Question

The nurse obtains a health history from an older adult with prosthetic mitral valve who has symptoms of infective endocarditis. Which question by the nurse helps identify a risk factor for IE?

a) Do you have a history of a heart attack?
b) Is there a family history of endocarditis?
c) Have you had any recent immunizations?
d) Have you had any dental work?

Answer 1

The question that helps identify a risk factor for infective endocarditis in a patient with a prosthetic mitral valve is 'Have you had any dental work?' Since dental procedures can introduce bacteria into the bloodstream, they are significant risk factors for those with prosthetic heart valves.

Step-by-step explanation:

To identify a risk factor for infective endocarditis (IE) in an older adult with a prosthetic mitral valve, the most relevant question a nurse can ask is d) Have you had any dental work? This is because during dental procedures, particularly those that may cause bleeding such as extractions or gum surgery, bacteria from the mouth can enter the bloodstream. In someone with a prosthetic heart valve like a mitral valve, this poses a risk because the valve is more susceptible to infection. Procedures that cause intentional or accidental breaches in normal barrier defenses, including dental work, can result in bacteria entering the bloodstream, which may lead to endocarditis in individuals with certain heart conditions.

Individuals with pre-existing heart damage, prosthetic valves, or a history of rheumatic fever have a higher risk for endocarditis. This disease can rapidly destroy the heart valves, and dental work is a well-known risk factor for introducing bacteria into the bloodstream that could cause such infections.