Nokea
After teaching a client who is being discharged home after mitral valve replacement surgery, the nurse assesses the client's understanding. Which client statement indicates a need for additional teaching?
- A. I'll be able to carry heavy loads after 6 months of rest
- B. I will have my teeth cleaned by my dentist in 2 weeks
- C. I must avoid eating foods high in vitamin K
- D. I will use an electric razor for shaving
Correct Answer: B
Rationale: Clients who have defective or repaired valves are at high risk for endocarditis. The client should avoid dental procedures for 6 months because of the risk for endocarditis. The other statements reflect correct understanding of post-surgery care.
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A nurse teaches a client who is prescribed digoxin (Lanoxin) therapy. Which statement should the nurse include in this client's teaching?
- A. Hold the next dose of Imdur
- B. Increase your intake of foods that are high in potassium
- C. Hold this medication if your pulse rate is below 90 beats per minute
- D. Do not take this medication within 1 hour of taking an antacid
Correct Answer: D
Rationale: Digoxin should not be taken within 1 hour of antacids, as antacids can decrease its absorption. Holding Imdur is irrelevant to digoxin therapy. Potassium intake needs monitoring, but hypokalemia (not high potassium) is a concern with digoxin. The pulse rate threshold for holding digoxin is typically below 60 beats per minute, not 90.
A nurse is assessing a client with left-sided heart failure. For which clinical manifestations should the nurse assess?
- A. Pulmonary crackles
- B. Confusion, restlessness
- C. Pulmonary hypertension
- D. Dependent edema
- E. Cough that worsens at night
Correct Answer: A,B,E
Rationale: Left-sided heart failure leads to pulmonary congestion, causing pulmonary crackles, confusion, restlessness (due to hypoxia), and cough that worsens at night. Pulmonary hypertension and dependent edema are associated with right-sided heart failure.
A nurse assesses a client for signs of infective endocarditis. Which clinical manifestations should the nurse expect?
- A. Weight gain
- B. Night sweats
- C. Cardiac murmur
- D. Abdominal bloating
- E. Osler nodes
Correct Answer: B,C,E
Rationale: Clinical manifestations of infective endocarditis include night sweats, cardiac murmur, and Osler nodes. Weight gain and abdominal bloating are not typical; the latter is associated with heart transplant rejection.
After teaching a client with congestive heart failure (CHF), the nurse assesses the client's understanding. Which client statements indicate correct understanding of the teaching related to nutritional intake?
- A. I should limit my fluid intake to 2 liters per day
- B. I need to avoid adding salt to my foods
- C. I should eat foods high in potassium, like bananas
- D. I must avoid foods high in vitamin K
- E. I will check food labels for sodium content
Correct Answer: A,B,C,E
Rationale: Clients with CHF should limit fluid intake (typically to 2 liters/day), avoid adding salt, eat potassium-rich foods (especially if on diuretics), and check sodium content. Avoiding vitamin K is specific to clients on warfarin, not a general CHF requirement.
A nurse cares for a client recovering from prosthetic valve replacement surgery. The client asks, 'Why will I need to take anticoagulants for the rest of my life?' How should the nurse respond?
- A. The prosthetic valve requires thinner blood to function properly
- B. Blood clots form more easily in artificial replacement valves
- C. The vein taken from your leg reduces circulation in the leg
- D. The surgery left a lot of small clots in your heart and lungs
Correct Answer: B
Rationale: Synthetic valve prostheses and scar tissue provide surfaces on which platelets can aggregate easily and initiate the formation of blood clots. The other responses are inaccurate.