Nokea
The nurse is caring for a client diagnosed with mitral stenosis. Which client symptom change would most likely indicate to the nurse, a progression of this condition?
- A. Decreased systolic pressure
- B. Increased systolic pressure
- C. Widening pulse pressure
- D. Normal diastolic pressure
Correct Answer: A
Rationale: As mitral stenosis progresses, the systolic blood pressure will decrease due to the reduction of the cardiac output. Widening pulse pressure with normal diastolic pressure is associated more with aortic regurgitation.
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What nutritional intervention would be appropriate for a client with a valvular disorder?
- A. Limit sodium intake.
- B. Eat six small meals a day.
- C. Limit caloric intake to maintain optimal weight.
- D. Increase intake of B and C vitamins.
Correct Answer: A
Rationale: Clients with valvular disorders often need to limit sodium intake because decreasing the volume of blood decreases cardiac workload. Eating six small meals daily, limiting caloric intake, and increasing the intake of B and C vitamins would not help a client with a valvular disorder.
The nurse is caring for a client with a valvular disorder. The client is at risk for decreased cardiac output. What nursing intervention should a nurse perform for this client?
- A. Perform exercises consistently.
- B. Keep legs horizontal.
- C. Auscultate lung and heart sounds.
- D. Measure urine output.
Correct Answer: D
Rationale: The nurse should monitor urine output every 8 hours or more often if it is less than 500 mL/day. Renal output reflects the heart's ability to perfuse the renal arteries. The client should not perform any exercises and should be on bed rest. Keeping the client's legs horizontal and auscultating lung and heart sounds will not help in this condition.
The client has been diagnosed with aortic regurgitation. Which nursing data is most significant in identifying the cause for this disorder?
- A. Obesity
- B. Tobacco use
- C. Fen-Phen
- D. Lack of exercise
Correct Answer: C
Rationale: The incidence of mitral and aortic regurgitation increased by as much as 36% in 1997, due to the use of fenfluramine with phentermine (Fen-Phen) for weight loss. Obesity, tobacco use, and lack of exercise have been identified as risk factors for heart disease but not a significant identified cause for aortic regurgitation.
A client is scheduled for transcatheter aortic valve implantation (TAVI). Which statement from the nurse best explains this procedure to family members?
- A. A small incision in the chest wall will allow for valve repair.
- B. A catheter is used for partial replacement of the valve.
- C. A small window incision is made so a pig valve can replace the diseased valve.
- D. A complete aortic valve replacement is the best surgical treatment.
Correct Answer: B
Rationale: TAVI procedure is a minimally invasive procedure (no incision) that uses balloon valvuloplasty, stent, and partial replacement of the diseased valve using a portion of a pig valve. The TAVI is mostly used in older adults who are at high risk for the complete aortic valve replacement and helps to relieve recurring symptoms.
A client reports a family history of aortic stenosis. Which assessment finding would the nurse identify as a likely contributing factor?
- A. High blood pressure
- B. Missing aortic cusp
- C. Unidirectional blood flow
- D. Chest pain
Correct Answer: B
Rationale: In young adults, aortic stenosis usually is a consequence of a congenital defect in which the valve has two instead of three cusps. High blood pressure and chest pain are symptoms that can be exhibited in aortic stenosis. Unidirectional blood flow is the normal flow of blood through the heart.