Nokea
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.
You may also like to solve these questions
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.
What is the best technique to identify structural changes in the mitral valve?
- A. Chest radiography
- B. Cardiac catheterization
- C. Transthoracic echocardiogram
- D. Cardiac stress test
Correct Answer: C
Rationale: Standard transthoracic or transesophageal echocardiography is the best technique to identify structural changes in the mitral valve because the performance of the valve during the cardiac cycle can be evaluated. Chest radiography shows structures in the chest. Cardiac catheterization evaluates patency of arteries and measures pressures in cardiac chambers. Cardiac stress testing shows areas of the heart muscle that may become ischemic with exercise.
The nurse is interviewing a client who is being admitted for possible mitral regurgitation. Which historical fact is of greatest value to the nurse?
- A. Congenital neural tube defect
- B. Rheumatic fever
- C. One-pack-a-day smoker for 20 years
- D. Pacemaker inserted 2 years ago
Correct Answer: B
Rationale: Rheumatic fever and subsequent heart disease is the prominent cause of valvular insufficiency. Congenital neural tube defect is associated with spina bifida not mitral regurgitation. Smoking and insertion of pacemaker are significant to heart disorders but not of greatest value as rheumatic fever.
A client with aortic valve regurgitation is asking about the disease process. What would the nurse tell the client is the first sign of aortic valve regurgitation?
- A. Tachycardia
- B. Left-sided heart failure
- C. Pain
- D. Dysrhythmias
Correct Answer: A
Rationale: Tachycardia is one of the first signs of cardiac compensation. When valve damage affects the left ventricle, the client becomes aware of forceful heart contractions (palpitations). At first, palpitations occur only when lying flat or on the left side. Aortic valve regurgitation does not produce left-sided heart failure, pain, or dysrhythmias as the first symptom of disease.
A client with aortic regurgitation is experiencing dyspnea and chest pain with activity. The nurse knows that the cause of the symptoms can be best determined by which diagnostic test?
- A. Radionuclide scan
- B. Electrocardiogram (ECG)
- C. Transesophageal echocardiogram (TEE)
- D. Magnetic resonance imaging (MRI)
Correct Answer: A
Rationale: Because the symptoms occur with activity, a radionuclide scan could compare the blood flow through the heart at rest and during activity, giving valuable information about the severity of the diseased valve. ECG, TEE, and MRI are diagnostic tests used in the diagnosis of cardiac disease but less specific for exercise evaluation.