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?
Brain natriuretic peptide (BNP)
Cardiac enzymes
Blood urea nitrogen and creatinine
PT/INR
The Correct Answer is D
Brain natriuretic peptide (BNP): BNP is a hormone released by the heart in response to increased ventricular pressure and volume overload. It is typically elevated in conditions such as heart failure. While monitoring BNP levels may provide information about cardiac function and volume status, it is not specifically ordered for managing a mechanical valve.
b. Cardiac enzymes: Cardiac enzymes, such as troponin and creatine kinase (CK), are markers of myocardial damage and are typically elevated in conditions such as myocardial infarction. They are not specifically ordered for managing a mechanical valve unless there are signs or symptoms suggestive of myocardial ischemia or infarction.
c. Blood urea nitrogen and creatinine:- Monitoring blood urea nitrogen (BUN) and creatinine levels is important for assessing renal function, especially in individuals at risk of renal impairment due to factors such as medications or underlying conditions. While renal function is important in overall cardiac management, these tests are not specifically ordered for managing a mechanical valve unless there are concerns about renal function due to medications such as anticoagulants.
d. PT/INR (Prothrombin Time/International Normalized Ratio): PT/INR monitoring is crucial for managing patients with mechanical heart valves, as these valves are thrombogenic and increase the risk of thromboembolic events such as stroke or valve thrombosis. Warfarin, an oral anticoagulant, is commonly prescribed to maintain therapeutic anticoagulation. PT/INR monitoring helps ensure that the patient is within the target therapeutic range to prevent both thrombotic and bleeding complications associated with the mechanical valve.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
a. Kussmaul respirations: Metabolic acidosis leads to an accumulation of acids in the body, resulting in compensatory hyperventilation to try to decrease the levels of carbon dioxide and increase pH. Kussmaul respirations are deep, rapid, and labored breathing patterns characteristic of this compensation mechanism.
b. Muscle spasms: While muscle spasms can occur in various conditions, they are not specific to metabolic acidosis. Other factors, such as electrolyte imbalances or dehydration, may cause muscle spasms.
c. Paresthesia in fingers: Paresthesia (tingling or numbness) in the fingers can occur due to metabolic acidosis. Acidosis affects nerve function, leading to abnormal sensations in the extremities. It is not specific to metabolic acidosis.
d. Tinnitus: Tinnitus is not typically associated with metabolic acidosis. It is more commonly associated with conditions such as ototoxicity, Meniere's disease, or vascular disorders affecting the inner ear.
Correct Answer is D
Explanation
a. “The left side of your heart is having trouble overcoming the resistance in the blood vessels of your body.”
- This explanation is not specific to mitral stenosis. It describes systemic vascular resistance, which is a broader concept related to hypertension and vascular health. Mitral stenosis specifically involves narrowing of the mitral valve, which affects blood flow between the left atrium and left ventricle.
b. “When your heart beats, some of the blood that should leave the left ventricle is backing up through a leaking valve.”
- This explanation is more accurate for mitral regurgitation rather than mitral stenosis. Mitral regurgitation involves the leaking of blood backward through the mitral valve into the left atrium during ventricular systole. Mitral stenosis, on the other hand, involves narrowing or constriction of the mitral valve, which impedes the flow of blood from the left atrium to the left ventricle during diastole.
c. “The valve between your heart and lungs has become inelastic.”
- This explanation is not entirely accurate. While mitral stenosis does involve changes in the mitral valve structure, such as thickening and calcification, the term "inelastic" does not fully describe the pathology of mitral stenosis. Mitral stenosis is characterized by the narrowing (stenosis) of the mitral valve orifice, which restricts blood flow from the left atrium to the left ventricle.
d. “The mitral valve has become stiff and narrowed which slows the blood between the two chambers.”
- This explanation is the most accurate description of mitral stenosis. It correctly identifies the problem as the narrowing and stiffening (stenosis) of the mitral valve, which impedes the flow of blood from the left atrium to the left ventricle during diastole. This explanation helps the client understand how the condition affects the function of the mitral valve and the flow of blood within the heart.
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