The nurse is caring for a client with suspected infectious endocarditis. Which information obtained in the health history could contribute to the development of this problem?
Breast cancer treated with chemotherapy and radiation
Periodontal disease and gum surgery three months ago
Type II diabetic for ten years
Myocardial infarction one year ago
The Correct Answer is B
A. Breast cancer treated with chemotherapy and radiation: While cancer and its treatments can suppress the immune system, they are not direct causes of infectious endocarditis. The condition is more closely related to bacteremia and structural heart damage.
B. Periodontal disease and gum surgery three months ago: Periodontal disease involves chronic bacterial infection of the gums and supporting structures of the teeth, this transient bacteremia can lead to infectious endocarditis. Oral infections and invasive dental procedures can introduce bacteria into the bloodstream, particularly streptococci, which can colonize damaged heart valves and cause infectious endocarditis.
C. Type II diabetic for ten years: Diabetes increases the risk of infection generally, but it is not a specific cause of endocarditis. Without a portal of entry or bacteremia, the condition alone is not strongly associated with endocarditis.
D. Myocardial infarction one year ago: A prior MI may result in reduced cardiac function but does not directly lead to infectious endocarditis unless it has resulted in damaged valves or introduced infection, which is not indicated here.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Ensure all tubing connections are tightened: Tight tubing connections are critical in preventing accidental disconnection, which can result in rapid blood loss and air embolism. Arterial lines are under high pressure, so securing all connections is a top priority to ensure patient safety and maintain line integrity.
B. Apply a pressure dressing to the insertion site: A transparent occlusive dressing not a pressure dressing is used for arterial lines to allow for site visualization and reduce the risk of infection. A pressure dressing could obscure signs of bleeding or compromise the catheter’s position.
C. Perform an Allen's test: Allen’s test is performed prior to radial arterial line insertion to assess collateral circulation via the ulnar artery for preventing ischemic complications if the radial artery is compromised. Performing the test afterward does not prevent complications and is no longer relevant once the catheter is placed.
D. Obtain a portable x-ray to confirm placement: X-rays are used to confirm the placement of central lines, not peripheral arterial lines like the radial line. Arterial line placement is confirmed by waveform analysis and blood return, not imaging.
Correct Answer is B
Explanation
A. Diaphoresis, hypertension: While diaphoresis may occur in response to the discomfort or anxiety caused by a rapid heart rate, hypertension is not a typical feature of atrial flutter. The rapid ventricular response can more often lead to hypotension if cardiac output is compromised.
B. Palpitations, shortness of breath: These are hallmark symptoms of rapid atrial flutter. Palpitations result from the fast, irregular atrial contractions, while shortness of breath may occur due to decreased cardiac output and poor ventricular filling during rapid rates.
C. Systolic murmur, severe anxiety: Atrial flutter is not typically associated with a systolic murmur unless there is a pre-existing valvular condition. Anxiety may be present but is a nonspecific response and not as directly linked to atrial flutter as palpitations and dyspnea.
D. Visual changes, anorexia: These symptoms are not characteristic of atrial flutter. Visual changes may occur with severe hypotension or embolic events, and anorexia may be seen in chronic illness, but neither is directly tied to the acute presentation of atrial flutter.
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