Progressive Care Nursing Certification (PCCN) Practice Exam

After mitral valve replacement, what is the most likely component to include in a patient's care plan?

1. Positive inotropic agent

2. Anticoagulant

3. Prophylactic antibiotic

4. ACE inhibitor

The correct answer is: Anticoagulant

After a mitral valve replacement, including an anticoagulant in the patient's care plan is essential due to the increased risk of thromboembolism that follows this type of surgery. The replacement of the mitral valve can lead to changes in the blood flow dynamics, which may create conditions favorable for blood clot formation, especially if a mechanical valve is used. Therefore, anticoagulation therapy is typically initiated to help prevent complications such as stroke or venous thromboembolism. Monitoring for appropriate anticoagulation levels, such as INR for patients on warfarin, is critical in managing the patient's safety and ensuring that the anticoagulant therapy is effective without leading to excessive bleeding. The presence of prosthetic material can also increase the need for such therapy compared to those with native valve disease, making this a crucial component of postoperative care following mitral valve replacement. While a positive inotropic agent, prophylactic antibiotics, and ACE inhibitors may be part of care for certain patients, their roles are not as central immediately after mitral valve replacement as anticoagulation. Positive inotropic agents may be utilized in cases of heart failure but are not universally necessary. Prophylactic antibiotics are typically reserved for those with a history of endocarditis or specific procedures