Medical Surgical Endocarditis #1

Question

The nurse is caring for a client with a new prosthetic cardiac valve and is preparing discharge teaching. During discharge teaching, the nurse should provide education on the importance of antibiotic prophylaxis prior to which of the following?

Answers

  1. When exposed to influenza or pneumococcal pneumonia
    • Rationale:

      This answer is not correct because it is not necessary for a client with a new prosthetic cardiac valve to take prophylactic antibiotics when exposed to influenza or pneumococcal pneumonia. To help reduce the risk of endocarditis, the client should take prophylactic antibiotics prior to any invasive procedure, including dental procedures.

  2. Prior to the next cardiac stress test
    • Rationale:

      This answer is not correct because a cardiac stress test does not require prophylactic antibiotics, even with a new prosthetic cardiac valve. To help reduce the risk of endocarditis, the client should take prophylactic antibiotics prior to any invasive procedure, including dental procedures.

  3. Before any dental procedures
    • Rationale:

      This answer is correct because clients receiving prosthetic cardiac valves are at a higher risk of having bacterial (infective) endocarditis. Prophylactic antibiotics are recommended prior to dental procedures to help prevent infective endocarditis.

  4. Prior to any trip outside the United States
    • Rationale:

      This answer is not correct because it is not necessary for a client with a new prosthetic cardiac valve to take prophylactic antibiotics prior to any trip outside the United States . To help reduce the risk of endocarditis, the client should take prophylactic antibiotics prior to any invasive procedure, including dental procedures.

Overview

Clients receiving prosthetic cardiac valves are at a higher risk of having bacterial (infective) endocarditis. Prophylactic antibiotics are recommended prior to dental procedures to help prevent infective endocarditis.

Explanation

Learning Outcomes

Bacterial endocarditis is a condition which can occur if a person has rheumatic heart disease. To help reduce this risk, the client should take prophylactic antibiotics prior to any invasive procedure, including dental procedures. Rheumatic heart disease occurs as the result of the client not adequately treating strep throat or scarlet fever. Rheumatic heart disease clients or clients receiving prosthetic cardiac valves are at a higher risk of having bacterial (infective) endocarditis. This is an infection that can be caused by bacteria which enters the bloodstream and attaches itself to the heart valve or cardiac blood vessel. This vegetation which grows within the heart valve or vessel and can result in serious heart damage or death related to emboli.

Test Taking Tip

Although a seemingly odd connection, there is a strange connection between prosthetic cardiac valves and the oral cavity. Besides understanding the pathophysiology behind the connection, think about a valve that opens and closes like the mouth that opens and closes.

Video Rationale