Question 1

A student nurse is caring for a client with Infective Endocarditis. When the nursing instructor asks the student the etiology and pathophysiology of Infective Endocarditis, what would be an appropriate response by the student?

Accepted Answer

The most common causative agent of Infective Endocarditis is Streptococcus viridians. The pathophysiology of Infective Endocarditis involves the development of a bacterial or fungal infection on the endothelial layer of the heart, typically on the heart valves. The inflammation caused by this can lead to the formation of vegetations, which can cause valve destruction or embolization.

Question 2

The nursing instructor is discussing thrombophlebitis and venous stasis. What would the instructor tell the students is the best nursing intervention to help prevent venous stasis and thrombophlebitis for at-risk clients?

Accepted Answer

The best nursing intervention to help prevent venous stasis and thrombophlebitis for at-risk clients is to promote activity and exercise. This is because activity and exercise can promote venous return and prevent blood pooling in the lower extremities, which leads to the development of venous stasis and thrombophlebitis. Applying knee- or thigh-high elastic stockings and using a pneumatic venous compression device can be helpful in preventing venous stasis and thrombophlebitis, but they are not as effective as promoting activity and exercise. Promoting ankle-pumping exercises can help to some extent, but they may not be feasible for all at-risk clients. Therefore, promoting activity and exercise is the best nursing intervention.

Question 3

A student nurse is caring for a client with thromboangiitis obliterans. What self-care techniques should the student teach this client?

Accepted Answer

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Question 4

A young mother brings her 4-year-old in to the pediatric clinic with a mild fever and a red, spotty rash that is beginning to fade. The child's heart rate is rapid and the rhythm is abnormal. The mother states the child has been healthy until about 3 weeks ago when the child had a sore throat. You suspect Rheumatic Carditis. What organism causes Rheumatic Carditis?

Accepted Answer

Rheumatic Carditis is a complication of rheumatic fever which is caused by Group A beta-hemolytic strep infection.

Question 5

The nurse is caring for a client with Infective Endocarditis. The nurse teaches the client that they will have to take antibiotics periodically for the rest of the client's life. The client wants to know why. What would be the nurse's best answer to the client?

Accepted Answer

Once someone has had infective endocarditis, they are at a higher risk for developing it again. Antibiotics can help prevent the bacteria from growing on the heart valve and possibly causing another infection.

Question 6

A client with thrombophlebitis is admitted to your unit. What would be important to assess this client for?

Accepted Answer

Homans' signs are important to assess for in a client with thrombophlebitis. This involves assessing for pain in the calf when flexing the foot (known as dorsiflexion). Chvostek's sign is used to assess for hypocalcemia, Trousseau's sign is used to assess for hypocalcemia or hypomagnesemia, and Virchow's triad refers to the three factors that contribute to the formation of blood clots (stasis of blood flow, damage to blood vessel walls, and alterations in blood coagulation).

Question 7

You are admitting a client to the Emergency Department (ED), brought in by the paramedics, who has a presumptive diagnosis of emboli to the brain. What is the result of emboli to the brain?

Accepted Answer

Emboli to the brain can result in cerebrovascular accidents or strokes, which can cause neurological deficits and even death. Flank pain and renal failure are not typically associated with emboli to the brain. Sudden chest pain and dyspnea may be indicative of a pulmonary embolism, which is not the presumptive diagnosis given for this patient.

Question 8

You are doing client teaching with a client diagnosed with cardiomyopathy. What advice is incorrect to provide a client with cardiomyopathy?

Accepted Answer

Daily exercise for 2 to 3 hours is not appropriate for clients with cardiomyopathy, as it can put undue stress on the heart. Clients with cardiomyopathy should engage in physical activity as tolerated and as prescribed by their healthcare provider.

Question 9

You are caring for a client with pericarditis. What instructions should you provide a client with pericarditis who is suffering from decreased cardiac output?

Accepted Answer

Restricting caffeine and sodium can help to reduce the workload on the heart and decrease the symptoms of decreased cardiac output. Mild exercises may be encouraged as long as they do not exacerbate symptoms. Laying on the right side is not recommended as it can increase pressure on the heart. Administering anti-inflammatory drugs and analgesics may be a part of the treatment plan, but this alone does not address decreased cardiac output.

Question 10

A client with Infective Endocarditis is admitted to your unit. The client asks you how long they will be on IV medication. What should you respond?

Accepted Answer

The standard treatment for Infective Endocarditis typically involves a prolonged course of intravenous (IV) antibiotics, often for 2 to 6 weeks, depending on the causative organism, the presence of any prosthetic material, and the patient's response to treatment. This extended duration is necessary to ensure the complete eradication of the infecting bacteria from the heart valves or endocardial surface.

Question 11

The nurse is caring for a client with cardiomyopathy. What drugs should the nurse expect to be ordered to promote effective heart contractions and adequate cardiac output?

Accepted Answer

Cardiac glycosides, such as digoxin, are used to promote effective heart contractions and increase cardiac output in clients with cardiomyopathy. They work by increasing the force of myocardial contractions and slowing the heart rate, which helps to improve cardiac output. Sodium tablets may be used to help regulate electrolyte imbalances, but they do not directly promote heart contractions. Beta-blockers may be used to decrease heart rate and blood pressure, but they are not typically used to increase cardiac output in clients with cardiomyopathy. Antibiotics may be used to treat infections, but they do not directly affect cardiac function.

Question 12

In the clinic, you are caring for a client with Buerger's disease. What is a common symptom of Buerger's disease?

Accepted Answer

Intermittent claudication, or pain and cramping in the legs during physical activity, is a common symptom of Buerger's disease. Other symptoms may include skin ulcers, numbness and tingling in the feet, and a decrease in the temperature of the affected legs or feet. Cyanosis, redness, and black gangrenous areas may occur in advanced stages of the disease.

Question 13

The nurse is performing client teaching with a client who has just been diagnosed with cardiomyopathy. What instructions should the nurse provide a client with cardiomyopathy to avoid pulmonary complications that may compromise cardiopulmonary function?

Accepted Answer

The answer of The nurse is performing client teaching with...

Question 14

The nurse is precepting a new graduate nurse. Together they are caring for a client with infective endocarditis. What is a sign of infective endocarditis?

Accepted Answer

The answer of The nurse is precepting a new graduate...

Question 15

You are caring for a client with thrombophlebitis. When assessing this client, what would be most important to assess for?

Accepted Answer

Thrombophlebitis can lead to a pulmonary embolism, which presents with symptoms like chest pain and dyspnea, making it crucial to assess for these signs.

Question 16

The instructor is talking with a nursing student who is caring for a client with pericarditis. The instructor asks the student to name the main characteristic of pericarditis. What should be the student's answer?

Accepted Answer

The main characteristic of pericarditis is precordial pain, which is a sharp, stabbing pain behind the sternum that may radiate to the neck, shoulders, back, or abdomen. Dyspnea, fever, and respiratory symptoms may also be present but are not the main characteristic of pericarditis.

Question 17

An 85-year-old woman is brought to the Emergency Department (ED) by her son. The son tells the nurse that his mother is short or breath, even when she is lying down. She complains of constant fatigue and her legs swell. What type of cardiomyopathy would the nurse suspect the client has?

Accepted Answer

The symptoms described, such as shortness of breath even when lying down (orthopnea), constant fatigue, and leg swelling (edema), are indicative of heart failure, which is commonly associated with dilated cardiomyopathy. This condition leads to the heart's diminished ability to pump blood effectively, often resulting in these symptoms.

Question 18

Which type of cardiomyopathy is associated with syncope?

Accepted Answer

Hypertrophic cardiomyopathy is associated with a high risk of syncope due to various causes including arrhythmias, obstructed blood flow, and autonomic dysfunction.

Question 19

The nurse is writing a plan of care for a client diagnosed with thrombophlebitis. The client has impaired tissue perfusion. What nursing interventions should the nurse perform on a client with thrombophlebitis having impaired tissue perfusion?

Accepted Answer

Elevating the affected extremity in a straight plane on pillows will facilitate blood flow and promote venous return, improving tissue perfusion. Bending the client's knees or instructing the client to sit and cross the legs at the knee will impede blood flow and worsen impaired tissue perfusion. Applying cold compresses may provide comfort but will not directly improve tissue perfusion.

Question 20

You are caring for a client with myocarditis. The physician has ordered the client to be placed on bed rest. The client asks you why they have to be on bed rest. What is your best answer?

Accepted Answer

The workload of the heart is reduced while on bed rest, allowing it to heal faster. This is the reason why the physician has ordered bed rest for the client with myocarditis.

Quiz 23: Caring Forclients With Infectious and Inflammatory Disorders of the Heart and Blood Vessels