Priority Nursing Care
For a patient with a prosthetic pulmonary valve and fever, this nursing intervention should occur before administering IV antibiotics.
What is obtaining blood cultures?
This defect in Tetralogy of Fallot is primarily responsible for decreasing blood flow to the lungs and causing cyanosis.
What is pulmonary stenosis?
This is the primary goal of pulmonary valve replacement after Tetralogy of Fallot repair.
What is restoring one-way blood flow to the lungs and reducing right ventricular strain?
This daily habit is one of the most important ways to reduce the risk of infective endocarditis in patients with prosthetic heart valves.
What is maintaining good oral hygiene?
This assessment finding is most concerning for infective endocarditis.
What is a fever with a new heart murmur?
This abnormal circulation causes oxygen-poor blood to bypass the lungs and mix with oxygen-rich blood, leading to cyanosis in Tetralogy of Fallot.
What is right-to-left shunting (or mixing of oxygenated and deoxygenated blood)?
This imaging study is considered the gold standard for determining the timing of pulmonary valve replacement after TOF repair.
What is cardiac magnetic resonance imaging (cardiac MRI)?
After discharge, this symptom should be reported to the healthcare provider immediately because it may indicate recurrent infective endocarditis.
What is a fever greater than 100.4°F (38°C)?
Blood cultures are obtained before antibiotics for this reason.
What is identifying the organism causing the infection?
This is a common long-term complication after surgical repair of Tetralogy of Fallot that often leads to the need for pulmonary valve replacement.
What is pulmonary valve regurgitation?
Before cardiac MRI became the standard, clinicians commonly relied on these assessments to determine when pulmonary valve replacement was needed.
What are echocardiography, ECG, patient symptoms, and cardiac catheterization?
Patients with a Rastelli procedure and prosthetic pulmonary valve require lifelong follow-up with this specialist.
Who is an adult congenital cardiologist (or congenital heart disease specialist)?
This group of patients is at the highest risk for infective endocarditis.
Who are patients with prosthetic heart valves?
Patients who have undergone a Rastelli procedure require lifelong monitoring because this implanted structure may deteriorate over time.
What is the prosthetic pulmonary valve (or RV-to-pulmonary artery conduit)?
According to the research article, timely pulmonary valve replacement based on cardiac MRI guidelines helps preserve this chamber's function.
What is the right ventricle?
Following hospitalization for norovirus and EPEC gastroenteritis, this practice is most important for preventing reinfection and dehydration.
What are proper hand hygiene and maintaining adequate hydration?
This is the nurse's priority action when a patient with infective endocarditis suddenly develops hypotension, chest pain, and shortness of breath.
What is activate the rapid response team while assessing airway, breathing, and circulation (ABCs)?
This pathophysiologic change occurs when blood leaks backward through the pulmonary valve, causing the right ventricle to enlarge over time.
What is right ventricular dilation caused by pulmonary regurgitation?
Replacing the pulmonary valve before severe enlargement develops helps prevent this long-term complication.
What is irreversible right ventricular dysfunction?
Skipping these scheduled appointments or imaging studies increases the risk of missing deterioration of the prosthetic valve or RV-to-pulmonary artery conduit.
What are lifelong cardiology follow-up appointments and cardiac MRI/echocardiograms?