ch 29 prepU management of pts with complications from heart disease

the nurse is caring for a client with heart failure, what are the management goals for the client with heart failure? Increasing preload and afterload Promoting a healthy lifestyle Increasing cardiac output by strengthening muscle contractions Lowering the risk for hospitalization

Promoting a healthy lifestyle Increasing cardiac output by strengthening muscle contractions Lowering the risk for hospitalization

While auscultating the heart sounds of a client with heart failure, the nurse hears an extra heart sound immediately after the second heart sound (S2). How should the nurse document this sound? a third heart sound (S3). a murmur. a fourth heart sound (S4). a first heart sound (S1).

a third heart sound (S3)

A client with left-sided heart failure reports increasing shortness of breath and is agitated and coughing up pink-tinged, foamy sputum. The nurse should recognize these findings as signs and symptoms of what condition? cardiogenic shock. pneumonia. right-sided heart failure. acute pulmonary edema.

acute pulmonary edema

A client who has developed congestive heart failure must learn to make dietary adaptations. The client should avoid: angel food cake. canned peas. dried peas. ready-to-eat cereals.

canned peas

The nurse is admitting a client with frothy pink sputum. What does the nurse suspect is the primary underlying disorder of pulmonary edema? increased left atrial contractility increased right atrial resistance decreased left ventricular pumping decreased right ventricular elasticity SUBMIT ANSWER

decreased left ventricular pumping

The nurse is caring for a client with heart failure. What procedure should the nurse prepare the client for in order to determine the ejection fraction to measure the efficiency of the heart as a pump? Electrocardiogram A pulmonary arteriography A chest radiograph Echocardiogram

echocardiogram

the nurse is assessing a client with crackling breath sounds or pulmonary congestion. what is the cause of the congestion?

inadequate cardiac output

Which is a characteristic of right-sided heart failure? Cough Pulmonary crackles Dyspnea Jugular vein distention

jugular vein distention

A client has been diagnosed with systolic heart failure. What percentage will the nurse expect the patient's ejection fraction to be? 5% 65% 55% 30%

30%

A patient is seen in the emergency department (ED) with heart failure secondary to dilated cardiomyopathy. What key diagnostic test does the nurse assess to determine the severity of the patient's heart failure? Blood urea nitrogen (BUN) Complete blood count (CBC) Serum electrolytes B-type natriuretic peptide (BNP)

B-type natriuretic peptide (BNP)

A nurse is assessing a client with congestive heart failure for jugular vein distension (JVD). Which observation is important to report to the physician? JVD is noted at the level of the sternal angle. No JVD is present. JVD is noted 2 cm above the sternal angle. JVD is noted 4 cm above the sternal angle.

JVD is noted 4 cm above the sternal angle

The nurse is caring for a client with heart failure. What sign will lead the nurse to suspect right-sided heart failure? ascites resting bradycardia weight loss warm extremities

ascites

The nurse is teaching a group of clients with heart failure about how to decrease leg edema. What dietary advice will the nurse give to clients with severe heart failure? Encourage increased intake of vegetables with natural sodium. Avoid the intake of processed and commercially prepared foods. Avoid the intake of canned fruit and fruit juices. Encourage increased intake of red meat.

avoid the intake of processed and commercially prepared food

A client has been prescribed furosemide 80 mg twice daily. The asymptomatic client begins to have rare premature ventricular contractions followed by runs of bigeminy with stable signs. What action will the nurse perform next? Check the client's potassium level. Administer potassium. Notify the health care provider. Calculate the client's intake and output.

check the potassium levels

The nurse is providing care to a client with cardiogenic shock requiring a intra-aortic balloon pump (IABP). What is the therapeutic effect of the IABP therapy? decreased right ventricular workload decreased renal perfusion decreased left ventricular workload decreased peripheral perfusion to the extremities

decreased left ventricular workload

A client asks the nurse if systolic heart failure will affect any other body function. What body system response correlates with systolic heart failure (HF)? increased blood volume ejected from ventricle decrease in renal perfusion vasodilation of skin dehydration

decreased renal perfusion

the nurse is assessing a client with exacerbation of heart failure identifies which symptom as a cerebrovascular manifestation of heart failure ? dizziness ascites tachycardia nocturia

dizziness

Frequently, what is the earliest symptom of left sided heart failure?

dyspnea on exertion

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

echocardiogram

A client with congestive heart failure is admitted to the hospital after reporting shortness of breath. How should the nurse position the client in order to decrease preload? Head of the bed elevated 30 degrees and legs elevated on pillows Supine with arms elevated on pillows above the level of the heart Prone with legs elevated on pillows Head of the bed elevated 45 degrees and lower arms supported by pillows

head of bed elevated 45 degrees and lower arms supported by pillows

The nurse is assessing a newly admitted client with chest pain. What medical disorder is most likely causing the client to have jugular vein distention? pneumothorax myocardial infarction (MI) abdominal aortic aneurysm heart failure

heart failure

A nurse is administering digoxin. What client parameter would cause the nurse to hold the digoxin and notify the health care prescriber? atrial fibrillation rhythm heart rate of 55 beats per minute

heart rate of 55 beats per minute

A client is already being treated for hypertension. The doctor is concerned about the potential for heart failure, and has the client return for regular check-ups. What does hypertension have to do with heart failure? Hypertension causes the heart's chambers to shrink. Hypertension in older males regularly leads to heart failure. Heart failure occurs when blood pressures drops. Hypertension causes the heart's chambers to enlarge and weaken.

hypertension causes the hearts chambers to enlarge and weaken

The nurse is admitting a client with heart failure. What client statement indicates that fluid overload was occurring at home? "I eat six small meals a day when I am hungry." "I've stopped eating foods with salt, though I miss the taste." "My best time of the day is the morning." "I'm having trouble going up the steps during the day."

i'm having trouble going up the steps during the day

The nurse is assigned to care for a client with heart failure. What medication does the nurse anticipate administering that will improve client symptoms as well as increase survival? bumetanide cholestyramine diltiazem lisinopril

lisinopril

Which feature is the hallmark of systolic heart failure? Limited activities of daily living (ADLs) Pulmonary congestion Low ejection fraction (EF) Basilar crackles

low ejection fraction (EF)

A client diagnosed with heart failure presents with a temperature of 99.1° F, pulse 100 beats/minute, respirations 42 breaths/minute, BP 110/50 mm Hg; crackles in both lung bases; nausea; and pulse oximeter reading of 89%. Which finding indicates a need for immediate attention? nausea blood pressure lung congestion temperature

lung congestion

The nurse is caring for a client with heart failure who is receiving a diuretic medication. What implementation will help the nurse evaluate the client's response of the medication? using mechanical ventilation obtaining cardiac output with a pulmonary catheter asking the client about comfort level measuring intake and output

measuring the intake and output

A nurse is teaching clients newly diagnosed with coronary heart disease (CHD) about the disease process and risk factors for heart failure. Which problem can cause left-sided heart failure (HF)? Ineffective right ventricular contraction Pulmonary embolus Cystic fibrosis Myocardial ischemia

myocardial ischemia

The nurse is working in a long-term care facility with a group of older adults with cardiac disorders. Why would it be important for the nurse to closely monitor an older adult receiving digitalis preparations for cardiac disorders? Older adults are at increased risk for hyperthyroidism. Older adults are at increased risk for toxicity. Older adults are at increased risk for cardiac arrests. Older adults are at increased risk for asthma.

older adults are at increased risk for toxicity

Which describes difficulty breathing when a client is lying flat? Paroxysmal nocturnal dyspnea (PND) Tachypnea Orthopnea Bradypnea

orthopnea

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

preload

A client has been diagnosed with heart failure. What is the major nursing outcome for the client? Maintain a healthy diet. Reduce the workload on the heart. Sleep 8 hours per night. Walk 30 minutes three times a week

reduce the workload on the heart

A client is admitted to the ICU with a diagnosis of heart failure. The client is exhibiting symptoms of weakness, ascites, weight gain, and jugular vein distention. The nurse would know that the client is exhibiting signs of what kind of heart failure? Left-sided heart failure Chronic heart failure Acute heart failure Right-sided heart failure

right-sided heart failure

Which is a manifestation of right-sided heart failure? Systemic venous congestion Increase in forward flow Paroxysmal nocturnal dyspnea Accumulation of blood in the lungs

systemic venous congestion

The physician writes orders for a patient to receive an angiotensin II receptor blocker for treatment of heart failure. What medication does the nurse administer? Valsartan (Diovan) Carvedilol (Coreg) Metolazone (Zaroxolyn) Digoxin (Lanoxin)

valsartan (diovan)

A client with heart failure is having a decrease in cardiac output. What indication does the nurse have that this is occurring? Heart rate of 72 beats/minute Blood pressure 80/46 mm Hg Oxygen saturation 94% Respiratory rate of 20 breaths/minute

blood pressure 80/46 mmHg

the nurse recognizes that which laboratory test is a key diagnostic indicator of heart failure? Blood urea nitrogen (BUN) Brain natriuretic peptide (BNP) Complete blood count (CBC) Creatinine

brain natriuretic peptide (BNP)

A nurse caring for a client recently admitted to the ICU observes the client coughing up large amounts of pink, frothy sputum. Lung auscultation reveals coarse crackles in the lower lobes bilaterally. Based on this assessment, the nurse recognizes this client is developing decompensated heart failure with pulmonary edema. acute exacerbation of chronic obstructive pulmonary disease. bilateral pneumonia. tuberculosis.

decompensated heart failure with pulmonary edema

The nurse is teaching a client about medications prescribed for severe volume overload from heart failure. What diuretic is the first-line treatment for clients diagnosed with heart failure?

furosemide

The client with cardiac failure is taught to report which symptom to the health care provider or clinic immediately? Ability to sleep through the night Increased appetite Persistent cough Weight loss

persistent cough

The nurse completes an assessment of a client admitted with a diagnosis of right-sided heart failure. What will be a significant clinical finding related to right-sided heart failure? decreased O2 saturation levels pitting edema S4 ventricular gallop sign oliguria

pitting edema

Which nursing intervention should the nurse perform when a client with valvular disorder of the heart has a heart rate less than 60 beats/min before administering beta-blockers? Observe for symptoms of pulmonary edema. Withhold the drug and inform the primary health care provider. Check for signs of toxicity. Continue the drug and document in the client's chart.

withhold the drug and inform the primary health care provider

The nurse is caring for a client in the hospital with chronic heart failure who has marked limitations in his physical activity. The client is comfortable when resting in the bed or chair, but when ambulating in the room or hall, the client becomes short of breath and fatigued easily. What type of heart failure is this considered according to the New York Heart Association (NYHA)? Class IV (Severe) Class II (Mild) Class III (Moderate) Class I (Mild)

class III (moderate)

A patient is admitted to the intensive care unit (ICU) with left-sided heart failure. What clinical manifestations does the nurse anticipate finding when performing an assessment? (Select all that apply.) Cough Dyspnea Ascites Jugular vein distention Pulmonary crackles

cough dyspnea pulmonary crackles