Cardiovascular

The nurse is monitoring a client following cardioversion. Which observations should be of highest priority to the nurse?

Status of airway

The nurse reinforces dietary instructions to a client who will be taking warfarin sodium. The nurse tells the client to avoid which food item?

spinache

The nurse is planning to administer hydrochlorothiazide to a client. Which are concerns related to the administration of this medication?

Hypokalemia, hyperglycemia, sulfa allergy

A client diagnosed with angina pectoris returns to the nursing unit after experiencing an angioplasty. The nurse reinforces instructions to the client regarding the procedure and home care measures. Which statement by the client indicates an understanding of the instructions?

I will need to adhere to my dietary restrictions

The home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL (9.95 mmol/L). The client is taking cholestyramine. Which statement made by the client indicates the need for further teaching?

I'll cont to niconic acid from the health food store

A client takes digoxin 0.25 mg by prescription every day. When the nurse enters the client's room with the medication, the client's meal tray is untouched and the client says he has no appetite. Which action is the most appropriate?

Listen to the client's apical pulse. If it is less than 60 beats per minute, withhold the medication.

A postcardiac surgery client with a blood urea nitrogen (BUN) level of 45 mg/dL (16.2 mmol/L) and a serum creatinine level of 2.2 mg/dL (193.6 mcmol/L) has a total 2-hour urine output of 25 mL. The nurse understands that the client is at risk for which condition? BUN 7-20; creatine-F:0.5-1.0; M:0.6-1.2; Urine output (hr) 30mL min

Acute kidney injury

The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea, tachycardia, and lung crackles, and the nurse suspects pulmonary edema. The nurse immediately notifies the registered nurse (RN) and expects which interventions to be prescribed? Select all that apply.

Administering oxygen Inserting a Foley catheter Administering furosemide Administering morphine sulfate intravenously Transporting the client to the coronary care unit Placing the client in a low-Fowler's side-lying position

The nurse is asked to assist in preparing a heparin sodium infusion for a client with a diagnosis of thrombophlebitis. Which items should the nurse have available for this procedure? Select all that apply.

Protamine sulfate Intravenous tubing Intravenous infusion controller Intravenous insertion equipment

The nurse is caring for a client who has been admitted to the hospital with a diagnosis of angina pectoris. What are included in the discharge plan? Select all that apply.

Smoking cessation Get a flue vaccination Avoid aspirin products Decrease protein in diet Limit activity in cold weather Check blood pressure and pulse

The nurse carries out a standard prescription for a stat electrocardiogram (ECG) on a client who has an episode of chest pain. The nurse should take which action next?

The nurse carries out a standard prescription for a stat electrocardiogram (ECG) on a client who has an episode of chest pain. The nurse should take which action next?

A client with myocardial infarction (MI) has been transferred from the coronary care unit (CCU) to the general medical unit with cardiac monitoring via telemetry. The nurse assisting in caring for the client expects to note which type of activity prescribed?

Bathroom privileges and self-care activities, with supervised ambulation starting at 50'

The nurse is caring for a client who has been taking diuretics on a long-term basis. The nurse reviews the medication record, knowing that which medications if prescribed for this client would place the client at risk for hypokalemia?

Bumetanide is a loop diuretic, k sparring

The nurse is reinforcing dietary instructions to a client with heart failure (HF). The nurse determines that the client understands the instructions if the client states that which food item will be avoided?

Catsup

The nurse is caring for a client with chronic heart failure who is taking digoxin 0.125 mg daily. Before administering the medication, the nurse reviews the serum digoxin level that was drawn earlier in the day. The result is 1 ng/mL. Which action should the nurse take based on this laboratory result?

admin med as scheduled

A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin sodium. The nurse is told that the client's prothrombin time is 18 seconds with a control of 11 seconds. Which action should the nurse plan?

admin the next dose of warfarin

A client has an inoperable abdominal aortic aneurysm (AAA). Which measure should the nurse anticipate reinforcing when teaching the client?

antihypertensives

The nurse is reinforcing dietary instructions to a client who is taking triamterene. The nurse instructs the client that it is acceptable to consume which food item daily?

apple

A hospitalized client with a history of angina pectoris is ambulating in the corridor. The client suddenly complains of severe substernal chest pain. The nurse should take which action first?

assist the client to sit down

A client has been given a prescription for gemfibrozil. The nurse plans to instruct the client to limit intake of which food while taking this medication?

beef

The nurse is planning to administer amlodipine to a client. The nurse should plan to check which before giving the medication?

before admin amlodipine chk BP and heart rate

A client is diagnosed with thrombophlebitis. The nurse should tell the client that which prescription is indicated?

best rest with elevation of the affected extremity

A client has a history of left-sided heart failure. The nurse should look for the presence of which finding to determine whether the problem is currently active?

bilateral lung crackles

A client is scheduled for a dipyridamole thallium scan, the chemical equivalent to the stress test. The nurse should check to make sure that the client has not consumed which substance before the procedure?

caffeine additionally, aminophylline (antagonist) or theophylline should be avoided.

A client returning to the medical nursing unit following cardiac catheterization has a stat prescription to receive a dose of procainamide. The licensed practical nurse assisting in caring for the client obtains which piece of equipment to adequately determine the client's response to this medication?

cardiac monitor

A hospitalized client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and blood pressure, the nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, "My chest still hurts." Which appropriate actions should the nurse take? Select all that apply.

check BP Administer second dose of nitro check client's chest pain level

A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. The nurse listens to breath sounds expecting to hear which breath sounds bilaterally?

crackles

A client has experienced an episode of pulmonary edema. The nurse determines that the client's respiratory status is improving if which breath sounds are noted?

crackles in the lung bases

The nurse notes that a client in a long-term care facility is receiving a daily dose of furosemide. The nurse writes in the care plan to monitor which parameter on a daily basis?

daily monitor weight

A client is admitted with an arterial ischemic leg ulcer. The nurse expects to note that this ulcer has which typical characteristic?

deep and painful

The nurse should anticipate the use of which medications in the treatment of the client with heart failure? Select all that apply.

diuretics Cardiac glycosides Phosphodiesterase (PDE) inhibitors Angiotensin-converting enzyme (ACE) inhibitors

A client taking an aldosterone antagonist known as eplerenone for hypertension asks about side effects of this medication. The nurse tells the client that which sign/symptom is a side effect?

elevated k

The nurse has reinforced dietary instructions to a client with coronary artery disease. Which statement by the client indicates an understanding of the dietary instructions?

i will routinely use polyunsaturated oils in my diet

The nurse is reinforcing medication instructions to a client who has been prescribed simvastatin. Which is the action of simvastatin?

inhibit hepatic synthesis of cholesterol

A client with diabetes mellitus who has been controlled with daily insulin has been placed on atenolol for the control of angina pectoris. Because of the effects of atenolol, the nurse determines that which is the most reliable indicator of hypoglycemia?

low blood sugar

The client scheduled for a right femoropopliteal bypass graft is at risk for compromised tissue perfusion to the extremity. The nurse takes which action before surgery to address this risk?

mark where the pulses are felt in legs prior to surgery

The health care provider is discharging a client with a diagnosis of primary hypertension. Which health maintenance instructions should the nurse reinforce in the discharge teaching plan? Select all that apply.

monitor BP at home restrict sodium get reg eye exam follow-up apts for BP are important

Clients who are given a prescription for sildenafil should be taught that a potentially fatal medication interaction can occur with which medication?

nitro

The nurse has reinforced instructions to a client receiving enalapril maleate. Which statement by the client indicates a need for further teaching?

notify MD if nausea occurs

The nurse is setting up the bedside unit for a client being admitted to the nursing unit from the emergency department with a diagnosis of coronary artery disease (CAD). The nurse should place highest priority on making sure that which is available at the bedside?

oxygen tubing and flowmeter

The nurse is preparing to administer furosemide to a client with a diagnosis of heart failure. Which is the most important laboratory test result for the nurse to review before administering this medication?

potassium levels

The nurse is assisting in developing a plan of care for a client receiving warfarin sodium. The nurse selects which problem as the priority in caring for this client?

potential for injury

The nurse notes bilateral 2+ edema in the lower extremities of a client with known coronary artery disease who was admitted to the hospital 2 days ago. Based on this finding, the nurse should implement which action?

review the intake/output

A client is admitted to the hospital with a venous stasis leg ulcer. The nurse is reviewing the physical examination in the medical record. Which symptom is least likely to be noted by the primary health care provider?

sharp pain in the leg

The nurse is reinforcing discharge teaching to the client who was given a prescription for nifedipine for blood pressure management. Which instructions should the nurse reinforce? Select all that apply.

take pulse daily weigh at the same time every day palpitations may occur early on in tx be careful of orthostatic BP

A client with angina pectoris has just been started on medication therapy with nitroglycerin. In planning care for this client, the nurse should place priority on measuring which data?

with nitro priority is placed on vital signs

An ambulatory clinic nurse is interviewing a client who is complaining of flulike symptoms. The client suddenly develops chest pain. Which question best assists the nurse to discriminate pain caused by a noncardiac problem?

Does the pain get worse when you breathe in?

The nurse is planning measures to decrease the incidence of chest pain for a client with angina pectoris. The nurse should do which intervention to effectively accomplish this goal?

provide a quiet low stimulus environment

The licensed practical nurse (LPN) is assisting in caring for a client with a diagnosis of myocardial infarction (MI). The client is experiencing chest pain that is unrelieved by the administration of nitroglycerin. The registered nurse administers morphine sulfate to the client as prescribed by the health care provider. Following administration of the morphine sulfate, the LPN plans to monitor which indicator(s)?

respirations and BP

A student nurse is assigned to assist in caring for a client with acute pulmonary edema who is receiving digoxin and heparin therapy. The nursing instructor reviews the plan of care formulated by the student and tells the student that which intervention is unsafe?

restricting the client's potassium

A client has an Unna boot applied for treatment of a venous stasis leg ulcer. The nurse notes that the client's toes are mottled and cool, and the client verbalizes some numbness and tingling of the foot. Which interpretation should the nurse make of these findings?

the boot has been applied to tightly

The nurse is preparing to care for a client who will be arriving from the recovery room after an above-the-knee amputation. The nurse ensures that which priority item is available for emergency use?

surgical turniqet

The nurse carries out a standard prescription for a stat electrocardiogram (ECG) on a client who has an episode of chest pain. The nurse should take which action next?

preactivity pulse rate of 86 with post activity pulse rate of 94

The nurse is monitoring a client who is taking propranolol. Which data collection finding would indicate a potential serious complication associated with propranolol?

development of auditory wheezes

The nurse in the preoperative holding unit administers a dose of scopolamine to a client. The nurse monitors the client for which common side effect of the medication?

dry mouth

A client is at risk for complications of heart failure. Which is the nurse's priority for early detection of the most likely cause of complications with this client?

evaluating total body fluids

A client is taking nicotinic acid for hyperlipidemia, and the nurse reinforces instructions to the client about the medication. Which statement by the client indicates an understanding of the instructions?

take ibuprofen 30 min before med to reduce flushing

The nurse is planning adaptations needed for activities of daily living for a client with cardiac disease. The nurse should incorporate which instruction in discussion with the client?

take in daily fiber to reduce straining associated with constipation

A client with aldosteronism has been instructed on spironolactone treatment. Which client statement indicates that the client needs further teaching about the medication?

this medication will make my blood gluclose decrease

A client who is taking hydrochlorothiazide has also been prescribed triamterene. The client asks the nurse why both medications are required. Which response is the most accurate to give to the client?

triamterene is a potassium sparring while hydrochlorothiazide is potassium excreting

The nurse is collecting data on a client with a diagnosis of angina pectoris who takes nitroglycerin for chest pain. During the admission, the client reports chest pain. The nurse immediately asks the client which question?

where is the pain located

A client brings the following medications to the clinic for a yearly physical. The nurse realizes which medication has been prescribed to treat heart failure?

digoxin

A client is seen in the health care provider's office for a physical examination after experiencing unusual fatigue over the last several weeks. Height is 5 feet, 8 inches, with a weight of 220 pounds. Vital signs are temperature 98.6° F oral, pulse 86 beats per minute, respirations 18 breaths per minute, and blood pressure 184/96 mm Hg. Random blood glucose is 110 mg/dL. In order to best collect relevant data, which question should the nurse ask the client first?

when was the last time you had your bp checked

A health care provider (HCP) writes a prescription for digoxin, 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is important to do which?

withhold medication and alert PHCP if pulse is less than 60

A client is admitted to the hospital with a diagnosis of pericarditis. The nurse reviews the client's record for which sign or symptom that differentiates pericarditis from other cardiopulmonary problems?

Anterior chest pain Pericardial friction rub Weakness and irritability Chest pain that worsens on inspiration

A client with angina pectoris is experiencing chest pain that radiates down the left arm. The nurse administers a sublingual nitroglycerin tablet to the client. The client's pain is unrelieved, and the nurse determines that the client needs another nitroglycerin tablet. Which vital sign is most important for the nurse to check before administering a second dose of the medication?

BP

A client is scheduled for a cardiac catheterization using a radiopaque dye. The nurse checks which most critical item before the procedure?

Intake and output Height and weight Peripheral pulse rates Prior reaction to contrast media

The nurse is checking the neurovascular status of a client who returned to the surgical nursing unit 4 hours ago, after undergoing an aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable and unchanged from admission. Based on this data, the nurse should make which determination about the client's neurovascular status?

Normal, caused by increased blood flow through the leg

A client asks the nurse about metabolic syndrome and what it means. The teaching plan should include which characteristics that define metabolic syndrome? Select all that apply.

The triglyceride level is not considered in the diagnosis of metabolic syndrome. Blood pressure is elevated with systolic values greater than 130 mm Hg and diastolic values greater than 85 mm Hg. Fasting blood glucose levels are greater than 200 mg/dL or the client is taking medication for glucose control. The client has abdominal obesity with a waist greater than 40 inches in males and greater 35 inches in females. High density lipoprotein (HDL) cholesterol is greater than 40 mg/dL for males or 50 mg/dl in females or on drug treatment.

The nurse is reinforcing instructions to a client with angina pectoris about measures to reduce recurrence of chest pain. The nurse should stress to the client the importance of taking which measure?

avoiding exposure to very hot or cold

A client asks the nurse about metabolic syndrome and what it means. The teaching plan should include which characteristics that define metabolic syndrome? Select all that apply.

bp greater than systolic 130 / 85 dystolic greater waist greater than 40 for males and 35 for females

A licensed practical nurse (LPN) is assisting in the care of a client who is having central venous pressure (CVP) measurements taken by the registered nurse (RN). The LPN should assist the RN by placing the bed in which position for the reading?

flat

A client has been diagnosed with Prinzmetal's angina. The nurse reviews the medical record and notes which accompanying characteristics?

happens at the same time everyday severe pain treated with calcium channel blockers

A client with known coronary artery disease (CAD) begins to experience chest pain while getting out of bed. The nurse should take which action?`

have the pt lie back down

A client is receiving heparin sodium by continuous intravenous (IV) infusion. The licensed practical nurse (LPN) is concerned that the client received a bolus of medication when the tubing was removed from the IV pump during a gown change. The LPN immediately notifies the registered nurse or health care provider and then checks to see whether which medication is available in the medication supply area in case it is prescribed?

protamine sulfate

The nurse is asked to assist another health care member in providing care to a client who is placed in a modified Trendelenburg's position. The nurse interprets that the client is likely being treated for which condition?

shock

The nurse is admitting a client with acute pericarditis who reports chest pain. When planning the client's care, which positions should the nurse encourage the client to assume to alleviate the chest pain? Select all that apply.

sitting up and lean forward elevate the head of the bed 45 degrees

When preparing a client for a pericardiocentesis, in which position does the nurse place the client?

supine with the head elevated 45 - 60 degrees

The client's B-type natriuretic peptide (BNP) level is 691 pg/mL. Which intervention should the nurse institute when providing care for the client?

take daily weights and monitor trends

The nurse is collecting data on a client with a diagnosis of right-sided heart failure. The nurse should expect to note which specific characteristic of this condition?

dependent edema

A client has taken his first dose of lisinopril about 2 hours ago and begins to develop fullness in his face and hoarseness. Which action should the nurse take first?

determine client's ability to breathe easily

The nurse has reinforced home care instructions to a client who had a permanent pacemaker inserted. Which educational outcome has the greatest impact on the client's long-term cardiac health?

the ability to take an accurate pulse in the head and neck

Vasopressin is prescribed for the client with diabetes insipidus. During data collection, the nurse is particularly cautious in checking the client for which preexisting condition?

coronary artery disease

A client is being treated for heart failure and is receiving digoxin. The client's vital signs are blood pressure 85/50 mm Hg, pulse 96 beats per minute, and respirations 26 breaths per minute. To evaluate therapeutic effectiveness of this medication, the nurse should expect which change in the client's vital signs?

BP of 98/60; 80bpm; 20 breaths/min

The nurse is beginning to ambulate a client with activity intolerance caused by bacterial endocarditis. The nurse determines that the client is best tolerating ambulation if which parameter is noted?

Blood pressure that increases from 114/82 to 118/86 mm Hg

The nurse is preparing to administer digoxin, 0.125 mg orally, to a client with heart failure. Which vital sign is most important for the nurse to check before administering the medication?

heart rate

The nurse is caring for a client who is developing pulmonary edema. The client exhibits respiratory distress, but the blood pressure is unchanged from the client's baseline. As an immediate action before help arrives, the nurse should perform which action?

high fowler's position

A 1-year-old child has been prescribed digoxin to treat heart failure (HF). When should the nurse plan on withholding the prescribed dose of the medication?

hold digoxin with a child if HR is less than 80

Nifedipine has been prescribed for a client with Raynaud's disease, and the nurse reinforces medication instructions with the client about the medication. Which statement by the client indicates a need for further teaching?

nausea and vomiting are expected, so I really don't need to worry about if it occurs.

A client complaining of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension. These medications include a beta blocker, digoxin, and a diuretic. A tentative diagnosis of digoxin toxicity is made. Which assessment data supports this diagnosis?

nausea, loss of appetite, double vision

The nurse is caring for a client with a diagnosis of myocardial infarction (MI) and is assisting the client in completing the diet menu. Which beverage does the nurse instruct the client to select from the menu?

lemonade

An adult client just admitted to the hospital with heart failure also has a history of diabetes mellitus. The nurse consults with the registered nurse to verify a prescription for which medication that the client was taking before admission?

Chlorpropamide - hypoglycemic agent with antidiuretic

A client returns to the nursing unit after an above-knee amputation of the right leg. In which position should the nurse place the client?

For the 1st 24hr the foot of the bed should be elevated, not just the limb itself; following the 1st 24hr, the limb should be flat.

The nurse is assigned to assist with caring for a client after cardiac catheterization performed through the left femoral artery. The nurse should plan to maintain bed rest for this client in which position?

High-Fowler's position Supine with no head elevation Left lateral (side-lying) position Supine with head elevation no greater than 30 degrees

The clinic nurse is obtaining cardiovascular data on a client. The nurse prepares to check the client's apical pulse and places the stethoscope in which position?

at the mid-clavicular line, at the 5th intercostal space

The nurse is assisting in caring for a client in the telemetry unit and is monitoring the client for cardiac changes indicative of hypokalemia. Which occurrence noted on the cardiac monitor indicates the presence of hypokalemia? hyperkalemia?

hyperkalemia - tall peaked t waves hypokalemia - ST segment depression

The nurse is caring for a client who has been prescribed furosemide and is monitoring for adverse effects associated with this medication. Which should the nurse recognize as potential adverse effects? Select all that apply.

hypokalemia hypotension tinnitus

A client is being discharged following treatment for left-sided heart failure. The nurse is reinforcing teaching the client the purpose, actions, adverse effects, and use of digoxin and hydrochlorothiazide prescribed for daily use. Which statement by the client indicates a need for further teaching?

i should decrease my intake of high k foods

The nurse reinforces instructions to a client at risk for thrombophlebitis regarding measures to minimize its occurrence. Which statement by the client indicates an understanding of this information?

i will avoid sitting for long periods of time

A client with chronic atrial fibrillation is being started on amiodarone as maintenance therapy for dysrhythmia suppression. The nurse reinforces instructions to the client about the medication. Which statement by the client indicates a need for further teaching?

i will stop taking my other medication and start taking this one.

A client who has begun taking fosinopril is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. Which suggestion would provide the best support for the client?

inform the client symptoms should disappear with 3 months

A client seeks medical attention for intermittent episodes in which the fingers of both hands become cold, pale, and numb. The client states that they then become reddened and swollen with a throbbing, achy pain and Raynaud's disease is diagnosed. Which factor would precipitate these episodes?

ingestion of coffee or chocolate

For a client diagnosed with pulmonary edema, the nurse establishes a goal to have the client participate in activities that reduce cardiac workload. Which client activities will contribute to achieving this goal?

using the bedside comode

A client is being treated for acute heart failure with intravenously administered bumetanide. The vital signs are as follows: blood pressure, 100/60 mm Hg; pulse, 96 beats per minute; and respirations, 24 breaths per minute. After the initial dose, which is the priority assessment?

monitor BP

The nurse has reinforced instructions to the client with Raynaud's disease about self-management of the disease process. The nurse determines that the client needs further teaching if the client makes which statement?

moving to a warmer climate should help NOTE: manaagement of raynaud's disease should inc: smoking and caffeine cessation avoiding prolonged cold taking nifedipine to decrease muscle spasms

The nurse is planning to reinforce instructions to a client with peripheral arterial disease about measures to limit disease progression. The nurse should include which items on a list of suggestions to be given to the client? Select all that apply.

wear elastic stocking be careful not to injure foot/legs use heating pad to aide in vasodilation walk each day to increase circulation cut down on the amount of fats consumed

The nurse has completed client teaching about heart failure and prescribed medications that include digoxin and furosemide. The nurse documents that the teaching goals have been met if the client states knowing to report which symptom?

weight gain of 2-3lbs

A client with heart failure is scheduled to be discharged to home with digoxin and furosemide as ongoing prescribed medications. The nurse teaches the client to report which sign/symptom that indicates the medications are not producing the intended effect?

weight gain of 2-3lbs in a few days

The nurse is reinforcing dietary instructions to a client who is taking spironolactone. The nurse instructs the client to avoid which food in the daily diet?

citrus fruits

A client has a prescription for niacin. The nurse determines that the client understands the importance of this therapy if the client verbalizes the importance of which periodic monitoring?

cholesterol monitoring

The nurse is caring for a client who is taking metoprolol. The nurse measures the client's blood pressure (BP) and apical pulse immediately before administration. The client's BP is 122/78 mm Hg and the apical pulse is 58 beats per minute. Based on this data, which is the appropriate action?

With-hold medication

A client has just completed an information session about measures to minimize the progression of coronary artery disease (CAD). Which statement indicates an initial understanding of lifestyle alterations?

a diet that is low in fat