Good dental care is an important measure in reducing the risk of endocarditis. A teaching plan to promote good dental care in a client with mitral stenosis should include a demonstration of the proper use of:
A. A manual toothbrush
B. An electric toothbrush
C. An irrigation device
D. Dental floss
Correct Answer: A. A manual toothbrush
Daily dental care and frequent checkups by a dentist who is informed about the client’s condition are required to maintain good oral health. 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 B: Use of an electric toothbrush may cause the gums to bleed, introducing infection to the mucous membranes. The nurse practitioner and pharmacist must be aware of conditions that need antibiotic prophylaxis prior to any surgery or dental procedure.
Option C: An irrigation device may cause bleeding in the gums that may lead to infection. If a history of dental procedure is recognized, the time range from the procedure may range from 1 to 6 months prior to the onset of symptoms. The existence of endocarditis after routine heart surgery is low; however, in the setting of prosthetic material use, this can be a predisposing factor.
Option D: Dental floss may cause gums to bleed and allow bacteria to enter mucous membranes and the bloodstream, increasing the risk of endocarditis. There has been a significant reduction in the incidence of infective endocarditis in patients with a history of procedure, thanks to the recommendation of prophylactic treatment. However, not all procedures need prophylaxis.
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