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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.
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A client with progressive mitral valve prolapse is experiencing sympathetic nervous system symptoms in addition to prolapse symptoms. Which teaching point should be stressed by the nurse to minimize these effects?
- A. Antibiotic therapy before invasive procedures
- B. Low-dose aspirin daily
- C. Avoid caffeine.
- D. Decrease fluid and sodium intake.
Correct Answer: C
Rationale: The symptoms associated with sympathetic nervous response (anxiety, agitation, nervousness, and palpitations) are often managed with antianxiety medications and advisement to avoid caffeine and over-the-counter medications that contain stimulants. Periodic antibiotic therapy use before an invasive procedure is not associated with sympathetic nervous system symptoms. Low-dose aspirin is used to prevent thrombus formation. Decreasing fluid and sodium intake is indicated for the control of congestive failure.
A client with mitral stenosis develops a productive cough with pink, frothy sputum. The best interpretation made by the nurse would be to further evaluate for which complication?
- A. Pulmonary edema
- B. Congestive failure
- C. Thrombophlebitis
- D. Cardiogenic shock
Correct Answer: A
Rationale: A cough with productive, pink, frothy sputum and crackles in the bases of the lungs are signs of pulmonary congestion. Pink, frothy sputum would not be present in congestive failure, thrombophlebitis, or cardiogenic shock.
The client is scheduled for a percutaneous balloon valvuloplasty. The client asks the nurse how long it takes for the opening to close after the procedure. How should the nurse respond?
- A. Within 1 week
- B. Within 1 month
- C. Within 6 months
- D. Within 1 year
Correct Answer: C
Rationale: The opening usually closes within 6 months of a percutaneous balloon valvuloplasty. It usually takes longer than 1 week or 1 month, but less than 1 year.
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.
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.