For patient care with heart valve prosthesis, the nursing consultation comes as technological strategy of important and resolute care, backed by law, privative of the nurses, and offers numerous advantages in the care provided, facilitating health promotion, diagnosis and early treatment, in addition to prevention of avoidable situations [1] .

In the year 2012, there were held in Brazil 7461 procedures for exchanging heart valve, with a predominance of procedures performed in the South, followed by the Northeast, where mortality rate remained at 8%. This value is reduced when only analyzed the State of Ceara, which had a mortality rate of 4.62% over the same period [2] .

For reduction of the mortality rate by heart valve diseases, it is critical that patients undergoing valve replacement surgery are provided with an accompaniment of a multidisciplinary team during the hospitalization period, continuing after discharge. The carefully planned, systematic, competent and accountable offered to the patient in all operative phases and appropriate outpatient follow-through education for health contributes to better and faster rehabilitation [3] .

Given the above, it is necessary that the nurse, as a member of the multidisciplinary team, performs nursing consultation including educational, management, coordination and implementation of nursing care actions to encourage the patient, the family and the community to practice self-care [4] . The purpose of patient education is to increase his competence and confidence for self-management, in order to increase his responsibility and independence for self-care [5] .

The self-care practice is essential to prevent complications and to maintain the clinical stability of the patient. So it is important that the health care team recognizes these practices in order to implement an effective and quality care for promotion of self-care and prevention of complications.

It is believed that the results of this study can contribute to the recognition of the patient's peculiarities with mechanical heart valve, as the evolution of these patients is directly related to the practice of self-care and adherence throughout their lives, requiring constant, rigorous monitoring of the multidisciplinary team; in addition to direct care to an individual and a holistic manner, focusing on the real needs of the patient.

The context described above gives rise to the following driver questioning of this research: Which are the self-care practices performed by patients with mechanical valve prosthesis, considering the universal requirements, developmental and health deviation? The objective was to evaluate self-care practices performed by patients with mechanical valve prostheses followed in nursing consultation.

It is a descriptive study with cross-sectional design, quantitative, which took as a reference the theoretical model of Dorothea Orem [6] , who determines as self-care concept the ability that the individual has to play or practice activities for his own benefit, in order to maintain life, health and their well-being.

The study was conducted in two anticoagulation clinics for patients with mechanical heart valve prosthesis located in the city of Fortaleza/CE, from October 2013 to January 2014. The population was composed of patients undergoing cardiac surgery mechanical valve replacement followed in these clinics.

Self-care practices include the universal self-care requirements, developmental and health deviations. Universal self-care requirements contemplated seven practices: body care, oral hygiene, fluid intake, food intake, intestinal and urinary elimination, physical exercise and sleep and rest. Self-care developmental requirement addressed a practice that included smoking, drinking and illicit drug use. The requirements related to health deviations contemplated four practices: regular use of medication, attendance at health team consultations, INR control, knowledge about the disease and treatment. In total, there were 12 self-care practices; each contained the essential actions of each practice, ranging from three to eight shares for self-care practice.

To evaluate self-care, each share corresponds to a point. However, the Brazilian Guidelines for Valvular Heart Diseases [7] state that the embolic and hemorrhagic events and endocarditis are the most common and clinically significant complications of long-term replacement valve. Furthermore, valvular heart disease is associated with traditional risk factors for atherosclerosis, such as hyperlipidemia, and smoking.

Thus, oral hygiene practices, food intake, smoking, alcohol consumption, illicit drugs, regular use of medication, INR control and attendance at health team consultations took different score, weighing 2. The score rangedfrom zero to 86 points.

After getting the data, according to the description of the procedures of self-care practices, the score achieved was categorized using the classification based on P_33.3 and P_66.6 tertiles. So the three bands were: poor to 58 points, regular between 59 and 68, and excellent 68 to 83 (which was the highest score found).

For statistical analysis there were calculated the averages and standard deviations of socio demographic variables. The tests Student t and F of Snedecor (ANOVA) were used to comparing the means of quantitative variables. For the proportion of tests there were used the chi-square test and the likelihood ratio. There were considered as statistically significant the analysis with p < 0.05.

The ethical and legal aspects were complied according to Resolution 466/2012 [8] , being initiated the study after consideration and approval by the Ethics Committee of the Federal University of Ceara, under the Protocol N˚ 422.098.

The predominant sociodemographic characteristics of patients with mechanical heart valve prostheses were women (56.7%), the predominant age group was 40 - 59 years old (50.4%), more than 5 years of education (69.2%), married (63.8%), family income of a minimum wage (53.5%), non-white (55.1%), absence of labor activity (80.3%), Catholics (74%).

For clinical data related to valve surgery there were more frequent due to valve disease mitral stenosis (12.6%) and aortic insufficiency (12.6%), the affected valve was the mitral (52%), rheumatic fever history (56.6%) and surgery was performed more than 10 years ago (40.5%).

There were identified the practices of AC considering the requirements of universal self-care, developmental and health deviation of patients with mechanical valve prosthesis, according to the steps of the Theory of Orem’s Self-Care [6] , described in Tables 1-3.

Regarding the practice of personal hygiene, most patients performed the actions related to this practice. Among these actions, washed hair (97.6%) and daily bath (92.1%) were the most frequently performed.

In practice oral hygiene, it was found that 87.4% brushed their teeth before bed and 72.4% brushed their teeth after the main meals. But there was an AC deficit in relation to flossing, whose action was not performed by 70.9% of patients, as well as a high percentage of patients (71.7%) still used toothpick after meals, which confers a risk for bleeding and endocarditis.

In relation to food ingestion, it was observed that the actions related to such practice were followed by most patients. However, there was an AC deficit especially in items: balanced intake of foods containing vitamin K (32.1%) and it is approximately 5 to 6 meals per day (36.3%).

For the practice of smoking, drinking and illegal drugs, it was found that most patients adhered to the neces-