Medical Surgical Myocardial Infarction #3

Question

The nurse is caring for a young adult client following a balloon valvuloplasty of the aortic valve. During the post-procedure assessment, the nurse monitors for which complications related to valvuloplasty? Select all that apply.

Answers

  1. Sudden cardiac arrhythmia
    • Rationale:

      This answer is correct because complications of valvuloplasty include a sudden cardiac arrhythmia, such as atrial fibrillation, which makes the client at risk for emboli. Sudden mental status changes such as delirium may occur following post-procedure which may result from higher microembolic load, neuroinflammation in the brain, cerebral hypoperfusion, and alteration of cerebral acetylcholine levels. Nursing actions should include frequent reorientation strategies and neuro assessments immediately post-operatively.

  2. Emboli
    • Rationale:

      This answer is correct because due to the risk of atrial fibrillation, the client is at high risk of emboli. Therefore, coagulation therapy may be required postoperatively.

  3. Sudden mental status changes
    • Rationale:

      This answer is correct because sudden mental status changes such as delirium may occur following post-procedure which may result from higher microembolic load, neuroinflammation in the brain, cerebral hypoperfusion, and alteration of cerebral acetylcholine levels. Nursing actions should include frequent reorientation strategies and neuro assessments immediately post-operatively.

  4. Redness near the radial vein access site
    • Rationale:

      This answer is not correct because redness near the venous access site is incorrect since the access is arterial not venous. The most common site is the femoral artery.

  5. Stroke
    • Rationale:

      This answer is correct because of the potential for intraprocedure embolic event during a valvuloplasty. The nurse would monitor for stroke by neurological assessment by obtaining vital signs, observing for mental status changes, checking that pupils are equal, round, reactive to light and accommodation, testing central stimulus, and peripheral stimulus.

Overview

Complications of valvuloplasty include a sudden cardiac arrhythmia, such as atrial fibrillation, which makes the client at risk for emboli. Due to the risk of emboli and other neurologic effects, the client should be monitored for sudden mental status changes.

Explanation

Learning Outcomes

Complication of valvuloplasty is a sudden cardiac arrhythmia such as atrial fibrillation and heart block are risk factors, along with emboli. Therefore, coagulation therapy may be required postoperatively. Sudden mental status changes such as delirium may occur following post-procedure which may result from higher microembolic load, neuroinflammation in the brain, cerebral hypoperfusion, and alteration of cerebral acetylcholine levels. Nursing actions should include frequent reorientation strategies and neuro assessments immediately post-operatively.

Test Taking Tip

Watch for selections within “select all that apply” questions which may be symptoms of one of the selections, such as “emboli” and “sudden mental status changes” (which is caused by the emboli). Both are correct.

Video Rationale