Heart Failure & Valvular Diseases Q 43 - Gyan Darpan : Learning Portal
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Thursday 28 April 2022

Heart Failure & Valvular Diseases Q 43

When developing a teaching plan for a client with endocarditis, which of the following points is most essential for the nurse to include?
     A. “Report fever, anorexia, and night sweats to the physician.”
     B. “Take prophylactic antibiotics after dental work and invasive procedures.”
     C. “Include potassium rich foods in your diet.”
     D. “Monitor your pulse regularly.”

Correct Answer: A. “Report fever, anorexia, and night sweats to the physician.”

An essential teaching point is to report signs of relapse, such as fever, anorexia, and night sweats, to the physician. An early manifestation of the disease is mild. Prolonged duration of fever that persists for several months without other manifestations may be the only symptom. On the other hand, the onset can be acute and severe with high, intermittent fever.

Option B: To prevent further endocarditis episodes, prophylactic antibiotics are taken before and sometimes after dental work, childbirth, or GU, GI, or gynecologic procedures. Antibiotic therapy can be adjusted depending on the clinical status of the patient and laboratory findings regarding antibiogram. Antibiotics should be administered intravenously to achieve reliable sustained therapeutic levels.
Option C: A potassium-rich diet is not necessary for patients with endocarditis. In 2007, the AHA modified their infective endocarditis prophylaxis guidelines, and the indications for prophylaxis were reduced for dental procedures, genitourinary, and gastrointestinal tract procedures.
Option D: Daily pulse monitoring isn’t necessary for a client with endocarditis. The presence of a new heart murmur or sounds of changing heart murmur is associated with heart failure. Splenomegaly, Roth spots, Janeway lesions, splinter hemorrhage, Osler nodes, and petechial are frequently seen.

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