Medical Surgical Endocarditis #3

Question

Part of the plan of care for a client who recently received mechanical valve prosthesis is discharge education for home management. Which information will the nurse determine to have the most priority?

Answers

  1. The need to reschedule valve replacement within 5 years
    • Rationale:

      This answer is not correct because mechanical valves can last between 10-20 years. Regardless, discussing this is not a priority. The priority teaching is infection prevention (handwashing, avoidance of sick individuals and taking prophylactic antibiotics prior to any invasive procedure, including dental procedures) due to the risk of infective bacterial endocarditis .

  2. Report near high or low blood pressure and heart rates
    • Rationale:

      This answer is not correct because reporting borderline high or low blood pressure and heart rates are not priority over teaching on infection prevention. Nevertheless, reporting high or low heart rates (above and/or below parameters set by the healthcare provider—not borderline findings), palpitations, chest pain, shortness of breath, fluctuations in blood pressure, dizziness, and syncope are important to report.

  3. Strategies for preventing atherosclerosis
    • Rationale:

      This answer is not correct because although strategies for prevention of atherosclerosis are important, they are not a priority for immediate management of post-surgical and life-long management of valve prosthetics. The priority teaching is infection prevention (handwashing, avoidance of sick individuals and taking prophylactic antibiotics prior to any invasive procedure, including dental procedures) due to the risk of infective bacterial endocarditis .

  4. Strategies for infection prevention
    • Rationale:

      This answer is correct because bacterial endocarditis is a condition which can occur if a person has received a mechanical valve prosthesis. To help reduce this risk, the client should be taught infection prevention (handwashing, avoidance of sick individuals and taking 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. Infection prevention is a priority discharge teaching subject due to the risk of bacterial (infective) endocarditis.

Explanation

Learning Outcomes

Bacterial (infective) endocarditis is a condition which can occur if a person has received a mechanical valve prosthesis. To help reduce this risk, the client should be taught infection prevention (handwashing, avoidance of sick individuals and taking prophylactic antibiotics prior to any invasive procedure, including dental procedures). Bacterial endocarditis 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

It is important to remember the odd connection between the prosthetic heart valve and infective endocarditis. Prophylactic antibiotics are given for prosthetic heart valves when any procedure is done on the client. Remember “PROphylactic antibiotics and PROsthetic heart valve”.

Video Rationale