Cardiac-Vascular Nursing (CVRN) Practice Exam

Prior to which procedure should bacterial endocarditis prophylaxis be administered after heart valve surgery?

1. Colonoscopy

2. Sinus surgery

3. Plastic surgery

4. Dental procedures

The correct answer is: Dental procedures

Bacterial endocarditis prophylaxis is specifically indicated for certain procedures that pose a risk of introducing bacteria into the bloodstream, especially in patients who have had significant heart surgery, such as heart valve repair or replacement. This risk of bacteremia is particularly relevant during dental procedures, where invasive manipulation of the gums or oral cavity can potentially allow bacteria to enter the bloodstream. In the context of heart valve surgery, the guidelines typically emphasize the importance of prophylaxis during dental treatments since oral bacteria are a common cause of endocarditis. This is particularly critical for patients with prosthetic heart valves, previous endocarditis, or certain congenital heart defects. While colonoscopy and sinus surgery have their own risks, current guidelines generally do not recommend routine prophylaxis for these procedures unless there are specific risk factors. Additionally, plastic surgery falls into a different category of surgical management, where the risk and protocol regarding endocarditis prophylaxis are not emphasized. Thus, the requirement for bacterial endocarditis prophylaxis after heart valve surgery is primarily focused on dental procedures due to their potential to introduce bacteria into the bloodstream.