1340 PU ch 23: Caring for Clients with Infectious and Inflammatory Disorders of the Heart and Blood Vessels

If a client were to develop rheumatic carditis, which cardiac structure would most likely be affected?

mitral valve

The nurse completes an assessment of a client admitted with pericarditis. What client symptom will the nurse correlate with the diagnosis of pericarditis?

reports of constant chest pain

The nurse is caring for a client who is scheduled to undergo mechanical valve replacement. Client education should include which of the following?

Long-term anticoagulant therapy

A client is a candidate for percutaneous balloon valvuloplasty, but is concerned about how this procedure will affect her busy work schedule. What guidance should the nurse provide to the client?

"Clients usually remain at the hospital for 24 to 48 hours."

The nurse obtains a health history from a client with a prosthetic heart valve and new symptoms of infective endocarditis. Which question by the nurse is most appropriate to ask?

"Have you been to the dentist recently?"

The nurse determines that a client recently diagnosed with subacute bacterial endocarditis understands discharge teaching upon which client statement?

"I have to call my doctor so I can get antibiotics before seeing the dentist."

When teaching a client with rheumatic carditis and a history of recurrent rheumatic fever, which statement by the client indicates that teaching has been successful?

"I may have to take prophylactic antibiotics for up to 10 years."

A client with a confirmed DVT is being discharged from the ED. Which client statement indicates that the client has received proper nursing instruction and understands how to manage this condition?

"I need to do my leg exercises five times or more every hour."

The nurse is educating a client about the care related to a new diagnosis of mitral valve prolapse. What statement made by the client demonstrates understanding of the teaching?

"I will avoid caffeine, alcohol, and smoking."

A nurse working at a pediatric clinic is teaching a group of parents. A parent asks the nurse if it is okay to let the young child recover from a sore throat naturally, rather than bringing the child to the clinic for diagnosis and treatment. What is the nurse's best response?

"It may be streptococcal sore throat. Rheumatic heart disease can be prevented with early treatment."

A nurse is teaching a client about valve replacement surgery. Which statement by the client indicates an understanding of the benefit of an autograft replacement valve?

"The valve is made from my own heart valve, and I will not need to take any blood-thinning drugs when I am discharged."

A client who had a prosthetic valve replacement was taking warfarin to reduce the risk of postoperative thrombosis. The client visited the nurse at a clinic once a week. What INR level would alert the nurse to notify the health care provider?

3.8

Fred Edwards, a 48-year-old male, is a biker who has been diagnosed with Buerger's disease. He has a 30-pack-year history and owns a biker bar. In your client education with Mr. Edwards, what actions would you recommend to decrease the complications connected with Buerger's disease?

All options are correct Clean his arms and legs daily Prevent trauma to extremities Don't bite his fingernails

A client with a history of rheumatic heart disease knows that she is at risk for bacterial endocarditis when undergoing invasive procedures. Prior to a scheduled cystoscopy, the nurse should ensure that the client knows the importance of taking which of the following drugs?

Amoxicillin

A nurse is caring for a client receiving warfarin therapy following a mechanical valve replacement. The client had a prothrombin time and International Normalized Ratio (INR) drawn before breakfast. The laboratory report shows the client's INR reading was 4. What is the nurse's first priority ?

Assess the client for bleeding and notify the health care provider of the results.

An older adult client has been diagnosed with aortic regurgitation. What change in blood flow should the nurse expect to see on this client's echocardiogram?

Blood to flow back from the aorta to the left ventricle

The nurse is caring for a patient diagnosed with pericarditis. What serious complication should this patient be monitored for?

Cardiac tamponade

A nurse evaluates a client and suspects pericarditis. What indicator is considered the most characteristic symptom of pericarditis?

Chest pain

A nurse is teaching a client about an upcoming surgery to separate fused cardiac leaflets. Which term is used to describe this surgery?

Commissurotomy

A client with a recent myocardial infarction was admitted to the hospital with a new diagnosis of mitral valve regurgitation. Which assessment data obtained by the nurse should be immediately communicated to the health care provider?

Crackles audible throughout the lungs

A client is admitted to the hospital with possible acute pericarditis and pericardial effusion. The nurse knows to prepare the client for which diagnostic test to confirm the client's diagnosis?

Echocardiography

The nurse is admitting a client with reports of dyspnea on exertion and fatigue. The client's ECG shows dysrhythmias that are sometimes associated with left ventricular hypertrophy. What diagnostic tool would be most helpful in diagnosing cardiomyopathy?

Echocardiogram

The nurse is auscultating the heart of a client diagnosed with mitral valve prolapse. Which is often the first and only manifestation of mitral valve prolapse?

Extra heart sound

A client is diagnosed with rheumatic endocarditis. What bacterium is the nurse aware causes this inflammatory response?

Group A, beta-hemolytic streptococcus

Which recurring condition most commonly occurs in clients with cardiomyopathy?

Heart failure

The nurse suspects a diagnosis of mitral valve regurgitation when what type of murmur is heard on auscultation?

High-pitched blowing sound at the apex

In which type of cardiomyopathy does the heart muscle actually increase in size and mass weight, especially along the septum?

Hypertrophic

The nurse is creating a plan of care for a client with a cardiomyopathy. What priority goal should underlie most of the assessments and interventions that are selected for this client?

Improved cardiac output

A client who suffered blunt chest trauma in a motor vehicle accident reports chest pain during deep inspiration. On auscultation, the nurse detects a pericardial friction rub — a classic sign of acute pericarditis. To relieve this chest pain, which position should the nurse encourage the client to assume?

Leaning forward while sitting

Ralph Wilson, is a 52-year-old client in the hospital unit where you practice nursing. He is being treated for myocarditis. Which of the following nursing interventions should you perform to reduce cardiac workload in a client with myocarditis?

Maintain the client on bed rest

Which nursing intervention should a nurse perform to reduce cardiac workload in a client diagnosed with myocarditis?

Maintain the client on bed rest

Mary Seaver is admitted to the pediatrics unit where you practice nursing. She was admitted by her pediatrician due to suspected rheumatic fever. Aggressive antibiotic therapy and comfort measures have been instituted to minimize the long-lasting effects of the systemic inflammation. If Mary were to develop rheumatic carditis, which cardiac valve most likely would be affected?

Mitral valve

A client has been admitted with an aortic valve stenosis and has been scheduled for a balloon valvuloplasty in the cardiac catheterization lab later today. During the admission assessment, the client tells the nurse he has thoracolumbar scoliosis and is concerned about lying down for any extended period of time. What is a priority action for the nurse?

Notify the surgeon immediately.

The nurse is caring for a client with a history of endocarditis. What topic should the nurse prioritize during health promotion education?

Oral hygiene

A community health nurse is presenting an educational event and is addressing several health problems, including rheumatic heart disease. What should the nurse describe as the most effective way to prevent rheumatic heart disease?

Recognizing and promptly treating streptococcal infections

A nurse is conducting a health history on a client with a primary diagnosis of mitral stenosis. Which disorder reported by the client is the most common cause of mitral stenosis?

Rheumatic endocarditis

What is the most common cause of mitral stenosis?

Rheumatic endocarditis

A nurse is obtaining a history from a new client in the cardiovascular clinic. When investigating for childhood diseases and disorders associated with structural heart disease, which finding should the nurse consider significant?

Rheumatic fever

A client has undergone a successful heart transplant and has been discharged home with a medication regimen that includes cyclosporine and tacrolimus. In light of this client's medication regimen, what nursing diagnosis should be prioritized?

Risk for infection

The nurse is providing discharge teaching for a client with rheumatic endocarditis but no valvular dysfunction. On which nursing diagnosis should the nurse focus her teaching?

Risk for infection

A client has a history of rheumatic fever as a child. Which instructions should be provided before the client has any dental work done?

Take prophylactic antibiotics.

A nurse is caring for a client with pericarditis and auscultates a pericardial friction rub. What action does the nurse ask the client to do to distinguish a pericardial friction rub from a pleural friction rub?

The nurse asks the client to hold the breath during auscultation.

The nurse is teaching a client with cardiomyopathy. Which statement is a valid teaching point?

The treatments include medications, medical devices, surgery, or transplantation.

The nurse is teaching a client diagnosed with aortic stenosis appropriate strategies for attempting to relieve the symptom of angina without resorting to taking medications. What should the nurse teach the client?

To rest and relax before taking nitroglycerin

A client is diagnosed with pericarditis. What symptom will be the nurse's priority for treatment?

acute pain

A client is diagnosed with dilated cardiomyopathy. What is the most likely cause of the client's condition?

chronic alcohol abuse

The nurse suspects a client has developed pericarditis after a week of cold-like symptoms. Which of the client's signs and symptoms indicate pericarditis?

fever, chest discomfort, and elevated erythrocyte sedimentation rate (ESR)

A nurse is caring for a client with end-stage cardiomyopathy and the client's spouse asks the nurse to clarify one of the last treatment options available that the health care provider mentioned. What is considered to be one of the last treatments for end-stage cardiomyopathy?

heart transplantation

A nurse reviewing a client's echocardiogram report reads the following statements: "The heart muscle is asymmetrically thickened and the overall size and mass are increased, especially along the septum. The ventricular walls are thickened, reducing the size of the ventricular cavities. Several areas of the myocardium show evidence of scarring." The nurse knows these manifestations are indicative of which type of cardiomyopathy?

hypertrophic