1. The nurse obtains a health history from an older patient with a prosthetic mitral valve who has
symptoms of infective endocarditis (IE). Which question by the nurse is most focused on
identifying a risk factor for I
...
1. The nurse obtains a health history from an older patient with a prosthetic mitral valve who has
symptoms of infective endocarditis (IE). Which question by the nurse is most focused on
identifying a risk factor for IE?
a. “Do you have a history of a heart attack?”
b. “Is there a family history of endocarditis?”
c. “Have you had any recent immunizations?”
d. “Have you had dental work done recently?”
ANS: D
Dental procedures place the patient with a prosthetic mitral valve at risk for IE. Myocardial
infarction, immunizations, and a family history of endocarditis are not risk factors for IE.
2. During the assessment of a young adult patient with infective endocarditis (IE), the nurse
would expect to find
a. substernal chest pressure. c. a pruritic rash on the chest.
b. a new regurgitant murmur. d. involuntary muscle movement.
ANS: B
New regurgitant murmurs occur in IE because vegetations on the valves prevent valve closure.
Substernal chest discomfort, rashes, and involuntary muscle movement are clinical
manifestations of other cardiac disorders such as angina and rheumatic fever.
3. The nurse identifies the nursing diagnosis of decreased cardiac output related to valvular
insufficiency for the patient with infective endocarditis (IE) based on which assessment
finding(s)?
a. Fever, chills, and diaphoresis
b. Urine output less than 30 mL/hr
c. Petechiae on the inside of the mouth and conjunctiva
d. Increase in heart rate of 15 beats/minute with walking
ANS: B
Decreased renal perfusion caused by inadequate cardiac output will lead to decreased urine
output. Petechiae, fever, chills, and diaphoresis are symptoms of IE but are not caused by
decreased cardiac output. An increase in pulse rate of 15 beats/min is normal with exercise.
4. When planning care for a patient hospitalized with a streptococcal infective endocarditis (IE),
which intervention is most appropriate for the nurse to include?
a. Arrange for placement of a long-term IV catheter.
b. Monitor labs for levels of streptococcal antibodies.
c. Teach the importance of completing all oral antibiotics.
d. Encourage the patient to begin regular aerobic exercise.
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