A nurse is teaching a group of parents about bacterial endocarditis (BE) and follow-up care. Which parents should be instructed to obtain prophylactic antibiotics prior to dental cleaning? (Select all that apply.)
A.
Child after complete repair via catheter for 1 year
B.
Child after transplant, no residual defect, for 6 months
C.
Child with congenital repair with residual defect, for life
D.
Child with one prior episode of bacterial endocarditis
E.
Child with prosthetic mitral valve for the first 6 months
ANS: B, C, D
Guidelines for who needs prophylaxis prior to invasive procedures were updated in 2007. They include children post-cardiac transplantation who do not have residual valve problems for 6 months post-transplant, any child with a residual defect after a surgical repair for the remainder of his or her life, and children who have already had one (or more) episode of BE. Prophylaxis after complete repairs is for 6 months. Prophylaxis after valve replacement is lifelong.
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