Which treatment best applies to the care of a client newly diagnosed with infective endocarditis?

Complete bedrest for the duration of the treatment with subcutaneous enoxaparin.

Long-term anticoagulant therapy with IV heparin followed by oral warfarin.

Administration of IV penicillin, followed by oral penicillin for 10 weeks.

Hospitalization for initial IV antibiotics, followed by continued IV antibiotics at home.

Answer and Explanation

The Correct Answer is D

Choice A reason: Complete bedrest for the duration of the treatment with subcutaneous enoxaparin is not the best approach for managing infective endocarditis. While bed rest may be recommended initially to reduce cardiac workload, long-term bed rest is not necessary and could lead to complications such as muscle atrophy or thromboembolism. Subcutaneous enoxaparin is used for prophylaxis against deep vein thrombosis, but it does not address the underlying infection.

Choice B reason: Long-term anticoagulant therapy with IV heparin followed by oral warfarin is not the standard treatment for infective endocarditis. Although anticoagulant therapy may be necessary in some cases, such as for patients with prosthetic valves or specific cardiac conditions, it is not the primary treatment for the infection itself. The focus should be on eradicating the infection with appropriate antibiotics.

Choice C reason: Administration of IV penicillin, followed by oral penicillin for 10 weeks, is not the typical treatment regimen for infective endocarditis. While penicillin may be part of the antibiotic therapy, the duration and route of administration need to be tailored to the specific causative organism and the patient's clinical condition. Usually, a combination of antibiotics and a specific treatment plan is developed based on culture and sensitivity results.

Choice D reason: Hospitalization for initial IV antibiotics, followed by continued IV antibiotics at home, is the best treatment approach for a client newly diagnosed with infective endocarditis. This allows for intensive management and monitoring during the critical initial phase of treatment, ensuring that the infection is adequately controlled. Transitioning to continued IV antibiotics at home provides the necessary long-term therapy while allowing the patient to recover in a familiar environment. This approach ensures compliance with the treatment regimen and reduces the risk of complications.

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Correct Answer is A

Explanation

Choice A reason: Obtaining daily weights of the client is the best action to assess the therapeutic effect of furosemide in managing early chronic kidney disease. Daily weights provide valuable information about fluid balance and the effectiveness of the diuretic in reducing fluid retention. Consistent weight monitoring helps determine if the medication is achieving its goal of managing fluid overload, which is a common issue in CKD patients.

Choice B reason: Assessing acid-base balance is important in managing CKD, but it is not the primary action to assess the therapeutic effect of furosemide. While diuretics can influence electrolyte levels and acid-base balance, monitoring fluid status through daily weights is more directly related to evaluating the effectiveness of the medication.

Choice C reason: Assessing the client's serum creatinine is crucial for monitoring kidney function and progression of CKD. However, it is not the primary action to determine the therapeutic effect of furosemide. The focus of furosemide therapy is to manage fluid balance, and daily weights provide a more immediate and relevant assessment of this effect.

Choice D reason: Auscultating heart sounds is part of a comprehensive assessment of a CKD patient, but it is not the best action to evaluate the therapeutic effect of furosemide. Heart sounds can provide information about cardiac function and potential complications, but they do not directly measure the effectiveness of fluid management achieved by the diuretic.

A. You will not need vascular access to perform PD. B. This can be done in the comfort of your home. C. You will have no risk for infection with PD. D. You have some flexibility in when you do the exchanges. E. It takes less time than hemodialysis treatments.

Correct Answer is ["A","B","D","E"]

Explanation

Choice A reason: Not needing vascular access to perform PD is a significant advantage for patients. Peritoneal dialysis uses the peritoneal membrane in the abdomen as a filter to clean the blood, which eliminates the need for vascular access, such as fistulas or catheters required in hemodialysis. This can reduce the risks associated with vascular access, such as infections and complications related to surgical procedures.

Choice B reason: Being able to perform PD in the comfort of one's home is a major benefit. Patients can manage their dialysis treatments at home, which offers more convenience and flexibility compared to traveling to a dialysis center for hemodialysis sessions. This can greatly improve the quality of life and reduce the burden of frequent trips to healthcare facilities.

Choice C reason: Stating that there is no risk for infection with PD is inaccurate. While PD offers many benefits, it does carry a risk of peritonitis, an infection of the peritoneal cavity. Patients must be educated on proper technique and hygiene to minimize this risk. Hence, this statement is not accurate and should not be included as an advantage.

Choice D reason: Having flexibility in when to do the exchanges is another benefit of PD. Patients can schedule their dialysis exchanges at times that best fit their lifestyle and daily routines. This flexibility allows for greater independence and freedom compared to the fixed schedules required for in-center hemodialysis.

Choice E reason: PD can take less time than hemodialysis treatments, especially when considering travel and waiting times associated with in-center hemodialysis. Although the actual dialysis process for PD requires regular exchanges throughout the day or night, it integrates more seamlessly into daily life, making it a time-efficient option for many patients.

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Which treatment best applies to the care of a client newly diagnosed with infective endocarditis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is taking furosemide 40 mg/day for management of early chronic kidney disease (CKD). To assess the therapeutic effect of the medication, what action of the nurse is best?

Correct Answer is A

Explanation

A patient is unsure of the decision to undergo peritoneal dialysis (PD) and wishes to discuss the advantages of this treatment with the nurse. Which statements by the nurse are accurate regarding PD? Select all that apply.

Correct Answer is ["A","B","D","E"]

Explanation

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A nursing student learns about modifiable risk factors for coronary artery disease. Which factors does this include? Select all that apply.

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A nurse is caring for a patient with atrial fibrillation. In addition to an antidysrhythmic, what medication does the nurse plan to administer?

Nursing interventions such as taking daily weights, I&O, and monitoring specific gravity relate to which kidney function?

Which instruction would best reduce the symptoms of a client with heart failure and assure more comfort at home?

After a diagnosis of chronic kidney disease (CKD), the client was started on epoetin. Which finding indicates that the medication has been effective?