Question 1

The nursing instructor is teaching the junior nursing students about aortic regurgitation. What classification of drugs are used to treat aortic regurgitation?

Accepted Answer

Cardiac glycosides are used to treat aortic regurgitation because they increase the force of myocardial contraction, which helps to reduce the amount of blood that regurgitates back into the left ventricle.

Question 2

What disease process is mitral regurgitation associated with?

Accepted Answer

Mitral regurgitation is most commonly associated with rheumatic carditis, which is inflammation of the heart valves caused by streptococcal infection. Aortic stenosis is a separate valve disorder, while cellulitis and pulmonary fibrosis are not associated with valve disorders.

Question 3

The nurse caring for a client with a diagnosis of mitral valve prolapse would recommend what when tachycardia occurs?

Accepted Answer

D

Question 4

A client has a suspected diagnosis of aortic valve regurgitation. What diagnostic test would reveal high left ventricular pressure and backward movement of blood?

Accepted Answer

Cardiac catheterization is the gold standard test for diagnosing aortic valve regurgitation. It allows for direct measurement of left ventricular pressure and can show the backward movement of blood through the aortic valve. Balloon angiography, cardiac enzyme blood work, and chest radiography would not provide the necessary information to confirm this diagnosis.

Question 5

You are the nurse caring for a client with mitral valve prolapse. What is the significance of a systolic murmur?

Accepted Answer

A systolic murmur in a client with mitral valve prolapse could indicate mitral valve regurgitation, where blood flows back into the left atrium during systole instead of being pumped out to the body. This can lead to potential complications such as heart failure if left untreated. Tightening of the chordae tendineae can cause an early or mid-diastolic murmur, while heart palpitations may be a symptom but would not be directly related to a systolic murmur. Impending heart failure would not be the immediate significance of a systolic murmur, but rather a potential complication if left untreated over time.

Question 6

A client with an incompetent aortic valve leaks blood backward into the left ventricle. What does this backflow cause in the left ventricle?

Accepted Answer

Backflow of blood into the left ventricle would increase the volume of blood in the ventricle, causing hypervolemia.

Question 7

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?

Accepted Answer

Before administering beta blockers to clients with valvular disorders of the heart, the nurse should take the client's apical pulse. Beta blockers can slow down the heart rate and exacerbate valvular stenosis or regurgitation, so it is important to assess the client's baseline heart rate and rhythm. If the client's heart rate is below 60 bpm or there are signs of heart block, the nurse should hold the medication and notify the healthcare provider. Monitoring the prothrombin time or for episodes of bleeding would be important for clients receiving anticoagulant therapy. Monitoring for bluish discoloration of the palms may be important in clients with peripheral vascular disease or Raynaud's disease, but it is not specifically related to valvular disorders.

Question 8

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?

Accepted Answer

The answer of The nurse is caring for a client...

Question 9

The nursing instructor is discussing the care of clients with valvular disorders. What nursing interventions would the instructor explain to the students are appropriate when a client with a valvular disorder of the heart is receiving oral anticoagulant therapy?

Accepted Answer

Monitoring prothrombin time (PT) is appropriate for clients receiving oral anticoagulant therapy as it helps to adjust the dosage of the medication to maintain a therapeutic level of anticoagulation and prevent bleeding or blood clots. Monitoring for adverse symptoms and blood pressure are important for all clients, not just those on anticoagulant therapy. Observing for symptoms of cinchonism is not relevant to clients with valvular disorders.

Question 10

A client with aortic valve regurgitation is asking about their disease process. What would you, as the nurse, tell the client is the first sign of aortic valve regurgitation?

Accepted Answer

The answer of A client with aortic valve regurgitation is...

Question 11

You are doing discharge teaching with a client who has a diagnosis of mitral valve prolapse. What would be important to include in your teaching to prevent tachycardia and heart palpitations?

Accepted Answer

Avoiding coffee is important to prevent tachycardia and heart palpitations as caffeine can be a stimulant for the heart. Increasing fluid intake and maintaining adequate sodium intake can be important for other aspects of mitral valve prolapse management, but they do not directly address the prevention of tachycardia and heart palpitations. Avoiding strenuous activities may be important for some individuals with mitral valve prolapse, but it is not specific to preventing tachycardia and heart palpitations.

Question 12

You are caring for a client with a valvular disorder. What nutritional intervention would be appropriate for a client with a valvular disorder?

Accepted Answer

Limiting sodium intake is appropriate for clients with valvular disorders as excess sodium can cause fluid retention and make the heart work harder.

Question 13

Your client is scheduled for a percutaneous balloon valvuloplasty. The client asks you how long it takes for the opening to close after the procedure. What would be your best response?

Accepted Answer

Percutaneous balloon valvuloplasty is a procedure used to open a narrowed heart valve. The opening created by the procedure can gradually narrow again over time, often within 6 months, due to restenosis.

Question 14

Your client is complaining of severe dizziness and drowsiness. On assessment, you find the client has bradycardia and a bluish discoloration of the palms and fingernails. What do these signs and symptoms indicate?

Accepted Answer

Severe dizziness, drowsiness, bradycardia, and bluish discoloration of palms and fingernails are all signs of overdose, which could be due to an overdose of medication or a toxic substance. Immediate medical attention is required. Cinchonism is a condition caused by an overdose of quinine or related compounds, which may cause symptoms such as tinnitus, headache, and nausea. Hypokalemia is a condition caused by low levels of potassium in the blood, which may cause symptoms such as weakness, palpitations, and muscle cramps. Hypertension is a condition characterized by high blood pressure, which may cause symptoms such as headache, dizziness, and blurred vision. None of these conditions alone would explain all of the client's symptoms.

Question 15

You are teaching a class of junior nursing students about valvular disease of the heart. What would you tell them is a symptom of aortic stenosis that is also a symptom of other valvular disorders?

Accepted Answer

Fatigue is a common symptom of aortic stenosis but it can also be a symptom of other valvular disorders such as mitral regurgitation or tricuspid regurgitation. Palpitations and pain are less commonly associated with valvular disorders.

Question 16

What is the best technique to identify structural changes in the mitral valve?

Accepted Answer

Transthoracic echocardiogram is the best technique to identify structural changes in the mitral valve. It is a non-invasive imaging test that uses high-frequency sound waves to produce images of the heart. It can provide detailed images of the mitral valve and allow clinicians to assess the degree of valve stenosis or regurgitation, as well as the extent of any structural abnormalities. Chest radiography and cardiac stress test may provide some information but are not as specific as the echocardiogram. Cardiac catheterization is an invasive test that may be required in some cases, but it is not typically used as a first-line diagnostic tool for mitral valve disease.

Question 17

A student nurse is caring for a client with mitral valve prolapse. The client's treatment is not working. The client asks you what would be the last treatment the physician would try. What would be your best response?

Accepted Answer

Valve replacement is typically the last resort treatment for mitral valve prolapse if other treatments are not successful.

Question 18

You are a clinic nurse caring for a client with a suspected valvular disorder of the heart. The client is suspected of having ventricular enlargement. What diagnostic test would be used to confirm a diagnosis of ventricular enlargement?

Accepted Answer

Chest radiograph is used to confirm a diagnosis of ventricular enlargement.

Question 19

A nurse is teaching a client with mitral stenosis. What is appropriate client education for the nurse to give to a client with mitral stenosis who is dyspneic at night?

Accepted Answer

Sleeping in a sitting position can help alleviate dyspnea in clients with mitral stenosis since it reduces the pressure on the lungs and the heart, making it easier to breathe. This position also reduces congestion in the lungs and other airways. Sleeping during the day or taking sleeping pills may interfere with the client's daily routine and might not address the issue of dyspnea. Sleeping in a flat position with the face parallel to the ceiling can make it difficult for the client to breathe, increase the workload of the heart, and worsen dyspnea.

Question 20

You are caring for a 77-year-old male newly diagnosed with aortic valve stenosis. The client tells you he has never been sick before and wants to know what has caused his problem. What is the best response to this client?

Accepted Answer

Aortic valve stenosis is an age-related degenerative change caused by the progressive buildup of calcium deposits on the aortic valve.

Quiz 24: Caring for Clients With Valvular Disorders of the Heart