Cardiac

Which diagnostic study is usually performed to confirm the diagnosis of heart failure? A. Electrocardiogram (ECG) B. Echocardiogram C. Serum electrolytes D. Blood urea nitrogen (BUN)

A. Electrocardiogram (ECG) An echocardiogram is usually performed to confirm the diagnosis of heart failure. ECG, serum electrolytes, and a BUN are usually completed during the initial workup.

Which term describes the degree of stretch of the ventricular cardiac muscle fibers at the end of diastole? A. Afterload B. Preload C. Ejection fraction D. Stroke volume

B. Preload Preload is the the degree of stretch of the ventricular cardiac muscle fibers at the end of diastole. Afterload is the amount of resistance to ejection of blood from a ventricle. The ejection fraction is the percentage of blood volume in the ventricles at the end of diastole that is ejected during systole. Stroke volume is the amount of blood pumped out of the ventricle with each contraction.

A nurse is administering digoxin. What client parameter would cause the nurse to hold the digoxin and notify the health care prescriber? A. blood pressure of 125/80 B. urine output of 300 mL in eight hours C. atrial fibillation rhythm D. heart rate of 55 beats per minute

D. heart rate of 55 beats per minute Digoxin therapy slows conduction through the AV node. A heart rate of 55 is slow and the digoxin therapy may slow the heart rate further. Blood pressure of 125/80 is normal. Urine output of 300 mL is adequate, so the kidneys are functioning. Atrial fibrillation is not a parameter to hold medication.

A nurse is caring for a client with heart failure. The nurse knows that the client has left-sided heart failure when the client makes which statement? A. "I sleep on three pillows each night." B. "My feet are bigger than normal." C. "My pants don't fit around my waist." D. "I don't have the same appetite I used to."

A. "I sleep on three pillows each night." Orthopnea is a classic sign of left-sided heart failure. The client commonly sleeps on several pillows at night to help facilitate breathing. Swollen feet, ascites, and anorexia are signs of right-sided heart failure.

Incomplete closure of the mitral valve results in backflow of blood from the: A. Left ventricle to left atrium B. Right ventricle to the right atrium C. Right atrium to right ventricle D. Left atrium to left ventricle

A. Left ventricle to left atrium Incompetent closure of the mitral valve can result from disease processes that alter valve leaflets, mitral annulus, chordae tendineae, and the papillary muscle. When mitral valve leaflets thicken, fibrose, and contract, they cannot close completely during systole. This forces blood backward from the left ventricle into the left atrium during systole.

Which nursing intervention should a nurse perform to reduce cardiac workload in a client diagnosed with myocarditis? A. Maintain the client on bed rest B. Administer a prescribed antipyretic C. Elevate the client's head D. Administer supplemental oxygen

A. Maintain the client on bed rest The nurse should maintain the client on bed rest to reduce cardiac workload and promote healing. The nurse should administer supplemental oxygen to relieve tachycardia that may develop from hypoxemia. If the client has a fever, the nurse should administer a prescribed antipyretic along with independent nursing measures like minimizing layers of bed linen, promoting air circulation and evaporation of perspiration, and offering oral fluids. The nurse should elevate the client's head to promote maximal breathing potential.

The nurse is caring for a client with manifestations of dilated cardiomyopathy. When planning care, which consideration would the nurse make? A. Place bed in a high or semi-high Fowler's position as needed. B. Assist client to bathroom every 2 hours. C. Instruct client to avoid strenuous activity. D. Assess abdominal girth daily.

A. Place bed in a high or semi-high Fowler's position as needed. Dilated cardiomyopathy has clinical manifestations of dyspnea on exertion and when lying down. Depending on level of dyspnea, placing the client in an upright Fowler's position is helpful. Clients with hypertrophic cardiomyopathy have syncopal episodes and can collapse following strenuous activity. Assistance with ambulation to avoid falls is helpful. Restrictive cardiomyopathy includes manifestations of ascites and assessment of abdominal girth.

A client seeks medical attention for dyspnea, chest pain, syncope, fatigue, and palpitations. A thorough physical examination reveals an apical systolic thrill and heave, along with a fourth heart sound (S4) and a systolic murmur. Diagnostic tests reveal that the client has a new onset of hypertrophic cardiomyopathy (HCM). What will be included on the plan of care? A. an insertion of an implantable cardiac defibrillator B. teaching about heart transplantation surgery C. establishing a daily exercise program D. beginning a weight reduction diet

A. an insertion of an implantable cardiac defibrillator The hypertrophied cardiac muscle decreases the effectiveness of the heart's contraction, decreasing cardiac output. The goal is to prevent sudden death. An implantable cardiac defibrillator will prevent lethal dysrhythmias. Teaching about heart transplantation surgery is not a priority. Exercise programs and weight reduction diet are not appropriate at this time for a symptomatic client with cardiomyopathy.

A client is diagnosed with dilated cardiomyopathy. What is the most likely cause of the client's condition? A. chronic alcohol abuse B. heredity C. scleroderma D. previous myocardial infarction

A. chronic alcohol abuse Chronic alcohol ingestion is one of the main causes of dilated cardiomyopathy. Other causes include history of viral myocarditis, an autoimmune response, and exposure to other chemicals in addition to alcohol. Heredity is considered the main cause of hypertrophic cardiomyopathy. Scleroderma is a connective tissue disorder thought to cause restrictive cardiomyopathy. Scar tissue that forms after a myocardial infarction is thought to be a cause of restrictive cardiomyopathy.

Which nursing intervention should a nurse perform when a client with cardiomyopathy receives a diuretic? A. Administer oxygen B. Check regularly for dependent edema C. Maintain bed rest D. Allow unrestricted physical activity

B. Check regularly for dependent edema The nurse should regularly monitor for dependent edema if the client with cardiomyopathy receives a diuretic. Oxygen is administered either continuously or when dyspnea or dysrhythmias develop. Bed rest is not necessary. The nurse should ensure that the client's activity level is reduced and should sequence any activity that is slightly exertional between periods of rest.

A client is brought to the emergency department via rescue squad with suspicion of cardiogenic pulmonary edema. What complication should the nurse monitor for? Select all that apply. A. Nausea and vomiting B. Pulmonary embolism C. Cardiac dysrhythmias D. Respiratory arrest E. Cardiac arrest

C. Cardiac dysrhythmias D. Respiratory arrest E. Cardiac arrest Pulmonary edema is fluid accumulation in the lungs, which interferes with gas exchange in the alveoli. It represents an acute emergency and is a frequent complication of left-sided heart failure. Cardiac dysrhythmias and cardiac or respiratory arrest are associated complications. Nausea and vomiting are not complications but are symptoms of many disorders. The client is not at increased risk for the development of pulmonary embolism with pulmonary edema.