The nurse is caring for a client who is having a mitral valve replacement with a mechanical valve. What instructions should the nurse be sure the client understands prior to being discharged?

The valve is prone to calcification.

The client will require anticoagulation.

The valve should last for 10 to 15 years.

There is a low potential for thrombi formations so anticoagulation is not necessary.

Answer and Explanation

The Correct Answer is B

A. The valve is prone to calcification: Mechanical valves resist calcification due to their synthetic composition. Calcification is more common in bio-prosthetic valves which degrade over time under pressure.
B. The client will require anticoagulation: Mechanical valves create turbulent blood flow and have a high risk of clot formation. Long-term anticoagulation therapy, typically with warfarin, is necessary to prevent thromboembolic complications such as stroke.
C. The valve should last for 10 to 15 years: Mechanical valves generally have excellent durability and often last over 20 years. This longevity makes them suitable for younger clients who can tolerate long-term anticoagulation therapy.
D. There is a low potential for thrombi formations so anticoagulation is not necessary:
Mechanical valve surfaces are highly thrombogenic and significantly elevate the risk for clot formation. Ongoing anticoagulation is a standard and essential component of postoperative care.

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Correct Answer is A

Explanation

A. Echocardiography: This test uses ultrasound to visualize heart structures and assess left ventricular function and thickness. It’s the primary tool for evaluating hypertensive effects on the heart.
B. Positron emission tomography (PET) scan: PET scans assess metabolic activity and are used in oncology and some cardiac studies but are not first-line for evaluating left ventricular changes due to hypertension.
C. Fluorescein angiography: This test is used in ophthalmology to assess retinal blood vessels and has no relevance to cardiac or ventricular function.
D. Computed tomographic (CT) scan: CT scans may detect structural abnormalities but are not typically used to assess left ventricular function in hypertension. Echocardiography is more precise and noninvasive for this purpose.

A. "I will receive chemotherapy until most of the cancer is gone, and then I will get my own stem cells back." B. ‘I hope they find a bone marrow donor who matches." C. “I will need to be in protective isolation for up to 3 months after treatment." D. "The doctor will remove cells from my bone marrow before beginning chemotherapy."

Correct Answer is B

Explanation

A. "I will receive chemotherapy until most of the cancer is gone, and then I will get my own stem cells back.": This correctly describes the autologous transplant process, where the client receives high-dose chemotherapy followed by reinfusion of their own previously harvested stem cells. This approach avoids donor-related complications.
B. "I hope they find a bone marrow donor who matches.": This indicates a misunderstanding, an autologous transplant uses the client’s own stem cells, not donor cells. Mentioning a donor implies confusion with an allogeneic transplant and signals the need for further teaching.
C. "I will need to be in protective isolation for up to 3 months after treatment.": This is accurate because high-dose chemotherapy destroys immune cells, leaving the client highly susceptible to infection. Protective isolation helps reduce the risk of life-threatening opportunistic infections during recovery.
D. "The doctor will remove cells from my bone marrow before beginning chemotherapy.": This statement aligns with the autologous transplant protocol. Stem cells are collected before chemotherapy begins to preserve them for later reinfusion, once the high-dose treatment is complete.

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The nurse is caring for a client who is having a mitral valve replacement with a mechanical valve. What instructions should the nurse be sure the client understands prior to being discharged?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is teaching a client about hypertension and the effects on the left ventricle. What diagnostic test will the nurse describe?

Correct Answer is A

Explanation

The nurse is caring for a client is scheduled for chemotherapy followed by autologous stem cell transplant. Which of the following statements by the client indicates a need for further teaching?

Correct Answer is B

Explanation

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