A client age 62 has a mitral valve replacement with a mechanical valve. Which information does the nurse include in the client's postoperative teaching plan?

The need for anticoagulation therapy for the duration of the valve.

The probability that the valve will need to be replaced in seven years.

The need to avoid high-voltage electrical fields.

The need to check the pulse daily to determine the functioning of the valve.

Answer and Explanation

The Correct Answer is A

A. The need for anticoagulation therapy for the duration of the valve: Mechanical valves promote turbulent blood flow, greatly increasing thrombus formation risk. Lifelong anticoagulation is required to prevent stroke or valve thrombosis, making this a critical component of postoperative education.

B. The probability that the valve will need to be replaced in seven years: Mechanical valves are highly durable and typically last a lifetime. They do not require routine replacement unless complications occur, so presenting a seven-year expectancy is inaccurate.

C. The need to avoid high-voltage electrical fields: Daily life rarely exposes clients to electrical fields that would interfere with a mechanical valve, which is a passive device. Restrictions of this type apply more to pacemakers, not prosthetic valves.

D. The need to check the pulse daily to determine the functioning of the valve: Pulse checks do not assess mechanical valve function, which is monitored through clinical assessments and periodic echocardiography. Although pulse monitoring is generally beneficial, it does not specifically evaluate valve performance.

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Correct Answer is B

Explanation

A. Sinus bradycardia, B/P 108/60: Sinus bradycardia with stable blood pressure and no signs of poor perfusion is usually not an emergency. While it may require monitoring and possible medication adjustments, immediate pacing is not indicated unless the client becomes symptomatic with hypotension, syncope, or chest pain.

B. Complete heart block at a rate of 30 beats per minute B/P 60/40: Complete heart block with severe bradycardia and hypotension represents a life-threatening condition. The heart is unable to maintain adequate cardiac output, leading to shock and potential cardiac arrest. Emergency pacing is indicated to restore effective heart rate and perfusion, making this the highest priority.

C. Ventricular tachycardia, B/P 50/30: Ventricular tachycardia with hypotension is a medical emergency that may require immediate defibrillation or antiarrhythmic therapy, but it is not treated primarily with a pacemaker. Pacemakers are ineffective in terminating ventricular tachyarrhythmias, so other interventions take precedence.

D. Paroxysmal atrial tachycardia B/P 70/40: While this rhythm can cause hypotension, it is usually less immediately life-threatening than complete heart block with severe bradycardia. Treatment focuses on rate control, antiarrhythmic medications, or vagal maneuvers rather than emergency pacing unless bradycardia develops after treatment.

A. "The sudden, severe headache increases muscle tone and can cause further nerve damage." B. 'The suddenness of the onset of the syndrome tells us the body is struggling to maintain its normal state." C. The sudden increase in BP can raise the ICP or rupture a cerebral blood vessel." D. "Autonomic dysreflexia causes permanent damage to delicate nerve fibers that are healing."

Correct Answer is C

Explanation

A. "The sudden, severe headache increases muscle tone and can cause further nerve damage.": While headache is a common symptom of autonomic dysreflexia, it does not directly increase muscle tone or cause additional spinal cord damage. The headache is a result of elevated blood pressure rather than a cause of further nerve injury.

B. "The suddenness of the onset of the syndrome tells us the body is struggling to maintain its normal state.": The rapid onset signals a physiological emergency, but this explanation is vague and does not address the immediate life-threatening risk associated with uncontrolled hypertension during autonomic dysreflexia.

C. "The sudden increase in BP can raise the ICP or rupture a cerebral blood vessel.": Autonomic dysreflexia triggers a sudden, severe rise in blood pressure, which can lead to dangerous complications such as stroke, seizures, or increased intracranial pressure. Prompt recognition and intervention are critical to prevent these life-threatening outcomes.

D. "Autonomic dysreflexia causes permanent damage to delicate nerve fibers that are healing.": The condition primarily affects cardiovascular regulation rather than causing direct injury to spinal nerve fibers. While complications can be severe, permanent nerve damage is not the immediate risk that makes it an emergency.

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A client age 62 has a mitral valve replacement with a mechanical valve. Which information does the nurse include in the client's postoperative teaching plan?

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Naxlex Comprehensive Predictor Exams

An emergency indication for a pacemaker is

Correct Answer is B

Explanation

The nurse is providing health education to a client who has a C6 spinal cord injury. The client asks why autonomic dysreflexia is considered an emergency. What would be the nurse's best answer?

Correct Answer is C

Explanation

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