The nurse is caring for a patient who has had a mitral valve replacement. What information does the nurse need to include in the discharge instructions?

A. Good dental hygiene: Patients with prosthetic heart valves are at increased risk for infective endocarditis. Maintaining excellent oral care, including regular brushing, flossing, and routine dental visits, helps reduce the risk of bacteremia from the oral cavity, which can seed the prosthetic valve. Patient education on this is a critical component of discharge instructions. B. Activity restrictions: While some activity modifications may be advised initially postoperatively, most patients gradually return to normal activity levels unless otherwise indicated. General activity restrictions are not as essential as infection prevention education for long-term valve care. C. Diet modifications: Unless the patient has comorbid conditions such as heart failure or hyperlipidemia, there are no specific diet modifications required solely due to mitral valve replacement. Nutritional education may be part of overall recovery but is not the primary discharge focus. D. Long-term antibiotics: Prophylactic antibiotics are not routinely prescribed long-term for all patients after valve replacement. They are reserved for specific situations, such as prior to dental or invasive procedures, and should be used according to current guidelines rather than as a daily long-term regimen.