The nurse is assessing a client with a diagnosis of mitral stenosis. Which piece of assessment data indicates that the disease is worsening?

Jugular vein distention and +3 peripheral edema

Increase in systolic blood pressure 10 mmHg above cents norm

Complaints of epigastric pain after eating a large meal

Complaints of dyspnea while completing ADLs

Answer and Explanation

The Correct Answer is A

A. Jugular vein distention and +3 peripheral edema are signs of right-sided heart failure, which can result from worsening mitral stenosis. As the mitral valve becomes more narrowed, it leads to increased pressure in the left atrium and eventually backs up into the lungs and right side of the heart, causing fluid retention.
B. An increase in systolic blood pressure by 10 mmHg does not directly indicate worsening mitral stenosis. Blood pressure changes can occur for various reasons but are not as specific as signs of heart failure in this context.
C. Complaints of epigastric pain after eating a large meal are typically related to gastrointestinal issues rather than directly indicating worsening mitral stenosis.
D. Complaints of dyspnea while completing activities of daily living (ADLs) can be a sign of worsening mitral stenosis, but the additional signs of jugular vein distention and edema are more definitive indicators of worsening disease.

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Correct Answer is B

Explanation

A. Waxed dental floss is generally safe for most patients, including those receiving chemotherapy. It is important to be gentle when flossing to avoid injuring sensitive gums, which may be more prone to bleeding during chemotherapy due to reduced platelet count.

B. Alcohol-based mouthwashes should be avoided during chemotherapy because they can cause dryness and irritation to the mucous membranes in the mouth, which are already sensitive due to the side effects of chemotherapy. Alcohol can exacerbate mucositis (inflammation of the mucous lining) and increase discomfort.

C. Soaking dentures in hydrogen peroxide is generally safe for denture care, as hydrogen peroxide can be used to disinfect dentures. However, it is important to ensure that dentures are thoroughly rinsed after soaking to avoid irritation to the mouth.

D. Using a soft-bristled toothbrush is safe and recommended. A soft-bristled toothbrush is ideal for patients receiving chemotherapy, as their gums and mouth may become more sensitive. Brushing gently can help maintain oral hygiene without causing injury.

Correct Answer is ["1.5"]

Explanation

Step 1: Identify what is given
Prescribed dose: 6 mg
Available concentration: 4 mg/mL

Step 2: Use the formula
Volume (mL) = Prescribed Dose (mg) ÷ Concentration (mg/mL)
Volume = 6 ÷ 4 = 1.5 mL

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The nurse is assessing a client with a diagnosis of mitral stenosis. Which piece of assessment data indicates that the disease is worsening?

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