Nokea
A patient 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 patient?
- A. Patients generally stay in the hospital for 6 to 8 days.
- B. Patients are kept in the hospital until they are independent with all aspects of their care.
- C. Patients need to stay in the hospital until they regain normal heart function for their age.
- D. Patients usually remain at the hospital for 24 to 48 hours.
Correct Answer: D
Rationale: After undergoing percutaneous balloon valvuloplasty, the patient usually remains in the hospital for 24 to 48 hours. Prediagnosis levels of heart function are not always attainable and the patient does not need to be wholly independent prior to discharge.
You may also like to solve these questions
A patient who has undergone valve replacement surgery is being prepared for discharge home. Because the patient will be discharged with a prescription for warfarin (Coumadin), the nurse should educate the patient about which of the following?
- A. The need for regularly scheduled testing of the patients International Normalized Ratio (INR)
- B. The need to learn to sleep in a semi-Fowlers position for the first 6 to 8 weeks to prevent emboli
- C. The need to avoid foods that contain vitamin K
- D. The need to take enteric-coated ASA on a daily basis
Correct Answer: A
Rationale: Patients who take warfarin (Coumadin) after valve replacement have individualized target INRs; usually between 2 and 3.5 for mitral valve replacement and 1.8 and 2.2 for aortic valve replacement. Natural sources of vitamin K do not normally need to be avoided and ASA is not indicated. Sleeping upright is unnecessary.
The nurse is caring for a patient with mitral stenosis who is scheduled for a balloon valvuloplasty. The patient tells the nurse that he is unsure why the surgeon did not opt to replace his damaged valve rather than repairing it. What is an advantage of valvuloplasty that the nurse should cite?
- A. The procedure can be performed on an outpatient basis in a physicians office.
- B. Repaired valves tend to function longer than replaced valves.
- C. The procedure is not associated with a risk for infection.
- D. Lower doses of antirejection drugs are required than with valve replacement.
Correct Answer: B
Rationale: In general, valves that undergo valvuloplasty function longer than prosthetic valve replacements and patients do not require continuous anticoagulation. Valvuloplasty carries a risk of infection, like all surgical procedures, and it is not performed in a physicians office. Antirejection drugs are unnecessary because foreign tissue is not introduced.
A nurse is planning discharge health education for a patient who will soon undergo placement of a mechanical valve prosthesis. What aspect of health education should the nurse prioritize in anticipation of discharge?
- A. The need for long-term antibiotics
- B. The need for 7 to 10 days of bed rest
- C. Strategies for preventing atherosclerosis
- D. Strategies for infection prevention
Correct Answer: D
Rationale: Patients with a mechanical valve prosthesis (including annuloplasty rings and other prosthetic materials used in valvuloplasty) require education to prevent infective endocarditis. Despite these infections risks, antibiotics are not used long term. Activity management is important, but extended bed rest is unnecessary. Valve replacement does not create a heightened risk for atherosclerosis.
The nurse is admitting a patient with complaints of dyspnea on exertion and fatigue. The patients ECG shows dysrhythmias that are sometimes associated with left ventricular hypertrophy. What diagnostic tool would be most helpful in diagnosing cardiomyopathy?
- A. Cardiac catheterization
- B. Arterial blood gases
- C. Echocardiogram
- D. Exercise stress test
Correct Answer: C
Rationale: The echocardiogram is one of the most helpful diagnostic tools because the structure and function of the ventricles can be observed easily. The ECG is also important, and can demonstrate dysrhythmias and changes consistent with left ventricular hypertrophy. Cardiac catheterization specifically addresses coronary artery function and arterial blood gases evaluate gas exchange and acid balance. Stress testing is not normally used to differentiate cardiomyopathy from other cardiac pathologies.
A patient who has recently recovered from a systemic viral infection is undergoing diagnostic testing for myocarditis. Which of the nurses assessment findings is most consistent with myocarditis?
- A. Sudden changes in level of consciousness (LOC)
- B. Peripheral edema and pulmonary edema
- C. Pleuritic chest pain
- D. Flulike symptoms
Correct Answer: D
Rationale: The most common symptoms of myocarditis are flulike. Chest pain, edema, and changes in LOC are not characteristic of myocarditis.