✅✅
Which procedure describes splitting or separating fused cardiac valve
leaflets? - -commissurotomy
Commissurotomy is frequently used to repair mitral stenosis.
Annuloplasty refers to repair of a cardiac valve's outer ring. Chordoplasty
refers to repair of the chordae tendineae of atrioventricular valve leaflets.
Valvuloplasty is a general term that refers to repair of a stenosed or
regurgitant cardiac valve by commissurotomy, annuloplasty, leaflet
repair, and/or chordoplasty.
During assessment of a client admitted for cardiomyopathy, the nurse
notes the following symptoms: dyspnea on exertion, fatigue, fluid
✅✅
retention, and nausea. The initial appropriate nursing diagnosis is which
of the following? - -Decreased cardiac output
A primary nursing diagnosis for cardiomyopathy is decreased cardiac
output related to structural disorders caused by cardiomyopathy or to
dysrhythmia from the disease process and medical treatments. Dyspnea
on exertion, fatigue, and fluid retention are related to poor cardiac
output. Nausea is related to poor perfusion of the gastrointestinal
system. Autonomic dysreflexia is related to a spinal cord injury.
Ineffective airway clearance relates to the inability to clear secretions
from the airway, which is not an initial problem with cardiomyopathy.
Disturbed sensory perception is related to specific senses and not to
initial cardiomyopathy.
A nurse is caring for a client with acute mitral regurgitation related to an
acute myocardial infarction. The nurse knows to monitor the client
✅✅
carefully for symptoms of which initial complication or result? -
-Severe heart failure
Acute mitral regurgitation usually manifests as severe congestive heart
failure, resulting from blood flowing backward from the left ventricle to
the left atria and eventually into the lungs. Kidney failure could become a
problem later if cardiac output is too low, but not initially. CVA and an
infarcted bowel would not be caused by mitral regurgitation.
,A client is admitted to the hospital with aortic stenosis. What assessment
✅✅
findings would indicate the development of left ventricular failure? -
-Dyspnea, orthopnea, pulmonary edema
Signs and symptoms of progressive left ventricular failure include
breathing difficulties, such as orthopnea, PND, and pulmonary edema.
Distended jugular veins, pedal edema, and nausea are signs and
symptoms of right sided heart failure.
A nursing student is assigned to a patient with a mechanical valve
replacement. The patient asks the student, "Why do I have to take
✅✅
antibiotics before getting my teeth cleaned?" Which response by the
nursing student is most appropriate? - -"You are at risk of
developing an infection in your heart."
The patient is at risk for endocarditis and should take prophylactic
antibiotics before any invasive procedure. Antibiotics have nothing to do
with how much the teeth bleed. Cleaning of the teeth will not cause the
valve to malfunction. Using the word "vegetative" with the patient may
not be understood; therefore, it is not the most appropriate answer.
✅✅
The diagnosis of aortic regurgitation (AR) is confirmed by which of the
following? - -Echocardiography
Diagnosis is confirmed by echocardiography. Cardiac catheterization is
not necessary in most patients with AR. Exercise stress testing will
assess functional capacity and symptom response. A myocardial biopsy
may be performed to analyze myocardial tissue cells in patients with
cardiomyopathy.
A nurse is teaching a client about valve replacement surgery. Which
✅✅
statement by the client indicates an understanding of the benefit of an
autograft replacement valve? - -"The valve is made from my own
heart valve, and I will not need to take any blood-thinning drugs when I
am discharged."
, Autografts (i.e., autologous valves) are obtained by excising the client's
own pulmonic valve and a portion of the pulmonary artery for use as the
aortic valve. Anticoagulation is unnecessary because the valve is the
client's own tissue and is not thrombogenic. The autograft is an
alternative for children (it may grow as the child grows), women of
childbearing age, young adults, clients with a history of peptic ulcer
disease, and people who cannot tolerate anticoagulation. Aortic valve
autografts have remained viable for more than 20 years.
The nurse determines that a patient has a characteristic symptom of
✅✅
pericarditis. What symptom does the nurse recognize as significant for
this diagnosis? - -Constant chest pain
The most characteristic symptom of pericarditis is chest pain, although
pain also may be located beneath the clavicle, in the neck, or in the left
trapezius (scapula) region. Pain or discomfort usually remains fairly
constant, but it may worsen with deep inspiration and when lying down
or turning.
The nurse is caring for a patient diagnosed with pericarditis. What
✅✅
serious complication should this patient be monitored for? -
-Cardiac tamponade
The inflammatory process of pericarditis may lead to an accumulation of
fluid in the pericardial sac (pericardial effusion) and increased pressure
on the heart, leading to cardiac tamponade (see Chapter 29).
A nurse caring for a patient with mitral stenosis understands that the
✅✅
initial cause of disruption to the normal flow of blood through the heart is
due to: - -The increased resistance of a narrowed orifice between
the left atrium and the left ventricle.
Left atrial pressure increases because of the slowed blood flow into the
LV through the narrowed orifice. The left atrium dilates and
hypertrophies because of the increased blood volume. Pulmonary
venous pressure rises, and the circulation becomes congested. As a
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