A nurse is teaching several newly licensed nurses about cardiac valve replacement. Which of the following should the nurse include in the teaching?

The aortic and mitral valves are the most commonly replaced valves.

Mitral valve insufficiency occurs during the diastolic phase of the cardiac cycle.

Inadequate closure of the tricuspid valve causes overload in the left ventricle.

Aortic stenosis increases right ventricular systolic pressure and decreases afterload.

Answer and Explanation

The Correct Answer is A

A. The aortic and mitral valves are the most commonly replaced valves: This statement is accurate. The aortic and mitral valves are indeed the most commonly replaced valves in cardiac valve replacement surgeries. Aortic valve replacement is commonly performed for conditions such as aortic stenosis or regurgitation, while mitral valve replacement is often indicated for mitral regurgitation or stenosis.

B. Mitral valve insufficiency occurs during the diastolic phase of the cardiac cycle: This statement is incorrect. Mitral valve insufficiency, also known as mitral regurgitation, occurs during the systolic phase of the cardiac cycle. It involves the backflow of blood from the left ventricle into the left atrium during ventricular systole, leading to volume overload of the left atrium and potentially causing symptoms such as dyspnea and fatigue.

C. Inadequate closure of the tricuspid valve causes overload in the left ventricle: This statement is incorrect. Inadequate closure of the tricuspid valve leads to regurgitation of blood from the right ventricle back into the right atrium during ventricular systole. This condition, known as tricuspid regurgitation, causes volume overload in the right atrium and ventricle, rather than overload in the left ventricle.

D. Aortic stenosis increases right ventricular systolic pressure and decreases afterload: This statement is partially correct. Aortic stenosis indeed increases left ventricular systolic pressure and decreases afterload, not right ventricular pressure. The increased afterload on the left ventricle can lead to left ventricular hypertrophy and eventually heart failure. However, aortic stenosis does not directly affect right ventricular systolic pressure.

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Correct Answer is C

Explanation

Pantoprazole: Pantoprazole is a proton pump inhibitor commonly used to reduce stomach acid production. It is primarily indicated for the treatment of gastroesophageal reflux disease (GERD), peptic ulcers, and other conditions related to excessive stomach acid production. It does not play a role in managing Meniere's disease, which is a disorder of the inner ear characterized by episodes of vertigo, tinnitus, and hearing loss.

B) Warfarin: Warfarin is an anticoagulant medication used to prevent blood clot formation. It is commonly prescribed for conditions such as atrial fibrillation, deep vein thrombosis, and pulmonary embolism. Meniere's disease does not typically require anticoagulant therapy, so warfarin would not be indicated for its treatment.

C) Furosemide: Furosemide is a loop diuretic that helps reduce fluid retention by increasing urine output. In some cases of Meniere's disease, especially those associated with excessive endolymphatic fluid buildup in the inner ear, furosemide may be prescribed to help reduce fluid volume and alleviate symptoms such as vertigo and pressure sensation in the ear.

D) Oxybutynin: Oxybutynin is an anticholinergic medication primarily used to treat overactive bladder and urinary incontinence. It works by relaxing smooth muscle in the bladder, reducing bladder spasms and urinary urgency. While some individuals with Meniere's disease may experience associated symptoms such as frequent urination or urinary urgency, oxybutynin is not a standard treatment for Meniere's disease itself.

A. An abdominal aortic aneurysm is commonly found in the suprarenal aorta. B. An abdominal aortic aneurysm occurs as a result of a thickened wall of the abdominal artery. C. An abdominal aortic aneurysm is a dilation of the abdominal aorta greater than 30 mm in diameter. D. Abdominal aortic aneurysms might rupture if blood pressure is too low.

Correct Answer is C

Explanation

A. An abdominal aortic aneurysm is commonly found in the suprarenal aorta: This statement is incorrect. Abdominal aortic aneurysms (AAAs) are most commonly found infrarenally, below the level of the renal arteries, rather than in the suprarenal region.

B. An abdominal aortic aneurysm occurs as a result of a thickened wall of the abdominal artery: This statement is incorrect. An abdominal aortic aneurysm typically occurs due to weakening of the arterial wall, rather than thickening. The weakened wall allows the arterial wall to bulge or balloon out, forming an aneurysm.

C. An abdominal aortic aneurysm is a dilation of the abdominal aorta greater than 30 mm in diameter: This statement is correct. An abdominal aortic aneurysm is defined as a localized dilation of the abdominal aorta that exceeds 50% of the normal vessel diameter, typically greater than 30 mm in diameter. This dilation occurs due to weakening of the arterial wall, which can result from various factors such as atherosclerosis, hypertension, and genetic predisposition.

D. Abdominal aortic aneurysms might rupture if blood pressure is too low: This statement is incorrect. Abdominal aortic aneurysms are more likely to rupture when blood pressure is too high, rather than too low. Hypertension increases the pressure within the weakened arterial wall, potentially leading to rupture. Therefore, controlling blood pressure is crucial in managing abdominal aortic aneurysms to reduce the risk of rupture.

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