Author Question: Antiinfective prophylaxis is indicated for a pregnant client with a history of mitral valve stenosis ... (Read 103 times)

2125004343 · **on:** Jun 28, 2018

Antiinfective prophylaxis is indicated for a pregnant client with a history of mitral valve stenosis related to rheumatic heart disease because the client is at risk of developing:

a. hypertension.
b. postpartum infection.
c. bacterial endocarditis.
d. upper respiratory infections.

Question 2

When planning intrapartum care for a client with heart disease, the nurse should include:

a. taking vital signs according to standard protocols.
b. continuously monitoring cardiac rhythm with telemetry.
c. massaging the uterus to hasten birth of the placenta.
d. maintaining the infusion of intravenous fluids to avoid dehydration.

Bsand8 · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: C
Because of vegetations on the leaflets of the mitral valve and the increased demands of pregnancy, the client is at greater risk of bacterial endocarditis. Pulmonary hypertension may occur with mitral valve stenosis, but antiinfective medications will not prevent it from occurring. Women with cardiac problems must be observed for possible infections during the postpartum period but are not given prophylactic antibiotics to prevent them. Women are not put on prophylactic antibiotics to prevent upper respiratory infections.

Answer to Question 2

ANS: B
A client with heart disease should have a cardiac monitor and possibly an arterial line for continuous blood pressure monitoring, as well as hemodynamic monitoring. Vital signs may need to be taken more frequently because of the extra workload on the heart. The uterus should not be massaged to hasten the birth of the placenta because this could cause undue overload on the heart. Circulatory overload can occur, so IV fluids may not be used or may be used minimally.