When conducting discharge teaching for a client who has had a mechanical valve replacement, which information should the nurse plan to include?
It will no longer be necessary to take daily doses of anticoagulants.
The client will need to take an antibiotic before dental procedures.
Mechanical valves usually must be replaced within 7 to 10 years after insertion.
Heparin injections will be required to decrease the incidence of clot formation.
The Correct Answer is B
A. It will no longer be necessary to take daily doses of anticoagulants: Clients with mechanical valves are at high risk for thromboembolism and require lifelong anticoagulation therapy. Stopping anticoagulants places the client at risk for valve thrombosis and systemic emboli such as stroke.
B. The client will need to take an antibiotic before dental procedures: Prophylactic antibiotics are recommended before dental procedures to prevent infective endocarditis in clients with mechanical heart valves.
C. Mechanical valves usually must be replaced within 7 to 10 years after insertion:
Mechanical valves are highly durable and often last 20 years or more. Unlike bioprosthetic valves, they do not require routine replacement unless complications occur.
D. Heparin injections will be required to decrease the incidence of clot formation:
Heparin may be used short-term postoperatively, but long-term anticoagulation for mechanical valves is typically managed with oral agents like warfarin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Evaluate complete blood cell counts: While baseline labs, including CBC, are useful, they are not the immediate priority before a pericardiocentesis. These values provide general health data but do not guide acute decision-making for cardiac tamponade.
B. Assess for paradoxical pulse: A paradoxical pulse an exaggerated drop in systolic blood pressure during inspiration is a hallmark sign of cardiac tamponade. Recognizing this finding helps confirm clinical suspicion and prioritize urgent intervention.
C. Discontinue anticoagulants: Stopping anticoagulants is important to prevent bleeding during the procedure, this must be done under provider guidance and may not be feasible if the situation is emergent. It is a safety consideration but not the most urgent nursing action.
D. Monitor central venous pressure (CVP): CVP monitoring can reflect rising intrapericardial pressure in tamponade but often requires invasive access and may not be immediately available. It provides supportive data, but clinical signs such as paradoxical pulse offer more immediate diagnostic relevance.
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"C"},"D":{"answers":"D"}}
Explanation
- Amlodipine: Amlodipine inhibits the influx of calcium ions into vascular smooth muscle and cardiac muscle, leading to vasodilation and reduced blood pressure. It’s used primarily for hypertension and angina.
- Aspirin: Aspirin irreversibly inhibits cyclooxygenase (COX), thereby reducing thromboxane A2 production and platelet aggregation. It lowers the risk of clot formation in clients with suspected myocardial infarction.
- Lisinopril: Lisinopril blocks the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. It lowers blood pressure and reduces afterload, which helps reduce cardiac workload in clients with hypertension or heart failure.
- Nitroglycerin: Nitroglycerin dilates both veins and arteries, particularly the coronary arteries, reducing myocardial oxygen demand and improving oxygen delivery. It’s used to relieve angina and manage acute chest pain.
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