The nurse in the oral surgery clinic reviews a client's medical record prior to surgery. Which will the nurse immediately report to the oral surgeon? Select all that apply.

Question

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Clients with a history of congenital heart disease and those with prosthetic valves are at risk for developing infective endocarditis, an infection of the endothelial lining of the heart, with oral surgery and certain procedures (eg, dental work). These clients should receive prophylactic antibiotic therapy prior to any such procedure or surgery. Clients on warfarin therapy due to the presence of prosthetic valves or for other reasons will have a therapeutically elevated International Normalized Ratio (2.0-3.0) to inhibit blood clot formation. However, this will place these clients at risk for excessive bleeding during surgical procedures (Options C, D, and F). (Option A) A history of obesity and a calorie-restricted diet are not significant for oral surgery. (Option B) This creatinine level is within normal limits (0.6-1.3 mg/dL [53-115 µmol/L]) and would not require reporting. Educational objective: Prior to oral surgery, it is necessary to report findings that will place a client at risk for the development of endocarditis (eg, presence of prosthetic valves, history of congenital heart disease) and bleeding (eg, elevated International Normalized Ratio).

The Nurse in the Oral Surgery Clinic Reviews a Client's