Inflammatory disorders of the heart

A 25-yr-old patient with a group A streptococcal pharyngitis does not want to take the antibiotics prescribed. What should the nurse tell the patient to encourage the patient to take the medications and avoid complications of the infection? "The complications of this infection will affect the skin, hair, and balance." "You will not feel well if you do not take the medicine and get over this infection." "Without treatment, you could get rheumatic fever, which can lead to rheumatic heart disease." "You may not want to take the antibiotics for this infection, but you will be sorry if you do not."

"Without treatment, you could get rheumatic fever, which can lead to rheumatic heart disease." Rheumatic fever (RF) is not common because of effective use of antibiotics to treat streptococcal infections. Without treatment, RF can occur and lead to rheumatic heart disease, especially in young adults. The complications do not include hair or balance. Saying that the patient will not feel well or that the patient will be sorry if the antibiotics are not taken is threatening to the patient and inappropriate for the nurse to say.

The nurse expects what assessment finding in a patient diagnosed with acute pericarditis?

1 Pulsus paradoxus 2Muffled heart sounds 3Pericardial friction rub Correct 4Narrowed pulse pressure The hallmark finding in acute pericarditis is a pericardial friction rub. Muffled heart sounds, pulsus paradoxus, and a narrowed pulse pressure are findings associated with cardiac tamponade, not acute pericarditis.

What is the therapeutic role of digoxin in treating myocarditis?

1 To decrease preload 2To treat an enlarged heart 3To improve cardiac output 4To improve myocardial contractility Correct Myocarditis is the diffuse inflammation of myocardium. Digoxin improves myocardial contractility and reduces the heart rate. Diuretics reduce the fluid volume and decrease the preload. ACE inhibitors reduce afterload and treat enlarged heart associated with myocarditis. Intravenous medications like nitroprusside reduce afterload and improve cardiac output by decreasing systemic vascular resistance.

The nurse assesses a patient with infective endocarditis and expects that if petechiae are observed, they will be found in what location of the body?

1 Toes 2Nail beds 3Fingertips 4Conjunctivae Correct

A patient with suspected infective endocarditis (IE) is scheduled for cardiac catheterization. The nurse recognizes that the purpose of the test for this patient is what? 1 To evaluate valve function 2 To detect the presence of murmurs 3 To check for the presence of infection 4To check for the presence of vegetations

4 To check for the presence of vegetations

The patient had a history of rheumatic fever and has been diagnosed with mitral valve stenosis. The patient is planning to have a biologic valve replacement. What protective mechanisms should the nurse teach the patient about using after the valve replacement? Long-term anticoagulation therapy Antibiotic prophylaxis for dental care Exercise plan to increase cardiac tolerance Take β-adrenergic blockers to control palpitations.

Antibiotic prophylaxis for dental care The patient will need to use antibiotic prophylaxis for dental care to prevent endocarditis. Long-term anticoagulation therapy is not used with biologic valve replacement unless the patient has atrial fibrillation. An exercise plan to increase cardiac tolerance is needed for a patient with heart failure. Taking β-adrenergic blockers to control palpitations is prescribed for mitral valve prolapse, not valve replacement.

What is the nursing priority for a patient with rheumatic fever? Antibiotic therapy Anticoagulation therapy Optimizing joint mobility Application of ice packs to painful joints

Antibiotic therapy Patients with a history of rheumatic fever frequently require ongoing antibiotic therapy. Heat should be applied to painful joints. Anticoagulation is not indicated in this patient population. A priority

While auscultating a patient who underwent trauma, the nurse auscultates a quick, strong heartbeat that collapses immediately. The patient has severe dyspnea and describes the chest pain as 8 out of 10 on the pain scale. Which condition does the nurse suspect? Aortic valve stenosis Mitral valve stenosis Aortic valve regurgitation Mitral valve regurgitation

Aortic valve regurgitation A quick, strong beat that collapses immediately is known as water-hammer pulse. Water-hammer pulse, dyspnea, and chest pain due to trauma indicate aortic regurgitation (AR). Aortic stenosis (AS) is characterized by angina, exertional dyspnea, syncope, and left ventricular failure. Mitral valve stenosis involves exertional dyspnea, hoarseness, hemoptysis, chest pain, and seizures. Mitral valve regurgitation is associated with weakness, fatigue, palpitations, and dyspnea.

A patient is admitted to the hospital with a diagnosis of acute mitral valve regurgitation. What is the priority nursing intervention? Auscultate the lung sounds. Observe for bloody sputum. Assess for water-hammer pulse. Palpate lower extremities for edema

Auscultate the lung sounds. Auscultation of the lung sounds is the priority nursing intervention in acute mitral valve regurgitation. In acute mitral valve regurgitation there is a rapid increase in left atrial pressure and volume, which leads to pulmonary congestion, resulting in pulmonary edema and possible cardiogenic shock. Hemoptysis can occur with mitral valve stenosis, not acute mitral valve regurgitation. Lower extremity edema is a manifestation of tricuspid stenosis. Water-hammer pulse is a manifestation of chronic, severe aortic valve regurgitation.

The nurse should include which instructions when teaching a patient with mitral valve prolapse about self-care? Select all that apply. Avoid caffeine. Avoid all exercise. Avoid heavy lifting or isometric exercises. Avoid ephedrine in over-the-counter medications. Use antibiotics prophylactically prior to a procedure. Immediately report shortness of breath, fatigue, and palpitations.

Avoid caffeine. Avoid ephedrine in over-the-counter medications Immediately report shortness of breath, fatigue, and palpitations The nurse will teach a patient with mitral valve prolapse to immediately report shortness of breath, fatigue, palpitations, or other symptoms such as anxiety to the healthcare provider, or if necessary, activate the emergency response system. Avoiding caffeine and ephedrine will prevent heart palpitations. The patient is encouraged to begin or maintain an exercise program to maintain optimal health. The use of antibiotics prior to a procedure is not necessary with mitral valve prolapse. Instructing a patient to avoid heavy lifting or isometric exercises is reserved for patients with a symptomatic or a pathologic cardiac condition such as cardiomyopathy.

The nurse is caring for an older patient that is diagnosed with pulmonic stenosis. The nurse anticipates that which type of conservative therapy may be prescribed? Annuloplasty Balloon valvuloplasty Mitral commissurotomy Sapien Transcatheter Heart Valve (THV)

Balloon valvuloplasty Balloon valvuloplasty or percutaneous transluminal balloon valvuloplasty (PTBV) is generally indicated for older adults and for those who are poor surgery candidates. PTBV is used for mitral, tricuspid, and pulmonic stenosis. Annuloplasty is the reconstruction of annulus that is beneficial in patients with mitral or tricuspid regurgitation. Mitral commissurotomy or valvulotomy is used in patients with pure mitral stenosis. Sapien Transcatheter Heart Valve (THV) is beneficial in patients with atrial stenosis.

The patient had myocarditis and is now experiencing fatigue, weakness, palpitations, and dyspnea at rest. The nurse assesses pulmonary crackles, edema, and weak peripheral pulses. Sinoatrial tachycardia is evident on the cardiac monitor. The Doppler echocardiography shows dilated cardiomyopathy. What collaborative and nursing care of this patient should be done to improve cardiac output and the quality of life (select all that apply.)? Decrease preload and afterload. Relieve left ventricular outflow obstruction. Control heart failure by enhancing myocardial contractility. Improve diastolic filling and the underlying disease process. Improve ventricular filling by reducing ventricular contractility.

Decrease preload and afterload. Control heart failure by enhancing myocardial contractility. The patient is experiencing dilated cardiomyopathy. To improve cardiac output and quality of life, drug, nutrition, and cardiac rehabilitation will be focused on controlling heart failure by decreasing preload and afterload and improving cardiac output, which will improve the quality of life. Relief of left ventricular outflow obstruction and improving ventricular filling by reducing ventricular contractility is done for hypertrophic cardiomyopathy. There are no specific treatments for restrictive cardiomyopathy, but interventions are aimed at improving diastolic filling and the underlying disease process.

Which type of surgical therapy utilizes cardiopulmonary bypass? Annuloplasty Closed procedure Balloon valvuloplasty Direct vision procedure

Direct vision procedure Direct vision procedure or open procedure is the surgical therapy that involves the use of cardiopulmonary bypass. Annuloplasty is the reconstruction of the annulus of a valve, and it does not require cardiopulmonary bypass. Closed procedure requires the insertion of transventricular dilator through the left ventricular apex into the mitral valve. Balloon valvuloplasty involves threading a balloon-tipped catheter from the femoral artery or vein into the stenotic valve.

A patient is admitted with suspected myocarditis. Which test is considered most diagnostic for this illness? Echocardiogram Endomyocardial biopsy Electrocardiogram (ECG) Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels

Endomyocardial biopsy Histologic confirmation of myocarditis is through an endomyocardial biopsy. A biopsy done during the first six weeks of acute illness is most diagnostic. This is the period in which lymphocytic infiltration and myocyte damage are present. The ECG changes for a patient with myocarditis are often nonspecific but may reflect associated pericardial involvement (e.g., diffuse ST segment changes). Dysrhythmias and conduction disturbances may be present. Laboratory findings are often inconclusive. They may include mild to moderate leukocytosis and atypical lymphocytes, increased ESR and CRP levels, elevated levels of myocardial markers such as troponin, and elevated viral titers. The virus is generally present in tissue and pericardial fluid samples only during the initial 8 to 10 days of illness. Nuclear scans, echocardiography, and magnetic resonance imaging (MRI) are used to assess cardiac function.

The nurse finds diastolic murmurs in a patient who says, "I'm finding it hard to breathe, and sometimes I cough up blood." What condition does the nurse suspect? Mitral valve stenosis Aortic valve stenosis Mitral valve prolapse Aortic valve regurgitation

Mitral valve stenosis Coughing up of blood from the bronchi, larynx, or lungs is known as hemoptysis, and difficulty breathing is dyspnea. Hemoptysis, dyspnea, and diastolic murmurs indicate mitral valve stenosis. Aortic valve stenosis is characterized by angina, dyspnea, syncope, and left ventricular failure. Mitral valve prolapse is an abnormality of the mitral valve leaflets and the papillary muscles that involves dysrhythmias, ventricular tachycardia, palpitations, light-headedness, and dizziness. Aortic valve regurgitation is associated with abrupt dyspnea, chest pain, left ventricular failure, and cardiogenic shock

An 80-yr-old patient with uncontrolled type 1 diabetes mellitus is diagnosed with aortic stenosis. When conservative therapy is no longer effective, the nurse knows that the patient will need to do or have what done? Aortic valve replacement Take nitroglycerin for chest pain. Open commissurotomy (valvulotomy) procedure Percutaneous transluminal balloon valvuloplasty (PTBV) procedure

Percutaneous transluminal balloon valvuloplasty (PTBV) procedure The PTBV procedure is best for this older adult patient who is a poor surgery candidate related to the uncontrolled type 1 diabetes mellitus. Aortic valve replacement would probably not be tolerated well by this patient, although it may be done if the PTBV fails and the diabetes is controlled in the future. Nitroglycerin is used cautiously for chest pain because it can reduce blood pressure and worsen chest pain in patients with aortic stenosis. Open commissurotomy procedure is used for mitral stenosis.

A patient with mitral valve stenosis presents with hemoptysis. The nurse suspects that the symptom is caused by what? 1 Atrial fibrillation 2 Pulmonary hypertension 3 Decreased cardiac output 4 Atrial enlargement pressing on the laryngeal nerve

Pulmonary hypertension Pulmonary hypertension causes hemoptysis or bleeding in the lungs and the coughing up of blood due to increased pressure in the pulmonary circulation. Atrial fibrillation in patients with mitral valve prolapse results in fatigue and palpitations. Decreased cardiac output results in chest pain in patients with mitral valve prolapse. Hoarseness occurs due to atrial enlargement pressing on the laryngeal nerve in patients with mitral valve prolapse.

While admitting a patient with pericarditis, the nurse will assess for what manifestations of this disorder? Pulsus paradoxus Prolonged PR intervals Widened pulse pressure Clubbing of the fingers

Pulsus paradoxus Pericarditis can lead to cardiac tamponade, an emergency situation. Pulsus paradoxus greater than 10 mm Hg is a sign of cardiac tamponade that should be assessed at least every 4 hours in a patient with pericarditis. Prolonged PR intervals occur with first-degree AV block. Widened pulse pressure occurs with valvular heart disease and increased intracranial pressure. Clubbing of fingers may occur in subacute forms of infective endocarditis and valvular heart disease.

Which diagnostic study is used to assess congenital heart disease in a patient? 1 Chest x-ray 2 Doppler color-flow imaging 3 Real time 3-D echocardiography 4 Computerized tomography scan

Real time 3-D echocardiograph

The nurse conducts a complete physical assessment on a patient admitted with infective endocarditis. Which finding is significant? Regurgitant murmur at the mitral valve area Point of maximal impulse palpable in fourth intercostal space Heart rate of 94 beats/min and capillary refill time of 2 seconds Respiratory rate of 18 breaths/min and heart rate of 90 beats/min

Regurgitant murmur at the mitral valve area A regurgitant murmur of the aortic or mitral valves would indicate valvular disease, which is a complication of endocarditis. All the other findings are within normal limits.

The nurse is caring for a patient who received a mechanical aortic valve replacement two years ago. Current lab values include an international normalized ratio (INR) of 1.5, platelet count of 150,000/µL, and hemoglobin of 8.6g/dL. Which nursing action is most appropriate? Assess the vital signs. Start intravenous fluids. Monitor for signs of bleeding. Report laboratory values to the health care provider.

Report laboratory values to the health care provider. Patients with mechanical valve replacement are placed on anticoagulants and should be in a therapeutic INR range of 2.5 to 3.5. Administration of Coumadin (Warfarin) prolongs clotting time and prevents clot formation on the valve. The low INR would require a call to the healthcare provider for an order increase the medication dose. Vital signs would be unchanged related to the low INR. Intravenous fluids are not indicated. The patient is at risk of forming clots, not bleeding.

Which type of valvular heart disease occurs almost exclusively in patients that abuse drugs intravenously? 1 Tricuspid stenosis 2 Pulmonic stenosis 3 Aortic valve stenosis 4 Mitral valve stenosis

Tricuspid stenosis Tricuspid stenosis is the disease of the tricuspid valve that occurs in patients who abuse drugs intravenously or who have had rheumatic fever. Pulmonic stenosis is congenital. Aortic valve stenosis occurs due to rheumatic fever. Mitral valve stenosis occurs due to rheumatic heart disease.

The nurse auscultates an irregular, rapid heart rate in a patient with mitral valve prolapse. Which type of medication does the nurse expect will be prescribed? Statin Nitrate β-blocker Anti-ischemic

β-blocker Palpitations are fast, hard, and irregular heartbeats. Propranolol is an example of a β-blocker that slows the heart rate by acting on the β-adrenergic receptors located on the heart cells. A statin, such as atorvastatin, is used primarily to treat elevated blood cholesterol levels and reduce the risk of cardiovascular disease. An anti-ischemic medication, such as trimetazidine, improves glucose control and improves cardiac function in dilated cardiomyopathy. A nitrate, such as isosorbide dinitrate, is used to prevent angina attacks by dilating blood vessels.

A patient has been admitted with acute pericarditis. How should the nurse care for this patient? Select all that apply.

1Provide an overbed table. Correct 2Tell the patient to avoid alcohol. Correct 3Administer antiinflammatory medications. Correct 4Discontinue use of proton pump inhibitors. 5Keep the patient in a Trendelenberg position.

The nurse is teaching a community group about preventing rheumatic fever. What information should the nurse include? 1 Prompt recognition and treatment of streptococcal pharyngitis 2 Avoidance of respiratory infections in children born with heart defects 3 Completion of 4 to 6 weeks of antibiotic therapy for infective endocarditis 4 Requesting antibiotics before dental surgery for individuals with rheumatoid arthritis

1 Prompt recognition and treatment of streptococcal pharyngitis The nurse should emphasize the need for prompt and adequate treatment of streptococcal pharyngitis infection, which can lead to the complication of rheumatic fever.

The nurse reviews laboratory test results for a patient with acute infective endocarditis. Which test result is significant for determining the plan of treatment?

1 Blood cultures Corect 2C- reactive protein 3White blood cell count 4Erythrocyte sedimentation rate

A patient is suspected of having hypertrophic cardiomyopathy (CMP). The nurse anticipates a prescription for what primary diagnostic study?

1 Echocardiogram Correct 2Heart catheterization 3Nuclear stress testing 4Electrocardiogram (ECG) The echocardiogram is the primary diagnostic tool used to confirm hypertrophic cardiomyopathy. The electrocardiogram will reveal some dysrhythmias associated with the ventricle. Heart catheterization and nuclear stress testing may also be helpful in diagnosing and treating hypertrophic cardiomyopathy, but the echocardiogram will be the first choice of test.

A patient's assessment findings include peripheral edema, distended neck veins, and lung crackles. What diagnosis does the nurse anticipate?

1 Myocarditis Correct 2Polyarthritis 3Aortic valve stenosis 4Rheumatic heart disease Peripheral edema (swollen limbs), jugular vein distention (distended neck veins), and crackling heart sounds indicate myocarditis. Polyarthritis is a manifestation of rheumatic fever, characterized by swelling, redness, tenderness of knees, ankles, elbows, and wrists. Aortic valve stenosis is characterized by angina, syncope, dyspnea, heart failure, and absence of S2. Rheumatic heart disease is a chronic condition that results from rheumatic fever; it is associated with scarring and deformity of the heart valves.

What is a noninfectious cause of pericarditis?

1 Myxedema Correct 2 Lyme disease 3 Rheumatic fever 4Ankylosing spondylitis Myxedema is swelling of the skin and underlying tissues giving a waxy consistency, typical of patients with underactive thyroid glands; it is a noninfectious cause of pericarditis. Lyme disease is an infectious cause of pericarditis. Rheumatic fever and ankylosing spondylitis are hypersensitive or autoimmune causes of pericarditis.

While reviewing a patient's medical record, the nurse notices loss of elasticity of the pericardial sac. Which condition does the nurse suspect in this patient?

1 Pericarditis 2Pericardiectomy 3Pericardiocentesis 4Chronic constrictive pericarditis Correct

A patient with infective endocarditis is being discharged from the health care facility. What should the nurse teach the patient and caregiver about nursing care at home? Select all that apply.

1Avoid exercise. Correct 2Continue follow-up care. Correct 3 Ensure complete bed rest. 4 Take antibiotics as scheduled. Correct 5 Avoid people with an upper respiratory tract infection Correct The nurse should teach the patient to avoid people with infection, especially upper respiratory tract infection. The patient should continue to receive antibiotics as scheduled, and the caregiver should observe the patient for any adverse drug reaction. The nurse should explain to the patient the importance of good follow-up care, good nutrition, and early treatment of infections. The patient should take periods of rest between activities. The patient may ambulate and perform moderate activity without exertion. The patient should be assisted in performing range-of-motion (ROM) exercises to prevent problems with reduced mobility.

The nurse is caring for a patient with valvular heart disease who experiences atrial dysrhythmias. The nurse anticipates a prescription for which type of medication? 1 Nitrate 2 Positive inotrope 3 Calcium channel blocker 4 Angiotensin-converting enzyme (ACE) inhibitor

Calcium channel blocker Atrial dysrhythmia is an irregular heartbeat that occurs in the atrium. Calcium channel blockers dilate arteries by reducing calcium flux into the cells, which increases myocardial oxygen supply and prevents atrial dysrhythmias. Nitrates and ACE inhibitors are vasodilators that are used in the treatment of heart failure. Positive inotropes are used to treat heart failure in patients with valvular heart disease.

A 72-yr-old man with a history of aortic stenosis is admitted to the emergency department. He reports severe left-sided chest pressure radiating to the jaw. Which medication, if ordered by the health care provider, should the nurse question? Aspirin Oxygen Nitroglycerin Morphine sulfate

Nitroglycerin Aspirin, oxygen, nitroglycerin, and morphine sulfate are all commonly used to treat acute chest pain suspected to be caused by myocardial ischemia. However, nitroglycerin should be used cautiously or avoided in patients with aortic stenosis as a significant reduction in blood pressure may occur. Chest pain can worsen because of a drop in blood pressure.

The patient with pericarditis is complaining of chest pain. After assessment, which intervention should the nurse expect to implement to provide pain relief? Corticosteroids Morphine sulfate Proton pump inhibitor Nonsteroidal antiinflammatory drugs

Nonsteroidal antiinflammatory drugs Nonsteroidal antiinflammatory drugs (NSAIDs) control pain and inflammation. Corticosteroids are reserved for patients already taking corticosteroids for autoimmune conditions and those who do not respond to NSAIDs. Morphine is not necessary. Proton pump inhibitors are used to decrease stomach acid to avoid the risk of gastrointestinal bleeding from the NSAIDs.

The nurse provides teaching to a patient with acute rheumatic fever (RF). Which statement made by the patient indicates a need for further education? 1"I will receive ibuprofen for my joint pain." 2"I will need to take antibiotics to stop the infection." 3"Exercise is important to help me regain my strength." 4"I can have a heating pad placed on my painful knees if needed."

3 "Exercise is important to help me regain my strength."

A 55-yr-old female patient develops acute pericarditis after a myocardial infarction. Which assessment finding indicates a possible complication? 1 Presence of a pericardial friction rub 2 Distant and muffled apical heart sounds 3 Increased chest pain with deep breathing 4 Decreased blood pressure with tachycardia

4 Decreased blood pressure with tachycardia Cardiac tamponade is a serious complication of acute pericarditis. Signs and symptoms include narrowed pulse pressure, tachypnea, tachycardia, a decreased cardiac output, and decreased blood pressure. The other symptoms are consistent with acute pericarditis.

The nurse assesses a patient with valvular heart disease. The nurse recalls that the absence of what heart sound is indicative of aortic valve stenosis? Absence of S1 Absence of S2 Absence of S3 Absence of S4

Absence of S2 Aortic stenosis occurs as the result of rheumatic fever and is characterized by a diminished or absent S2. A diminished or absent S1, S3, or S4 is associated with aortic valve regurgitation

Which patients are most at risk for developing infective endocarditis (select all that apply.)? Older woman with disseminated coccidioidomycosis Homeless man with history of intravenous drug abuse Patient with end-stage renal disease on peritoneal dialysis Man with complaints of chest pain and shortness of breath Adolescent with exertional palpitations and clubbing of fingers Female with peripheral intravenous site for medication administration

Older woman with disseminated coccidioidomycosis Homeless man with history of intravenous drug abuse Patient with end-stage renal disease on peritoneal dialysis

When caring for a patient with infective endocarditis, the nurse will assess the patient for which vascular manifestations (select all that apply.)? Osler's nodes Janeway's lesions Splinter hemorrhages Subcutaneous nodules Erythema marginatum lesions

Osler's nodes Janeway's lesions Splinter hemorrhages Osler's nodes, Janeway's lesions, and splinter hemorrhages are all vascular manifestations of infective endocarditis. Subcutaneous nodules and erythema marginatum lesions occur with rheumatic fever.

A patient reports severe chest pain radiating to the neck and arms. Assessment findings include a scratching, grating, and high-pitched sound at the lower sternal border of the chest. The nurse recognizes the presence of the hallmark finding of what condition? Subacute nodules Acute pericarditis Rheumatic endocarditis Chronic rheumatic carditis

Acute pericarditis Severe chest pain radiating to the neck, arms, and shoulders indicates acute pericarditis. Pericardial friction rub is scratching, grating, and high-pitched sound heard at the lower sternal border of the chest; this condition is associated with patients who have acute endocarditis. Subacute nodules are small, firm, painless, and hard swellings over the knees, elbows, and wrists associated with rheumatic fever. Rheumatic endocarditis and chronic rheumatic carditis are complications associated with rheumatic fever.

The nurse assesses a patient and suspects acute mitral valve regurgitation (MR). Which symptoms support the nurse's suspicion? Select all that apply. Palpitations Cool extremities Peripheral edema Thready, peripheral pulses Audible third heart sound (S3)

Cool extremities Thready, peripheral pulses Mitral regurgitation is a valvular heart disease that causes backward flow of blood from the left ventricle to the left atrium due to incomplete valve closure during systole. Acute mitral regurgitation is characterized by thready peripheral pulses and cool extremities. Palpitations, peripheral edema, and an audible third heart sound (S3) are symptoms of chronic mitral regurgitation.

An 80-year-old patient who is a poor surgery candidate is diagnosed with aortic stenosis. The nurse anticipates that what procedure will likely be recommended? Annuloplasty Aortic valve replacement Open commissurotomy (valvulotomy) procedure Percutaneous transluminal balloon valvuloplasty (PTBV) procedure

Percutaneous transluminal balloon valvuloplasty (PTBV) procedure The PTBV procedure is generally indicated for an older patient who is a poor surgery candidate. Annuloplasty is an option for patients with mitral or tricuspid regurgitation. An open commissurotomy procedure is used for mitral stenosis. Valve replacement may be required for mitral, aortic, tricuspid, and occasionally pulmonic valve disease.

The nurse assesses a patient with infective endocarditis and expects what clinical manifestations? Select all that apply. Roth's spots Osler's nodes Aschoff's bodies Janeway's lesions Sydenham's chorea

Roth's spots Osler's nodes Janeway's lesions Osler's nodes are painful, tender, red or purple, pea-sized lesions found on the fingertips or toes in patients with infective endocarditis. Janeway's lesions are flat, painless, small, red spots that may be seen on the palms and soles of patients with infective endocarditis. Roth's spots are also seen in patients with infective endocarditis during fundoscopic examination of retinal lesions. Aschoff's bodies are nodules that are formed in patients with rheumatic heart disease. Sydenham's chorea is a central nervous system manifestation of