5-cardiac

A nurse is providing teaching to a client who has hypertension and a new prescription for hydrochlorothiazide. Which of the following instructions should the nurse provide? Weigh weekly to monitor therapeutic effect. Take the medication on an empty stomach. Take the medication early in the day. Muscle pain is an expected adverse effect.

c)

The client complains of fatigue, vertigo, and shortness of breath with daily activities. Current vital signs are: blood pressure 86/46 mm Hg, pulse rate 100/min, respiratory rate 28/min. Oxygen saturation 94% on 2 L via nasal cannula. Client has an 18 g capped IV in the right antecubital space. There is a new prescription for 0.9% sodium chloride at 125 mL/hr. There is also a prescription for the transfusion of 2 units of packed RBCs; the first unit has been ordered from the blood bank. Oxygen is to be titrated to maintain an oxygen saturation of 92%.

18 g

0900: Client admitted with report of chest pain radiating to the left arm, sweating, shortness of breath, and epigastric discomfort.Client awake, alert, and oriented x3.Lung sounds clear bilaterally, S1S2 heart sounds noted.All pulses palpable.

The nurse should administer oxygen to the client at 2 L/min via nasal cannula and request a prescription for aspirin 325 mg because the client is likely experiencing a myocardial infarction. When hypoxemia is present, oxygen is prescribed to maintain the arterial oxygen saturation at 90% or greater. Aspirin therapy inhibits platelet aggregation and vasoconstriction, decreasing the likelihood of thrombosis. The nurse should monitor the client's electrocardiogram (ECG) rhythm. Dysrhythmias are the leading cause of prehospital death in clients who have acute coronary syndrome (ACS). The nurse should also monitor the client's vital signs to ensure there are no complications such as cardiogenic shock.

The client reports nausea, vomiting, diarrhea, and weakness over the past 4 days. Skin warm, dry, and scaly. Skin turgor poor. Dark circles noted under eyes. Oral mucosa dry with thick, white coating on tongue. Alert and oriented at present but states has "been foggy last couple of days and vision has been blurry." Heart sounds distant with frequent early beat. Lungs clear to auscultation. No peripheral edema noted. Abdomen soft and flat with hypoactive bowel sounds. Generalized abdominal tenderness with palpation. Voids small amount dark yellow odorous urine. History of congestive heart failure, recurrent UTIs, and benign prostate hypertrophy.

The nurse should initiate a peripheral venous access and place the client on a cardiac monitor because the client is most likely experiencing digoxin toxicity, which can include manifestations of nausea, vomiting, diarrhea, and mental and visual disturbances. The nurse should monitor the client for dysrhythmias and monitor the client's electrolytes because digoxin toxicity and hypokalemia cause an increase in cardiac automaticity that can result in ectopic beats.

The client arrives to the ED and reports a "fluttering" and "racing" heartbeat. The client also reports dizziness and shortness of breath. Client placed on telemetry, cardiac rhythm is irregular, tachycardic and has unclear P waves. Blood pressure 165/88 mm Hg Pulse rate 126/min Respiratory rate 22/min Oxygen Saturation 94% on room air Name 2 actions + 2 monitor to assess teh client's progress.

The nurse should obtain a 12-lead ECG and administer an anticoagulant as prescribed because the client is most likely experiencing atrial fibrillation. Atrial fibrillation is characterized by manifestations of a fast, irregular heart rate that appears as a chaotic rhythm with unclear P waves. The nurse should monitor for manifestations of stroke as well as the client's PTT and INR because clients who have atrial fibrillation are at risk for the formation of clots. "flutter=fibrillation" (*ED=flutter + racing....inc HR) (*give dixogin to lower HR) (*dizzy=brain cell not getting enough nutr or O2) (*SOB=lung cells not get enough O2...blockage, poor perfusion) (*BP high=fluid overload) (*hi RR...low O2) (***Nursing epiphany: s/s are like clues that help you find out what's the real prob....so you can give them what htey need)

50-year-old client presented to emergency department reporting fever, chills, night sweats, and fatigue for the past several days. Yesterday, client became short of breath and has been unable to complete ADLs.

The nurse should obtain blood cultures and request an antibiotic because the client is most likely experiencing infective endocarditis due to their previous abscessed tooth. The client is experiencing fever, chills, night sweats, fatigue, Janeway lesions, and heart murmur. These are manifestations of infective endocarditis. The nurse should monitor the client's temperature and neurological status. An elevated temperature can indicate that a change in the antibiotic or surgical intervention is needed. In addition, the nurses should monitor the client's neurological status. A complication of endocarditis is an arterial embolization in which clots break off and travel through the body. This can affect the major organs, such as the brain and heart.

A nurse is teaching a client who has hypertension and a new prescription for atenolol. Which of the following findings should the nurse include as adverse effects of this medication? Bradycardia Tremor Cough Constipation

a)

A nurse is teaching a client who is taking atorvastatin daily. Which of the following statements by the client indicates an understanding of the teaching? "I will avoid drinking grapefruit juice." "I should take this medication without food." "I should expect my stools to turn clay-colored." "It is not necessary to have routine lab tests done."

a)

A nurse is teaching about necessary baseline examinations with a female client who is to start taking atorvastatin. Which of the following baseline examinations should the nurse include in the teaching? Liver function tests Hearing test Papanicolaou test Dental examination

a)

A nurse is assessing an older adult client who is receiving digoxin. The nurse should recognize that which of the following findings is a manifestation of digoxin toxicity? a) Anorexia b) Ataxia c) Photosensitivity d) Jaundice

a) (*like during 2nd sem sim w/ Caro) (*digoxin=lower HR) (*when toxic to body, cells send signal to rid fo it, poisonous to body...so vomit. (*Vomit=no food, so loss nutr to cells) (*no food=no nutr/eenrgy for cells to wrok) (*eye cells=vision blur (halos) (*taxis=flow) (*a=no) (*ataxis=no flow...no movemnt.."loss of coordination of muscles") (*photosensitivity=senstivie to light...) (*toxicity--> vomit--> no nutr to body cells, eyes, brain

A nurse is monitoring a client who received epinephrine for angioedema after a first dose of losartan. Which of the following data indicates a therapeutic response to the epinephrine? Respirations are unlabored. Client reports decreased groin pain of 3 on a 1 to 10 scale. The client's blood pressure when arising from resting position is at premedication levels. The client tolerates a second dose of medication with no greater than 1+ peripheral edema.

a) resp

A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? Check the client's vital signs. Request a dietitian consult. Suggest that the client rests before eating the meal. Request an order for an antiemetic.

a) vs

A nurse at a provider's office receives a phone call from a client who reports nausea and unrelieved chest pain after taking a nitroglycerin tablet 5 min ago. Which of the following is an appropriate response by the nurse? Tell the client to take an antacid. Instruct the client to call 911. Tell the client to take another nitroglycerin tablet in 15 min. Advise the client to come to office.

b)

A nurse in the emergency department is caring for a client who took 3 nitroglycerin tablets sublingually for chest pain. The client reports relief from the chest pain but now he is experiencing a headache. Which of the following statements should the nurse make? a) "A headache is an indication of an allergy to the medication." b) "A headache is an expected adverse effect of the medication." "A headache indicates tolerance to the medication." "A headache is likely due to the anxiety about the chest pain."

b)

A nurse is assessing a client who has hypercholesterolemia and is receiving simvastatin. Which of the following findings should the nurse recognize as a potential adverse effect? Urinary retention Muscle weakness Orthostatic hypotension Blurred vision

b)

A nurse is assessing a client who is taking lisinopril to treat hypertension. Which of the following findings is a priority to report? Dry cough Swelling of the tongue Nausea Nasal congestion

b)

A nurse is providing teaching for a client who has hypertension and a prescription change from metoprolol to metoprolol/hydrochlorothiazide. Which of the following statements by the client indicates an understanding of the teaching? "Now I will not have to diet to lose weight." "With the new medication, I should experience fewer side effects." "I will not have to do anything different because it is the same medication." "The extra letters after the name of medication means it is a stronger dose."

b)

A nurse is providing teaching to a client who has a new prescription for transdermal nitroglycerin paste. Which of the following statements by the client indicates the need for further teaching? "I should measure the dosage on the supplied paper." "I should leave the patch in place until it is time for the next dose." "I should get up slowly when I stand." "I might have a headache when I first start taking this medication."

b) Clients should have a period of 10 to 12 hr without the patch on to reduce the risk for nitrate tolerance.

A nurse is reviewing the medical record of a client who has hypertension and a new prescription for metoprolol. Which of the following findings should the nurse investigate further? Diet-controlled Type 2 diabetes mellitus A history of left-sided heart failure A concurrent prescription for tadalafil Recently treated bilateral pneumonia

b) heart failure

A nurse is caring for a client who has heart failure. Day 1: Bilateral breath sounds clear and present throughout.Weight 80 kg (176 lb)Urine output 480 mL/8 hr A nurse is reviewing the assessment finding for the client on day 4. Which of the following findings requires further action? (Select all that apply.) Weight Breath sounds Urine output Oxygen saturation Blood pressure Temperature

breath sounds weight oxygen sat BP

A nurse is providing teaching for a client who is on diuretic therapy and has a new prescription for potassium chloride (KCL) 20 mEq extended release PO daily. Which of the following instructions should the nurse provide about the new prescription? Take the extended release tablets on an empty stomach. Add an antacid if the medication causes indigestion. Take the extended release tablets whole. Expect urinary output to decrease while on this medication.

c)

Client has a history of emphysema and reports smoking 21 packs of cigarettes per year.

catheter

Client presents to the ED with substernal chest pain that comes and goes. The client states that the pain has been occurring for the last 8 hr. The pain, at times, radiates down the left arm. Client also reports intermittent nausea. Client appears pale and slightly diaphoretic. Client rates current pain as 7 on a scale of 0 to 10.

cont.

A nurse is providing teaching to a client who has hypertension and a new prescription for verapamil. Which of the following beverages should the nurse tell the client to avoid while taking this medication? Milk Orange juice Coffee Grapefruit juice

d) grapefruit

A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia? Furosemide Hydrochlorothiazide Metolazone Spironolactone

d) spir

A nurse is caring for a client who has a prescription for digoxin 0.25 mg PO daily. The amount available is digoxin 0.125 mg tab. The client's current vital signs are: blood pressure 144/96, heart rate 54/min, respirations 18/min, and temperature 98.6° F. Which of the following actions should the nurse take? Administer digoxin 0.125 mg. Administer digoxin 0.25 mg. Withold the digoxin dose for elevated blood pressure. Withhold the digoxin dose for decreased pulse rate.

d) withhold

A nurse is admitting a client to a medical-surgical unit following a fall at home.

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