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The nursing instructor is teaching the junior nursing students about aortic regurgitation. What classification of drugs is used to sustains the client with aortic regurgitation?
- A. Antihypertensives
- B. Anticoagulants
- C. Cardiac glycosides
- D. Antiarrhythmics
Correct Answer: C
Rationale: Because aortic regurgitation is mild and only slowly progressive in most people, clients are sustained with cardiac glycosides or beta-blockers and diuretics. Antihypertensives, anticoagulants, and antiarrhythmics are not the type of drugs used to treat aortic regurgitation.
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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 caring for a client with a valvular disorder of the heart. What intervention should the nurse perform before administering the prescribed beta-blockers to clients with valvular disorders of the heart?
- A. Monitor the prothrombin time.
- B. Monitor for episodes of bleeding.
- C. Take the client's apical pulse.
- D. Monitor for bluish discoloration of the palms.
Correct Answer: C
Rationale: Before administering beta-blockers, the nurse should take the client's apical pulse. If the heart rate is less than 60 beats/minute, the nurse should withhold the drug and inform the primary healthcare provider. Oral anticoagulant therapy requires close monitoring of prothrombin time or INR. The nurse should also closely monitor clients receiving oral anticoagulants for episodes of bleeding. Overdosage of beta-blockers indicates bluish discoloration of the palms.
Which symptom is most important in determining the diagnosis and nursing care for a client experiencing pulmonary hypertension?
- A. Increased stroke volume
- B. Bradycardia
- C. Frothy sputum
- D. High systolic pressure
Correct Answer: C
Rationale: Tachycardia, low systolic pressure, and decreased stroke volume are symptoms associated with pulmonary hypertension. A productive cough with pink-tinged frothy sputum can indicate progression of the disorder and need for treatment.
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.
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.