A client has received a tissue valve replacement for treatment of valve disease. Which complication occurs more often with this type of prosthetic valve?

Hemolytic anemia

Endocarditis

Hypertension

Elevated PT/INR

Answer and Explanation

The Correct Answer is B

a. Hemolytic anemia: Hemolytic anemia is more commonly associated with mechanical heart valves rather than tissue valves. Mechanical valves can cause damage to red blood cells as they move through the valve, leading to hemolysis and subsequent anemia. Tissue valves typically do not cause significant hemolysis.

b. Endocarditis: Endocarditis is a known complication associated with prosthetic heart valves, including tissue valves. While tissue valves generally have a lower risk of thrombosis compared to mechanical valves, they are still susceptible to bacterial colonization and subsequent endocarditis. Patients with prosthetic heart valves, regardless of type, are recommended to take antibiotic prophylaxis before certain dental or surgical procedures to reduce the risk of infective endocarditis

c. Hypertension: Hypertension is not specifically associated with tissue valve replacements. While hypertension is a common cardiovascular condition, it is not directly related to the type of prosthetic valve implanted.

d. Elevated PT/INR: Elevated prothrombin time (PT) and international normalized ratio (INR) are more commonly associated with mechanical heart valves rather than tissue valves. Mechanical valves require lifelong anticoagulation therapy with medications such as warfarin to prevent thrombosis. Tissue valves generally do not require long-term anticoagulation therapy, although they may still require short-term anticoagulation immediately after implantation.

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Correct Answer is D

Explanation

a. Dopamine: Dopamine is a medication that primarily acts as a vasopressor and inotropic agent. While it can increase cardiac contractility and improve cardiac output, it does not directly decrease afterload. In fact, dopamine may increase systemic vascular resistance (afterload) at higher doses.

b. Warfarin: Warfarin is an anticoagulant medication used to prevent blood clot formation, particularly in individuals with certain cardiac conditions such as atrial fibrillation or mechanical heart valves. While warfarin is important for preventing thromboembolic events in individuals with mitral valve regurgitation, it does not directly affect afterload.

c. Digoxin: Digoxin is a medication that primarily acts as a positive inotropic agent by increasing myocardial contractility. While it can improve cardiac function, particularly in individuals with heart failure, it does not directly decrease afterload.

d. Lisinopril: Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor medication that reduces blood pressure by inhibiting the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. By reducing angiotensin II levels, lisinopril dilates blood vessels and decreases systemic vascular resistance (afterload), thus reducing the workload on the heart. Therefore, lisinopril is the medication that would help decrease afterload for a client with mitral valve regurgitation.

A. Monitor blood glucose B. Neurovascular check of lower extremities C. Check coagulation studies D. Continuous ECG monitoring

Correct Answer is ["B","C","D"]

Explanation

a. Monitor blood glucose: Monitoring blood glucose levels may not be directly related to the procedure itself unless the client has a pre-existing condition such as diabetes mellitus. However, it is important to monitor for any changes in blood glucose levels post-procedure, especially if the client received medications such as intravenous dextrose during the procedure.

b. Neurovascular check of lower extremities: Assessing neurovascular status of the lower extremities is crucial after percutaneous coronary revascularization via the left groin site. This procedure involves accessing the femoral artery, which carries the risk of compromising blood flow to the lower extremity. Assessing for pulses, capillary refill, sensation, and motor function helps identify any potential complications such as bleeding, hematoma, or vascular compromise.

c. Check coagulation studies: Checking coagulation studies, such as activated partial thromboplastin time (aPTT) or prothrombin time (PT/INR), may be necessary after percutaneous coronary revascularization, especially if anticoagulant medications such as heparin were used during the procedure. Monitoring coagulation studies helps assess the client's risk of bleeding or thrombosis post-procedure.

d. Continuous ECG monitoring: Continuous electrocardiogram (ECG) monitoring is essential after percutaneous coronary revascularization to monitor for any changes in cardiac rhythm, ST-segment elevation or depression, and ischemic events. This helps identify any potential complications such as arrhythmias, myocardial infarction, or ischemia.

e. Verify contrast dye allergies: Verifying contrast dye allergies is important before performing any procedure involving the use of contrast media, such as percutaneous coronary revascularization. Allergic reactions to contrast dye can range from mild itching or rash to severe anaphylaxis. Identifying any allergies beforehand allows the healthcare team to take appropriate precautions and choose alternative imaging techniques if necessary.

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A client has received a tissue valve replacement for treatment of valve disease. Which complication occurs more often with this type of prosthetic valve?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is admitting a client diagnosed with mitral valve regurgitation. Which medication would help decrease afterload for this client?

Correct Answer is D

Explanation

The nurse is caring for a client after percutaneous coronary revascularization (PCR) via left groin site. Which assessments would the nurse obtain after the procedure? Select all that apply.

Correct Answer is ["B","C","D"]

Explanation

A client recently had aortic valve regurgitation treated with placement of a mechanical valve. Which laboratory test would be ordered for management of this type of prosthetic valve?

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A client has received a tissue valve replacement for treatment of valve disease. Which complication occurs more often with this type of prosthetic valve?

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The nurse is preparing discharge teaching for a client following placement of a mechanical aortic valve. Which information regarding warfarin(coumadin) therapy would the nurse include? Select all that apply.

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