Page 1712 - Saunders Comprehensive Review For NCLEX-RN

b. Percutaneous route or open heart
surgical approach.
D. Valve replacement procedures
1. Mechanical prosthetic valves: These prosthetic valves
are durable
2. Risk of clot formation is high as the body reacts to the
artificial materials; anticoagulation is required.

Thromboembolism can be a problem following valve

replacement with a mechanical prosthetic valve, and lifetime
anticoagulant therapy is required.
3. Bioprosthetic valves
a. Biological grafts are xenografts (valves
from other species)—porcine valves
(pig), bovine valves (cow), or
homografts (human cadavers). These
valves are less durable than
mechanical prosthetic valves.
b. The risk of clot formation is small;
therefore, long-term anticoagulation
may not be indicated.
4. Open heart surgical approach.
5. Preoperative interventions: Consult with the PHCP
regarding discontinuing anticoagulants 72 hours
before surgery.

6. Postoperative interventions

a. Monitor closely for signs of bleeding.
b. Monitor cardiac output and for signs of
heart failure.
c. Administer digoxin as prescribed to
maintain cardiac output and prevent
atrial fibrillation.

d. Client education (Box 52-8).

XV. Cardiomyopathy (Table 52-5)
A. Description
1. Cardiomyopathy is a subacute or chronic disorder of
the heart muscle.
2. Treatment is palliative, not curative, and the client
needs to deal with numerous lifestyle changes and a
shortened life span.
B. Types, signs and symptoms, and treatment (see Table 52-5)
XVI. Vascular Disorders
A. Venous thrombosis
1. Description

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