaneous pacing

Correct Answer is D

Explanation

A. Digoxin is a medication used primarily to treat heart failure and certain types of arrhythmias, such as atrial fibrillation. It works by increasing the force of heart contractions and slowing the heart rate. However, digoxin is not typically used to treat bradycardia and may actually exacerbate the condition by further slowing the heart rate.
B. While monitoring is an essential part of patient care, it is not sufficient alone in this situation. The client’s heart rate is very low (45 beats per minute) and their blood pressure is low (82/60 mm Hg), which suggests they are symptomatic and potentially unstable.
C. Defibrillation is used to treat life-threatening arrhythmias such as ventricular fibrillation or pulseless ventricular tachycardia. It is not used for sinus bradycardia, which is a slow heart rate rather than a rapid, disorganized rhythm requiring electrical shock.

D. Transcutaneous pacing involves applying external pacing pads to the skin to stimulate the heart and increase the heart rate. This is a suitable intervention for symptomatic bradycardia, especially when accompanied by low blood pressure and dizziness.

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A 67-year-old patient will be undergoing a mitral valve replacement for severe mitral valve stenosis. When reviewing the patient's chart, which of these infectious diseases would likely to be present in this patient's history?

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Naxlex Comprehensive Predictor Exams

The nurse recognizes the patient has clinical manifestations of left sided heart failure when noticing the following during the assessment

Correct Answer is B

Explanation

A client in sinus bradycardia, with a heart rate of 45 beats per minute and blood pressure of 82/60 mm Hg, reports dizziness. Which intervention should the nurse anticipate will be prescribed?

Correct Answer is D

Explanation

A 67-year-old patient will be undergoing a mitral valve replacement for severe mitral valve stenosis. When reviewing the patient's chart, which of these infectious diseases would likely to be present in this patient's history?

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