EXAM 3 4TH SEMESTER

A client with hypertension is started on verapamil. What teaching will the nurse provide for this client?

"Avoid grapefruit juice."

The nurse is caring for a client who experienced a recent cardiac event. Which client statement indicates maladaptive denial?

"I don't need to change. It hasn't killed me yet."

When caring for a client with an abdominal aortic aneurysm (AAA), the nurse suspects dissection of the aneurysm when the client makes which statement?

"I just started to feel a pain in my belly and low back."

Which statement by a client with heart failure indicates to the nurse the need for additional teaching

"I must weigh myself once a week and watch for signs of fluid retention."

The nurse discusses the importance of restricting sodium in the diet for a client with heart failure. Which client statement indicates the need for further teaching?

"I need to avoid eating hamburgers."

which statement by client to the nurse indicates an understanding of cigarette usage related to cardiovascular risks?

"I need to be completely cigarette free for at least 3 years"

The nurse is teaching a client with a new permanent pacemaker. Which client statement indicates a need for further teaching?

"I no longer need my heart pills."

Which nursing statement reflects appropriate cardiac physical assessment technique?

"I will auscultate the aortic valve in the second intercostal space at the right sternal border."

The nurse is providing discharge teaching to a client with heart failure, focusing on when to seek medical attention. Which client statement indicates understanding of the teaching?

"I will call the provider if I have a cough lasting 3 or more days."

which statement by client with a history of hypertension and heart problems would cause the nurse to suspect development of heart failure

"I've had to remove all of my rings for the past month"

A client who is to undergo cardiac catheterization must be taught which essential information by the nurse?

"Keep your affected leg straight for 2 to 6 hours."

The nurse is caring for a client who is scheduled for a percutaneous transluminal angioplasty (PTCA). Which client statement indicates a need for further teaching?

"My angina will be gone for good."

A patient is questioning the nurse about circulation and perfusion. Which is the best response by the nurse?

"Perfusion assists the cell by delivering oxygen and removing waste products."

The nurse is teaching a client with atrial fibrillation about a new prescription for warfarin. What teaching will the nurse include?

"Report bruising to your health care provider."

A client undergoing coronary artery bypass grafting asks why the surgeon has chosen to use the internal mammary artery for the surgery. Which nursing response is appropriate?

"These arteries remain open longer."

A client with angina has received education about acute coronary syndrome. Which client statement indicates understanding?

"This is a warning sign and I need to change my lifestyle to prevent a heart attack."

The nurse is caring a college athlete who collapsed during soccer practice. The client has been diagnosed with hypertrophic cardiomyopathy and states, "This can't be. I am in great shape. I eat right and exercise." Which nursing response is appropriate?

"This may be caused by a genetic trait."

Which instruction would the nurse give a client who is to have an exercise electrocardiography test?

"Wear comfortable loose-fitting clothes and supportive, rubber soled shoes."

During discharge planning after admission for a myocardial infarction, the client says, "I won't be able to increase my activity level. I live in an apartment, and there is no place to walk." Which nursing response is appropriate?

"Where might you be able to walk?"

A patient is experiencing periods of confusion, and the family is concerned. The patient's son asks the nurse for an explanation and recommendation. Which is the best response by the nurse?

"Your father may be having mini-strokes; I will notify his physician."

Which ECG waveforms and intervals are the normal measurements or positions? SATA

-PR interval 0.12-0.20 secs -QRS complex 0.06-0.10 secs -PR segment isoelectric line -QT interval less than half of the R to R interval -U wave follows T wave if present

How soon as the nurse expect, anginal pain to begin subsiding, after administering sublingual nitroglycerin to a client with chronic stable angina

1 to 2 minutes

what is the recommended therapeutic range for the INR for a client receiving warfarin sodium to prevent DVT and decrease the risk for stroke

1.5 to 2.0.

What diagnostic test with the nurse of time to determine whether a client admitted with acute onset chest pain and dyspnea had experienced a myocardial infarction

12 lead ECG troponins

Which factors with the nurse know as increasing the risk for atherosclerosis with an older African-American client

20 year history of type two diabetes sedentary lifestyle 25 pound overweight Grandmother died after a heart attack

Which client does the nurse consider to be at highest risk for neural induced distributive shock

21-year-old who has received 4 mg of morphine IV for acute pain

normal pulse pressure

30-40 mmHg

Which client will the nurse recognize as having a higher risk for obstructive shock

32-year-old with a pulmonary embolus

What will the nurse calculate the cardiac output to be when the clients heart rate is 68 bpm in the stroke volume is 50 mL

3400 L per minute

What is the nurse determine is the clients heart rate when assessing a six second telemetry ECG strip with five QRS complexes

50 bpm and bradycardic

What is the lowest mean arterial pressure necessary to perfuse the major organs of the body

60 to 70 mm Hg

normal MAP

60-65

which normal heart rate is the nurse expect to be initiated by the primary pacemaker of the heart inclines when the heart rate is regular? Select all that apply.

62 bpm 74 bpm 86 bpm 98 bpm

What is the clients pulse pressure when the nurse finds that his or her blood pressure is 148/86

62 mmHg

Which newly admitted client does the nurse consider to be at highest risk for development of sepsis?

68-year-old woman 2 days postoperative from bowel surgery

Takotsubo cardiomyopathy

: "broken heart syndrome" —ventricular apical ballooning likely due to increased sympathetic stimulation (stressful situations).

After receiving change-of-shift report about these four clients, which client would the nurse assess first?

A 46 year old with aortic stenosis who takes digoxin and has new-onset frequent premature ventricular contractions.

The cardiac care unit charge nurse is assigning clients to the oncoming shift. Which patient is appropriate to assign to a float RN from the medical-surgical unit?

A 64-year-old client admitted for weakness with sinus bradycardia and heart rate 58 beats/min.

An LPN/LVN is scheduled to work on the stepdown cardiac unit. Which client will the charge nurse assign to the LPN/LVN?

A 66 year old who has a prescription for a nitroglycerin patch and is scheduled for discharge to a long-term care later today.

Which client who has just arrived in the emergency department does the nurse assess as emergent and in need of immediate medical evaluation?

A 70 year old with a history of diabetes who has "tearing" back pain and is diaphoretic.

Which assessment data indicates proper function of the sinoatrial (SA) node?

A P wave precedes every QRS complex.

What is the correct technique for the nurse to use to check a clients lower extremities using the ankle brachial index

A blood pressure cuff is applied to the lower extremities and the systolic pressure is measured by Doppler ultrasound at both the dorsalis pedis and posterior tibial pulses

which findings with the nurse expect in a client with mitral valve stenosis? Select all that apply.

A client with mild mitral valve stenosis will likely be asymptomatic Classic sans include dyspnea, angina, and syncope Rumbling, apical, diastolic murmur Right sided heart failure with jugular vein distention

treatment for dilated cardiomyopathy

ACE/ARBs beta blockers diuretics anticoags ICD implant biventricular pacemaker LVAD heart transplant

Which characteristics place women at high risk for myocardial infarction (MI)? (Select all that apply.)

Abdominal obesity Family history Increasing age

What is the nurses priority action with a client with AAA suddenly exhibit decreased level of consciousness blood pressure 82/48 irregular apical pulse and profuse diaphoresis

Activate the rapid response team

what would the nurse expect to find in the history of a client admitted with acute arterial occlusion

Acute myocardial infarction or atrial fibrillation within the previous weeks

what is the nurse expect when a client describe substernal pain that radiates to the left shoulder is grating and worsens with inspiration and coughing

Acute pericarditis

The nurse is caring for a client with dark-colored toe ulcers and blood pressure (BP) of 190/100 mm Hg. Which nursing action does the nurse delegate to the LPN/LVN?

Administer a clonidine patch for hypertension.

what action does the nurse plan to take prior to a cardiac catheterization when a client states he or she has an allergy to seafood and iodine containing dyes

Administer an antihistamine, or a steroid before the test

Which risk factors are known to contribute to atrial fibrillation? (Select all that apply.)

Advancing age High blood pressure Excessive alcohol use

The nurse is teaching a class on diagnostic cardiovascular testing. Which teaching will the nurse include?

An alternative to injecting a medium into the coronary arteries is intravascular ultrasonography.

For which, finding in a client with mitral valve stenosis with the nurse, immediately notify the primary healthcare provider because of the potential for decompensation

An irregular heart rhythm, and ECG strip that indicates atrial fibrillation

Which statements are accurate about a clients true aneurysm?

Aneurysms may be described as fusiform or saccular The aneurysm creates a permanent dilation of an artery a congenitally weakened, arterial wall may result in an aneurysm The aneurysms section of the arterial wall is enlarged to at least twice its normal diameter

The nurse caring for a client with heart failure who is taking digoxin. What assessment data requires that nurse notify the health care provider? (Select all that apply.)

Anorexia Blurred vision Fatigue

Which essential medication's with the nurse provide teaching about postoperatively for a client who received a prosthetic valve replacement

Anticoagulants

When the nurse assesses a client in the clinic for a physical examination and find decrease skin temperature, what does this most likely indicate?

Arterial insufficiency

The nurse is assessing a client with right-sided heart failure. What assessment findings will the nurse anticipate? (Select all that apply.)

Ascites Peripheral edema

A client is exhibiting signs and symptoms of early shock. Which nursing actions support the psychosocial integrity of the client? (Select all that apply.)

Ask family members to stay with the client. Remain with the client. Reassure the client that everything is being done for him or her.

Which nursing assessment is specific to a client who had CABG surgery with the radial artery use as the graft

Assess hand color temperature, ulnar, pulse and capillary refill every hour initially

to determine if a client has a pulse deficit what procedure with the nurse follow?

Assess the apical and radial pulses for a four minute and calculate the difference

Which medication's will the nurse expect the cardiologist to put on hold before an exercise stress test

Atenolol and diltiazem

What is the nurses best response when a client asks about the difference between arteriosclerosis and atherosclerosis?

Atherosclerosis is forming plaques in arteries but arteriosclerosis is thickening of arterial walls associated with aging.

The home health nurse visits a client with heart failure who has gained 5 lb (2.3 kg) in the past 3 days. The client states, "I feel so tired and short of breath." Which action does the nurse take first?

Auscultate the client's posterior breath sounds.

What were the nurse teach a client with purple arterial disease about positioning and position changes

Avoid crossing legs at all times

Before administering which class of drugs with the nurse always check the clients heart rate

Beta blockers

Which piece of equipment with the nurse recommend for a client to manage hypertension at home

Blood pressure monitoring device

which type of dysrhythmia with a nurse expect to monitor for when a client experiences an inferior wall myocardial infarction

Bradycardia with second-degree heart block

Which exercise regimen with the nurse teach an older adult is best to meet guidelines for physical fitness to promote heart health

Brisk walk for 20 to 30 minutes each day

which method would the PACU nurse used to assess the patency of the graft after a client arterial revascularization with graft placement?

Check the affected limb, comparing it to the unaffected for changes in color, temperature impulse intensity, every 15 minutes for the first hour, then hourly

The client asks the nurse about modifiable risk factors for heart disease. What nursing response is appropriate? (Select all that apply.)

Cigarette smoking is one of the most significant modifiable risk factors. Increasing physical exercise is a method to modify your risk.

which manifestation with the nurse expect with a client labeled class I on the Killip scale for heart failure

Clear lung sounds, and absence of S3

which client assessment text priority when the nurse begins his or her shift?

Client with atrial fibrillation and sustained rapid ventricular response

For which client with the nurse question the prescription of hydrochlorothiazide

Client with hypokalemia

The nurse in the coronary care unit is caring for a group of clients who have had a myocardial infarction. Which client will the nurse see first?

Client with third-degree heart block on the monitor

which key points with the nurse include when teaching a client about signs and symptoms of returning or worsening heart failure that must be reported to the primary healthcare provider? Select all that apply.

Cold symptoms lasting more than 3 to 5 days Excessive awakening at night to urinate Development of dyspnea, or angina at rest or worsening angina Increased swelling in feet ankles or hands

which signs and symptoms indicate to the nurse that a client with a myocardial infarction in heart failure is going into cardiogenic shock

Cold, clammy skin with poor peripheral pulses Pulmonary congestion and tachypnea Urine output less than 0.5 to 1 mL per kilogram per hour. Agitation, restlessness, or confusion

Which safety precautions must be taken before defibrillating a client with ventricular fibrillation

Commando healthcare team members to stand clear of the clients bed

The assistive personnel (AP) is concerned about a postoperative client with blood pressure (BP) of 90/60 mm Hg, heart rate of 80 beats/min, and respirations of 22 breaths/min. What is the appropriate nursing action?

Compare these vital signs with the last several readings.

The nurse is caring for a patient on a telemetry unit who has a regular heart rhythm and rate of 60 beats/min; a P wave precedes each QRS complex, and the PR interval is 0.20 second. Additional vital signs are: blood pressure 118/68 mm Hg, respiratory rate 16 breaths/min, and temperature 98.8° F (37° C). All of these medications are available on the medication record. What action will the nurse take?

Continue to monitor.

Which assessment data cause the nurse to suspect that a client who had a myocardial infarction (MI) is developing cardiogenic shock? (Select all that apply.)

Cool, diaphoretic skin Crackles in the lung fields Anxiety and restlessness

The client in the cardiac care unit has had a large myocardial infarction. What assessment data indicates to the nurse the onset of left ventricular failure?

Crackles in the lung fields

What is the nurse expect when assessing a client on bedrest and finding that he or she has a left calf that is swollen warm to touch reddened and moderately painful

DVT

Which early reaction is most common in clients with chest discomfort associated with unstable angina or myocardial infarction

Denial

what is the first step when the nurse analyzes a clients ECG rhythm strip

Determine the heart rate

Which symptom with the nurse expect on assessment of a client with inflow peripheral arterial disease

Discomfort in the lower back buttocks or thighs after walking

what is the priority action for the nurse when a client is to have unfractured heparin discontinued, and to start receiving subcutaneous, low molecular weight heparin

Discontinue the infraction heparin at least 30 minutes before giving the first low molecular weight heparin injection

The nurse is caring for a client in the refractory stage shock. Which intervention does the nurse consider?

Discussion with family and provider regarding palliative care

The nurse is teaching a client with a new pacemaker. What teaching will the nurse include? (Select all that apply.)

Do not lean over electrical or gasoline motors. Be sure that you remember the rate at which your pacemaker is set. Avoid sudden, jerky movements for 8 weeks.

The nurse is teaching a group of teens about prevention of heart disease. Which point is most important for the nurse to emphasize?

Do not smoke or chew tobacco.

which American heart association guidelines would the nurse teach a client to fight obesity and improve cardiovascular health? Select all that apply.

Don't consume more calories than you can use in a day Consume foods that contain vitamins, minerals, and fibers Choose foods that are healthy and low in calories Eat vegetables, fruit, and whole grain foods

The nurse is caring for a client who is being treated for hypertensive crisis. Which prescribed medication would the nurse question?

Dopamine

S/S of hypertrophic cardiomyopathy

Dyspnea Chest pain Palpitations Syncope Sudden cardiac death dysrhythmias harsh systolic murmur S2 heart sound is split

Which atypical symptoms may be present in a female client experiencing myocardial infarction (MI)? (Select all that apply.)

Dyspnea Extreme fatigue Dizziness

Which parameter indicates to the nurse that a client exercise electrocardiogram should be stopped?

ECG shows ST segment depression

When the client asked the nurse about the best method of diagnosing, heart failure, what teaching would the nurse provide

Echocardiography

The nurse is caring for a client immediately following a cardioversion. What nursing actions are appropriate? (Select all that apply.)

Ensure electrodes are in place for continued monitoring. Assess the chest for burns. Document results of procedure. Administer oxygen.

The nurse plans to administer an antibiotic to a client newly admitted with septic shock. What action will the nurse take first?

Ensure that blood cultures were drawn.

What is the nurses best response when a client with peripheral arterial disease asks why he or she should exercise when walking causes pain

Exercise can improve blood flow to your legs, because small blood vessels will compensate for the blood vessels that are blocked off

Which diagnostic tests performed after a clients a cute stage of an unstable angina episode to determine if there are cardiac changes that are consistent with ischemia

Exercise tolerance test

Which signs or symptoms with the nurse expect when assessing a client with chronic constrictive pericarditis

Exertional, fatigue, and dyspnea Dependent edema Hepatomegaly

A client who is suffering from dyspnea on exertion and heart failure (HF) will most likely report which symptom during the health history?

Fatigue

The nurse is caring for a client with heart failure. What assessment data will the nurse anticipate? (Select all that apply.)

Fatigue Chest discomfort or pain Tachycardia

During which time frame is it most important for the nurse to monitor the client for graft occlusion after receiving revascularization with graft placement

First 24 hours

The best perform a 12 lead ECG on a client. How does the nurse place the leads on the client

Four leads are placed on the limbs and six are placed on the chest

Which activity with the nurse advise during the recovery. Period for a client returning home after AAA repair.

Gradually increasing walking

What is the nurses best action when auscultating S1 for a client is difficult

Have a client lean forward or roll to His or her left side.

What is the best action for the nurse to take when visiting a new client with CAD who is experiencing new one set of chest pain and shortness of breath?

Have the client to a 325 mg aspirin tablet and called 911

What priority question with the nurse asked before administering sublingual nitroglycerin to a middle-aged male client with chest pain

Have you taken a medication for erectile dysfunction within the past 24 to 48 hours?

The nurse is caring for a patient with acute coronary syndrome (ACS) and atrial fibrillation who has a new prescription for metoprolol. Which data is essential for the nurse to assess prior to administration?

Heart rate

The nurse administers amiodarone to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? (Select all that apply.)

Heart rate Heart rhythm QT interval

The nurse is caring for a postoperative client at risk for hypovolemic shock. Which assessment indicates an early sign of shock?

Heart rate 120 beats/min

The nurse is caring for a patient with atrial fibrillation (AF). In addition to an antidysrhythmic, what medication does the nurse anticipate administering?

Heparin

Which drug therapy with the nurse expect to be prescribed for a client with acute coronary syndrome to decrease the risk of recurrent myocardial infarction, stroke and mortality

High intensity statin therapy

The nurse is preparing to administer digoxin as prescribed to a client with heart failure and notes: Temperature: 99.8° F (37.7° C), Pulse: 48 beats/min and irregular, Respirations: 20 breaths/min, Potassium level: 3.2 mEq/L (3.2 mmol/L). What action will the nurse take?

Hold the digoxin, and obtain a prescription for a potassium supplement.

because many sudden, cardiac arrest victims die before reaching the hospital, which priority teaching point with the nurse, be sure to include in a community presentation about heart disease

How to operate an AED in the workplace

Which type of Cardiomyopathy may be present with sudden death as the first symptom

Hypertrophic

For which complication is the nurse monitor when a client with chronic stable angina is prescribed a calcium channel blocker

Hypotension

New York Heart Association Classification

I: no limitations of physical activity II: slight limitation of physical activity, but comfortable at rest III: marked limitation of physical activity, but comfortable at rest IV: symptoms with activity and at rest

positive chronotrope

INCREASES heart rate. Atropine

which clients are at greatest risk for development of infective endocarditis? Select all that apply.

IV Drug users Poore, dental health Opioid addiction's Systemic alterations in immunity Postoperative after valve replacement

which drug with the nurse is preparing to administer when a client enters the emergency department with chest pain described as a tearing sensation, diaphoresis blood pressure of 200/1,30 weak pulses, and a sense of apprehension

IV beta blocker

Which procedure has shown promise for managing clients with cardiogenic shock

Immediate reperfusion

When a client has an ejection fraction of less than 30% about which potential treatment does the nurse prepares to educate the client

Implantable cardioverter/defibrillator

What is the purpose of including exercise and activity in a cardiac rehabilitation program? (Select all that apply.)

Increase flexibility Increase cardiac output Increase muscle mass Increase blood flow through the arteries

Which symptom causes most clients to seek medical attention for peripheral arterial disease

Intermittent claudication

what is the nurses best explanation to a client for use of low-dose niacin to decrease LDL cholesterol and very low density lipoprotein cholesterol levels

It helps reduce side effects of flushing and feeling too warm

which client serum lipid tests suggest an increased risk for cardiovascular disease? Select all that apply.

LDL 170 Triglycerides 185 VLDL 39 Total cholesterol 250

Which procedure with the nurse provide teaching about to a client who has chronic atrial fibrillation, and is that increase risk for a stroke but it's not a candidate for anticoagulation

Left atrial appendage occlusion

which may be causes of a client paracardial friction rub? Select all that apply.

MI Cardiac tamponade Infection Inflammation Thoracotomy

which dog is the nurse prepared to administer to a client diagnosed with a dysrhythmia torsades de pointes

Magnesium sulfate

What is the best non-surgical intervention for a client with a 3 cm abdominal aortic aneurysm, to decrease the risk of rupture?

Maintenance of normal blood pressure and avoidance of hypertension

which condition would the nurse expect when a client has these findings (BP 200/130, sudden, headache, blurred vision, and dyspnea)

Malignant hypertension

How would the critical care nurse assess for post operative bleeding in a client who just had CABG surgery

Measure mediastinal and plural chest tube drainage at least once an hour and report drainage amount over 150 mL per hour to the surgeon

What is the nurses first action win the healthcare provider prescribes orthostatic blood pressure checks for a client

Measure the blood pressure after the client has been supine for three minutes

management of acute aortic regurgitation

Medical emergency! Immediate surgery

which priority action will the nurse take when providing care for a client with chest pain being treated with IV nitroglycerin

Monitor blood pressure continuously

Which assessment with the nurse perform to help prevent home from graft collapse after CABG surgery

Monitor blood pressure for hypotension

what are the priority nursing actions related to caring for an older adult client with heart failure who is prescribed digoxin? Select all that apply.

Monitor the ECG strip for early signs of toxicity, such as bradycardia Auscultate the apical pulse rate and rhythm for a full minute before administering the drug Observe for signs of toxicity, which are often nonspecific, such as anorexia fatigue, and blurred vision Report any changes in heart rate or rhythm to the healthcare provider Monitor serum, digoxin, and potassium levels Check the healthcare providers prescription for parameters to hold the drug

which instructions with the nurse give the LPN monitoring a client after cardiac catheterization by radial artery approach? Select all that apply.

Monitor the client vital signs every 15 minutes for one hour Assess the insertion site for bloody drainage or hematoma Assess peripheral pulses in skin temperature in color with every vital sign check Monitor intake and output Provide oral fluids for adequate contrast excretion

The nurse is assessing a client with arterial insufficiency. What assessment data would cause the nurse to suspect an acute arterial occlusion of the right lower extremity? (Select all that apply.)

Mottling of right foot and lower leg Numbness and tingling of right foot Cold right foot

which statement by the client who had a CABG surgery indicates to the nurse that his or her pain is related to the sternotomy and is not anginal in origin

My pain increases when I cough or take a deep breath

The nurse is assessing a female patient at the neighborhood clinic. The patient reports "feeling tired all the time." The nurse knows that fatigue may be an underlying symptom of which condition?

Myocardial infarction

What early sign of left ventricular failure is a client most likely to report to the nurse?

Nocturnal coughing

What is the nurses best first action when a client who has sepsis is found to have a blood glucose of 310

Notify the primary healthcare provider

What would be the nurses best action when I client reports dizziness when changing position from sitting to standing and sudden dry cough after starting a prescription of captopril

Notify the primary healthcare provider immediately about the side effects

A client comes to the emergency department with chest discomfort. Which action does the nurse perform first?

Obtains the client's description of the chest discomfort.

What frequency of drug dosage therapy with the nurse advocate for an older client with hypertension who lives alone and is able to manage his or her own care?

Once a day

which statements about percutaneous vascular interventions are accurate?

One or more arteries are dilated with a balloon catheter to open the vessel stents are often placed to ensure adequate blood flow Some clients are occlusion free for 3 to 5 years Clients who are candidates must have a collisions or stenosis that or accessible to the catheter?

which body area on a client with darker skin who is at high risk for shock will the nurse examined for indications of pallor and cyanosis

Oral mucous membranes

which statement best describes the functional capability of a client who is categorized as New York heart association class II?

Ordinary physical activity results in fatigue, palpitations, dyspnea, and anginal pain.

which wave form does the nurse recognize as atrial depolarization when a client is placed on a cardiac monitor

P-wave

which relatively new therapy would be tried for clients with familial hypercholesterolemia or for those who are unable to reduce LDLs with existing therapies

PCSK9 inhibitors

which test will the nurse teach a client or routinely done for follow up monitoring when the client is discharge with a prescription for warfarin

PT and INR

Based on the ideology and main cause of heart failure, the nurse knows that which client has the greatest need for health. Promotion measures to prevent heart failure.

Patient with hypertension

Which clients are at increased risk for peripheral arterial disease

Patient with hypertension Patient with diabetes Patient who smokes Patient who is black

Which procedure with the nurse expect to be recommended for a client with discreet, proximal noncalcified blockage in one coronary artery

Percutaneous coronary intervention

What is the priority medical surgical concept when the nurse is assessing a client for cardiovascular disease?

Perfusion

What would the nurse expect when assessing a client sliver extremities and finding decreased pedal pulses skin that is cool to touch loss of hair and thickends toenails?

Peripheral arterial disease

an alert and oriented client comes to the walk in clinic with left side of chest pain, mild shortness of breath and diaphoresis. What is the nurses first priority action

Place the client, in semi fowler position with supplemental oxygen

which blood product does the nurse anticipate will be order to infuse first and a client who has septic shock with poor clotting and hemorrhage

Platelets

A client is receiving unfractionated heparin (UFH) by infusion. What laboratory data will the nurse report to the primary health care provider (PCP)?

Platelets 32,000/mm3 (32 × 109/L)

The nurse is teaching a class about mechanical properties of the heart. What teaching will the nurse include?

Preload is the degree of stretch in the myocardial fibers

What is the nurse expect when assessing a client's elementary ECG strip and noting AY disorder QRS complex of 0.14 seconds and followed by a P-wave.

Premature ventricular complex, followed by atrial contraction

A client admitted after using cocaine develops ventricular fibrillation. After determining unresponsiveness, which action will the nurse take next?

Prepare for defibrillation.

Which action does the nurse perform to prevent kidney toxicity when caring for a client after cardiac catheterization?

Provide RV and oral fluids for 12 to 24 hours

Which change in laboratory, values or clinical symptoms in a client with hypovolemic shock indicates to the nurse that current therapy may need to be changed

Pulse pressure decreases from 28 to 22

What is the nurses next action five minutes after administering a sublingual nitroglycerin tablet to a client with chest pain?

Recheck pain, intensity, and vital signs

Which priority teaching with the nurse provide to a client with ineffective endocarditis, who is scheduled for an invasive dental procedure

Remind your healthcare provider to provide you with a prescription for a prophylactic antibiotics

which important teaching points with the nurse discuss with a client who receives a new permanent pacemaker? Select all that apply.

Report any pulse rate that is lower than the rate set on the pacemaker Avoid sources of strong electromagnetic field, such as magnets Carry a pacemaker identification card and wear a medical alert bracelet Avoid tight clothing to prevent pressure over the pacemaker generator

which actions are responsibilities of the monitor technician? select all that apply

Report client rhythm and significant changes to the nurse Print routine ECG strips for each monitored patient Watch the bank of cardiac monitors on a client care unit Interpret rhythm strips for each monitor client

which topics with the nurse be sure to cover when providing discharge instructions for a client with prosthetic valve surgery? Select all that apply.

Report dyspnea, syncope, dizziness, edema, and palpitations to your healthcare provider Use an electric razor to avoid skin cuts Notify your healthcare provider for any bleeding or excessive bruising Watch for, and report any fever or drainage and redness at the surgical site

what would be the priority, nursing action when a client experiences increasing pain, swelling, and tenseness after a thrombectomy?

Report the symptoms to the healthcare provider immediately

Which client assessment data is most consistent with cardiac pain requiring the nurse to notify the primary health care provider?

Reports of pressure in the upper abdomen and sternum and diaphoresis

The nurse is caring for a client with peripheral arterial disease (PAD). Which symptom will the nurse anticipate?

Reproducible leg pain with exercise

The nurse is caring for a client 36 hours after coronary artery bypass grafting. Which assessment causes the nurse to terminate an activity and return the client to bed?

Respiratory rate 28 breaths/min

what is the best advice the nurse would give to a client with moderate to severe cramping sensation in their legs or buttocks associated with an activity such as walking

Resting or lowering, the affected extremity can relieve the pain

Which instruction would the nurse give to the assistive personnel who is helping a client with heart failure and excessive aldosterone secretion

Restrict the clients fluid to 2 L per day and keep accurate intake and output

Which, finding my strongly indicates left heart failure, and a client when the nurse auscultates heart sounds

S3 Gallop

which client has an abnormal heart sound?

S3 in a 54-year-old

heart failure signs

S3/S4 heart sounds elevated jugular venous pressure pulsus alternans rales/crackles, ronchi, wheezes hepatosplenomegaly anasarca pedal edema presacral edema murmur

dilated cardiomyopathy assessment findings

S3/S4 heart tones systolic murmurs crackles diminished lung sounds tachypnea

what common assessment finding would the nurse expect to find in an older adult with cardiovascular disease

S4 heart sound

which finding would the nurse expect when I client experience is a non-ST segment elevation MI

ST depression, and T-wave inversion on a 12 lead ECG

what is the nurses best interpretation when reviewing a clients abdominal CT scan and noting that there is an out pouched segment coming off of the abdominal aorta

Saccular aneurysm

A client with heart failure is prescribed furosemide. Which assessment data concerns the nurse with this new prescription?

Serum potassium level of 2.8 mEq/L (2.8 mmol/L)

Which intervention provides safety during cardioversion?

Setting the defibrillator to the synchronized mode

Which symptom in a client with sepsis does the nurse consider a late indication of septic shock?

Severe hypotension

Which assessment by a new nurse requires the charge nurse to intervene?

Simultaneously palpating bilateral carotids

A client's rhythm strip shows a heart rate of 116 beats/min, one P wave occurring before each QRS complex, a PR interval measuring 0.16 second, and a QRS complex measuring 0.08 second. How does the nurse interpret this rhythm strip?

Sinus tachycardia

The nurse with teach a client to seek treatment for symptoms of myocardial infarction immediately rather than delay, because physical changes occur in how many hours after an MI

Six hours

The nurse is teaching a class on risk factors for cardiovascular disease. Which risk factors will the nurse include? (Select all that apply.)

Smoking history Family history of heart disease Elevated C-reactive protein levels Diabetes Mellitus

which statement by client at high-risk for hypovolemic shock is the greatest concern to the nurse

Something feels wrong, but I'm not sure what it is causing me to feel this way

The nurse is assessing a client with a cardiac infection. Which nursing assessment data causes the nurse to suspect infective endocarditis instead of pericarditis or rheumatic carditis?

Splinter hemorrhages

what is the most important teaching point for the nurse to emphasize with a client who has buergers disease

Stop smoking cigarettes and prevent exposure to tobacco to arrest the disease process

Which information from a clients medical history causes the nurse to check for abnormalities of the heart valves

Streptococcal infections of the throat

For which pathophysiological conditions can a healthy heart adopt to maintain perfusion to the body tissues

Stress and infection

For prevention of DVT, which drug with the nurse, expect the healthcare provider to prescribe

Subcutaneous, low molecular weight heparin

The nurse is assessing a client with chest pain to evaluate whether the client is experiencing angina or myocardial infarction (MI). Which assessment is indicative of an MI?

Substernal chest pressure relieved only by opioids

Which assessment data will the nurse associate with suspected pericarditis? (Select all that apply.)

Sudden-onset chest pain relieved by anti-inflammatory agents. Chest pain relieved by sitting upright. Pain in the chest described as sharp or stabbing.

When a client develops heart failure with initial compensatory mechanism of the heart, does the nurse expect to occur that will maintain cardiac output

Sympathetic stimulation

Which major self-management categories will the nurse include when teaching a client, newly diagnosed with heart failure, who is about to be discharged? Select all that apply.

Symptoms, what to do when they get worse Medications Activity Weight Diet

After administering sublingual nitroglycerin to a client who is baseline blood pressure is 130/80 for which finding would the nurse immediately notify the healthcare provider

Systolic pressure is 90

Which action increases the effectiveness of angiotensin II receptor blockers and angiotensin converting enzyme inhibitors in controlling hypertension for African-American clients

The ARB and ACE is given with a diarrhetic beta blocker, or a calcium channel blocker

Which nurse would be assigned to care for a client who is intubated with septic shock due to a methicillin-resistant Staphylococcus aureus (MRSA) infection?

The RN with 2 years of experience in intensive care unit (ICU).

which definition best describes a electrophysiologic property called automaticity Of myocardial pacemaker cells

The ability of cardiac cells to generate an electric impulse spontaneously and repetitively

automaticity

The ability of the heart to generate and conduct electrical impulses on its own.

when a client with heart failure walks 200 feet down the hall and develops a feeling of having us in the legs. How does the nurse interpret this finding

The activity is too stressful

stroke volume

The amount of blood ejected from the heart in one contraction.

what control systems play an important role in maintaining a clients blood pressure?

The arterial baroreceptor system Regulation of body fluid volume Vascular autoregulation The renin angiotensin aldosterone system

Which assessment data is most important for the nurse to report to the primary care provider prior to a coronary arteriogram?

The client develops wheezes and dyspnea after eating crab or lobster.

how does the nurse interpret a clients telemetry ECG sure if that shows four successive premature ventricular contractions

The client had an episode of nonsustained, ventricular tachycardia

How does the nurse best interpret a clients low density lipoprotein cholesterol value, which is greater than 190 and does not respond to dietary intervention

The client should be evaluated for secondary causes of hyper lipidemia and treated with starting therapy because of the high low density lipoprotein cholesterol level

The nurse is assigned to all of these clients. Which client would the nurse assess first?

The client who had percutaneous vascular intervention of the right femoral artery 30 minutes ago.

After receiving change-of-shift report in the coronary care unit, which client will the nurse assess first?

The client with acute coronary syndrome who has a 3-lb (1.4-kg) weight gain and dyspnea.

A client admitted for heart failure has a priority problem of hypervolemia related to compromised regulatory mechanisms. Which nursing assessment data, obtained the day after admission, is the best indicator that the treatment has been effective?

The client's weight decreases by 2.5 kg.

afterload

The force or resistance against which the heart pumps.

which statements about the structure of the heart are accurate? Select all that apply.

The heart normally pumps about 5 L of blood per minute The pericardium is a covering that protects the heart coronary artery bloodflow occurs primarily during diastole

How will the nurse interpret a change in the white blood cell count of a client with sepsis in which the band neutrophil count is increasing and the segmented neutrophil count is decreasing

The infection is becoming worse

Which nursing intervention for a client admitted today with heart failure will assist the client to conserve energy?

The nurse obtains a bedside commode before administering furosemide.

what is the nurse suspect when a client who had a bruit on assessment during the previous two days does not have a bruit on assessment today

The occlusion of the blood vessel is now 90%

preload

The precontraction pressure in the heart as the volume of blood builds up.

A client begins therapy with lisinopril. What does the nurse consider at the start of therapy with this medication?

The risk for hypotension

How are the nurse best interpret the electrocardio gram of a younger, athletic client, which shows sinus bradycardia with a rate of 54 bpm

The sinus bradycardia provides an adequate stroke volume that is associated with cardiac conditioning

Why are the clinical signs and symptoms of most types of shock the same regardless of what specific events or conditions caused the shock to occur?

The sympathetic nervous system is triggered by any type of shock in initiates the stress response

What drug with the nurse expect to be prescribed for a client with hypertension, and for whom lifestyle modifications, have failed to control blood pressure

Thiazide diuretic

How many cigarette pack years has the client smoked if they smoke half a pack a day for six years?

Three pack years

To assess if a client has had a myocardial infarction (MI), which lab value will the nurse assess?

Troponin

Which laboratory finding is consistent with acute coronary syndrome (ACS)?

Troponin 3.2 ng/mL (3.2 mcg/L)

A client has been admitted to the hospital with chest pain radiating down the left arm. Which test result best confirms that the client sustained a myocardial infarction (MI)?

Troponin of 5.2 ng/mL (5.2 mcg/L)

The nurse is preparing to teach a client that metabolic syndrome can increase the risk for myocardial infarction (MI). Which signs of metabolic syndrome will the nurse include? (Select all that apply.)

Truncal obesity Client taking losartan Glucose intolerance Hypercholesterolemia

The nurse is caring for a client who had abdominal aortic aneurysm (AAA) repair. Which assessment data is most concerning to the nurse?

Urine output of 20 mL over 2 hours

Following CABG surgery, a clients body temperature is below 96.8 Fahrenheit what measures with the nurse take to rewarm the client

Use lights and thermal blankets to slowly warm the client

The nurse is assessing the sleep patterns of a patient when the patient reports he has trouble sleeping when lying flat. Which is the best response by the nurse?

Use pillows to prop yourself up while sleeping.

The nurse is assessing a client with mitral stenosis who is to undergo a transesophageal echocardiogram (TEE) today. Which nursing action is essential?

Validate that the client has remained NPO.

which statement about the peripheral vascular system is accurate?

Veins have valves that direct blood flow to the heart and prevent backflow.

When a client has been an atrial fibrillation for three days and is scheduled for an elective cardioversion. What priority teaching does the nurse provide to the client?

Watch for any sign of bleeding and report this to your healthcare provider

what is the most reliable method of monitoring for fluid gain or loss in a client with heart failure?

Weigh the client daily at the same time in using the same scale

The nurse in the cardiology clinic is reviewing teaching provided at the client's last appointment regarding hypertension management. Which actions by the client indicate that teaching has been effective? (Select all that apply.)

Weight loss of 3 lb (1.4 kg) since last seen in the clinic. Reports eating a low-sodium diet. Reports drinking one less cup of coffee daily.

which lifestyle changes with the nurse teach a client to help control hypertension

Weight reduction, if overweight or obese Implement a healthy diet such as the dash diet use relaxation techniques to decrease stress Increase activity by use of a structured exercise program

When will the nurse be sure to hold a beta blocker drugs and notify the healthcare provider?

What a client heart rate is less than 50 bpm and systolic is less than 100

Which statement by a client indicates to the nurse correct understanding of resuming sexual activity in the presence of angina

When I can climb two flights of stairs, it is safe to resume sexual activity

when will the nurse expect the release of BNP for a client with heart failure

When a client has fluid overload

When sepsis is diagnosed in a client when will the nurse initiate the prescribed anabiotic therapy?

Within the first 24 hours after diagnosis

to improve gas exchange how much supplemental oxygen with the nurse provide a client with heart failure

Within the range prescribed by the HCP to keep saturation at 90% or more

The nurse is educating a group of women about the differences in symptoms of myocardial infarction (MI) in men versus women. Which teaching will the nurse include?

Women may experience extreme fatigue and dizziness as sole symptoms.

Which ECG strip pattern is evidence to the nurse that a client's temporary transvenous pacemaker has successfully depolarized the ventricles?

a pacer spike followed by a QRS complex

Which location would the nurse expect to be the most common for a client to form an aneurysm?

abdominal aorta

What were the nurse assess for when a client is suspected of having an abdominal aortic aneurysm

abdominal flank or back pain gnawing pain unaffected by movement Pulsation in the upper abdomen Auscultation of a bruit in the upper abdomen

contractility

ability of all muscle cells to contract after the impulse

conductivity

ability of each cell to receive an impulse to contract

orthopnea

ability to breathe only in an upright position

Amyloidosis

abnromal protiens that are folded into beta sheets cause damage and trigger apoptosis

Which complication with the nurse remain alert for in a client who has septic shock

acute respiratory distress syndrome

what is the priority intervention when a client comes to the emergency department with extreme anxiety, tachycardia, struggling for air and moist cough productive of frothy and blood tinged sputum

administer high flow oxygen therapy by face mask

which actions are essential nursing care for a client immediately after elective cardioversion? Select all that apply.

administer oxygen Assess vital signs and level of consciousness Monitor for dysrhythmias Maintain an open airway Document the results of the cardioversion

which statements about shock are true

affects all body organs Is a whole body responds to tissue hypoxia Results in widespread abnormal cellular metabolism May occur in older adults in response to UTI

management of chronic aortic regurgitation

afterload reduction to promote forward flow volume regulation RAAS interruption surgical intervention when pt is symptomatic

Which criteria are appropriate for a client with dilated cardiomyopathy to become a candidate for a heart transplant surgery

age generally less than 65 New York heart association class 3 or 4 Normal or only slightly increase, pulmonary vascular resistance Absence of active infection

Which are potential causes of dilated cardiomyopathy

alcohol abuse Infection Chemotherapy Poor nutrition

Which specific drug therapy will the nurse anticipate for management of the client who has septic shock

antibiotics

which absolute contraindications with the nurse assess for when a client is being considered for thrombolytic therapy

any prior intracranial hemorrhage Suspected, aortic dissection known malignant intracranial neoplasm Active bleeding or bleeding diathesis

aortic regurgitation

aortic valve leaflets do not close properly during diastole & the annulus may be dilated, loose or deformed

which laboratory values in a client with hypovolemic shock with the nurse associate with a progressive stage of shock

arterial blood, pH 7.32. Serum, lactate 9 Potassium 6.3.

What does the nurse suspect when assessing a client at risk for CVD who states my right foot turns very dark red when I sit too long and when I put my foot up, it turns pale

arterial insufficiency

Which drugs are useful in promoting circulation for client with chronic peripheral arterial disease?

aspirin pentoxifylline clopidogrel cilostazol

what is the priority action for the nurse when the monitor technician states that a client telemetry monitor shows a rhythm that appears as a wandering or fuzzy baseline

assess the client to differentiate artifact from an actual lethal rhythm

Which would be the best method for the nurse to confirm a report from the monitor technician about a change in a monitored clients heart rate

assess the client's heart rate directly by checking the apical pulse

which are nursing responsibilities for the care of a client with a newly implanted, permanent pacemaker? Select all that apply.

assess the implantation site for bleeding, swelling, redness, tenderness, or infection Monitor the ECG rhythm strip to ensure that the pacemakers working correctly Assess that the implantation side dressing is clean and dry Teaching a client about initial activity restrictions

Which actions are priority for the nurse to perform to prevent harm for a client with hypovolemic shock, who is receiving an infusion of dobutamine

assessing for chest pain throughout the infusion Measuring blood pressure every 15 minutes Checking the infusion site every 30 minutes

Which task with the nurse delegate to the assistive personnel when caring for a client in phase 1 of cardiac rehabilitation?

assist the client with ambulation to the bathroom

which criteria support the nurses assessment that a client ECG rhythm strip shows a normal sinus rhythm?

atrial and ventricular rates are regular P waves are present before every QRS complex QRS duration is consistent at 0.08 second Atrial and ventricular rates are 82 bpm

Which essential points with the nurse include when teaching a client with coronary artery disease how to manage activity at home

begin by walking the same distance at home as in the hospital three times each day Always carry a bottle of nitroglycerin with you Exercise outdoors when the weather is Pleasant Avoid straining

After calling for help, when the nurse finds a client in his or her room without a pulse, apneic and unconscious, which action should be taken next?

begin cardiac compressions

aortic stenosis treatment

beta blockers BP control valve replacements

What are complications of the nurse would monitor for after a client receives an Endo vascular stent graft for emergent repair of an abdominal aortic aneurysm

bleeding Misplacement of stent graph Peripheral embolization endoleak Aneurysm rupture

Which indicators of metabolic syndrome would the nurse expect in a client with heart failure?

blood pressure of 130/86, while taking a beta blocker Increase fasting glucose of 100 or higher Increase level of triglycerides of 150 or higher Decreased LDL - C of less than 50 forwomen

which drug with the nurse expect the primary healthcare provider to prescribe for a client to decrease blood pressure decrease triglycerides increase high density, lipoprotein cholesterol and lower low density lipoprotein cholesterol

caduet

which causes with the nurse recognizes leading to increased atrial irritability and premature atrial contractions in a clients myocardium

caffeine intake Anxiety Stress in life Infection

Which statements about the use of thrombolytic agent for a client with an acute myocardial infarction are accurate

call onto cannot receive timely percutaneous coronary intervention with indications of ST elevation. Myocardial infarction should be considered for fibrinolytic therapy A client who has received a thrombolytic agent must be carefully monitored before during, and after the drug is given The client must be assessed for absolute and relative contraindications before a thrombolytic agent is administered Monitor for bleeding, which is a major risk when a client receives thrombolytic therapy Indications that the client has been dissolved in the artery reperfused include sudden onset of ventricular dysrhythmia's

which complication is a client at most risk for when the nurse notes that excessive fluid was seen in the pericardial cavity on echocardiogram

cardiac tamponade

which assessment has the highest priority for the nurse to perform to prevent harm when caring for a client in hypovolemic shock who is receiving IV sodium nitroprusside

checking blood pressure every 15 minutes

Which findings with the nurse expect when assessing a client with chronic stable angina

chest discomfort that occurs in a pattern that is familiar to the patient Chest discomfort that occurs with moderate to prolong exertion Frequency, duration, and intensity of symptoms remain the same over several months Usually treated with rest and nitroglycerin Pain last less than 15 minutes

Which are characteristics, the nurse would expect to find in a client with unstable angina

chest pain occurs at risk or with exertion Pain causes several limitation of activities Ischemia does not cause myocardial damage or cell death The pain or pressure is poorly relieved by nitroglycerin

Sarcoidosis

chronic inflammatory disease in which small nodules (granulomas) develop in lungs, lymph nodes, and other organs

restrictive cardiomyopathy

class of cardiomyopathy where the heart is not dilated and the ejection fraction is normal, but there is diastolic dysfunction causes: amyloidosis and hemochromatosis

Which founding perhaps the nurse to immediately contact the surgeon for a client who had a minimally, invasive, direct coronary artery bypass

client has ECG changes, including Q waves and ST segment and T wave changes in leads V2 and V6

Which client does the nurse expect to have the highest risk for death related to damage to the left ventricle

client with an anterior wall MI

Which clients are potential candidates for coronary artery bypass graft surgery

client with angina and greater than 50% equation of the left main coronary artery that cannot be stented Client with vascular disease Client with coronary vessels unsuitable for percutaneous coronary intervention Client with ischemia or impending MI after angiography or PCI

When the nurse performs blood pressure screenings, which clients would be referred for further evaluation

client with heart disease and blood pressure of 148/90 Renal failure client with a blood pressure of 180/90 Client with muscle cramping taking a statin drug with a blood pressure of 124/82 COPD patient with blood pressure of 158/88

pericardium cardiomyopathy

commonly diagnosed one month before delivery and up to 4 months post delivery commonly missed, mistaken for "normal" symptoms of pregnancy ACE/ARB contraindicated during pregnancy

which actions are most appropriate for the nurse to take first when a client with blunt trauma to the abdomen who has been NPO for several hours now reports thirst and anxiety

compare current vital signs to baseline Measure abdominal girth

Chemoreceptors

compensatory mechanism for low bp

which are conservative management measures for a client's varicose veins

compression stockings Exercise to increase venous return Elevate the extremity

mitral stenosis

constriction of mitral valve extertional dyspnea is usually the first symptom symptoms can greatly worsen during pregnancy

Which instructions with the nurse give a client for following dietary recommendations of the American College of cardiology and the American Heart Association

consume, low-fat dairy products, poultry, and fish limit, intake of sweets and red meats Eat legumes, tropical vegetable oils, and nuts

systolic

contraction

which early symptoms indicate to the nurse at a clients heart failure is getting worse and pulmonary edema is developing? Select all that apply.

crackles in the lung bases Dyspnea at rest Disorientation

left sided heart failure

decreased emptying of left ventricle increased volumes in the left ventricle increased volumes in the left atrium increased volumes in pulmonary veins increased volumes in pulmonary capillaries movement of fluid from blood to alveoli alveolar flooding/pulmonary edema continued back up pressure that leads to right ventricular failure

pathophysiology of heart failure

decreased left ventricular performance activation of sympathetic nervous system activation of RAAS release of aldosterone

what is the priority problem when a nurse assesses a client with CVD and notes skin that is pale cool and moist.

decreased perfusion

negative inotrope

decreases contractility

negative chronotrope

decreases heart rate (metoprolol)

Which statement best defines the cardiovascular concept of preload

degree of myocardial fiber stretch at the end of diastole and just before the heart contracts

what is the most common in normal response by the client to a cardiovascular illness?

denial

what assessment findings with the nurse expect to find in a client with right sided heart failure? Select all that apply.

dependent edema Neck vein distention Hepatomegaly

For which manifestations with the nurse monitor when providing care for a client prescribed beta blocker therapy

depression Bradycardia Decreased level of consciousness Crackles or wheezes in the lungs Chest discomfort

MAP

determines how much blood is getting to the other organs systolic + diastolic x2/3

which statements about blood pressure are accurate? Select all that apply.

diastolic blood pressure is primarily determined by the amount of peripheral vasoconstriction Systolic blood pressure is the amount of pressure or force generated by the left ventricle to distribute blood into the aorta Paradoxical blood pressure is an exaggerated, decrease in systolic pressure by more than 10 mmHg during the inspiratory phase of the respiratory cycle

mitral stenosis s/s

diastolic murmur JVD hepatomegaly peripheral edema ascites mitral facies- rosy cheeks while the rest of the face is cyanotic

pulse pressure

difference between systolic and diastolic pressure

how do we influence cardiac output?

digoxin fluids epinephrine atropine levophed metoprolol

dilated cardiomyopathy

dilated left ventricle leads to ineffective pump during systole Causes: genetics thyrotoxosis myxedma excessive alcohol use chemo Weakened contractility Decreased cardiac output

cardiomyopathy

disease of the heart muscle 4 types: dilated hypertrophic restrictive infiltrative

which conditions will the nurse consider as increasing any clients risk for hypovolemic shock

diuretic therapy Prolong, diarrhea Continuous nasogastric suction Large, draining, abdominal wound

meds for HF

diuretics ACEs ARBs Beta blockers SGLT-2 inhibitors

which questions with the nurse used to assess clients P-wave on a ECG rhythm strip? Select all that apply

do all P waves look similar are P waves present are P waves occurring regularly are the P waves greater than 0.20 seconds are P-wave smooth rounded an upright

which questions with the nurse asked to assess the clients nicotine dependence? Select all that apply.

do you smoke even when you are ill? How soon after you wake up in the morning, do you smoke? Do you wake up in the middle of the night to smoke? Do you find it difficult not to smoke in places were smoking is prohibited

What is the nurses best advice for a client who is an avid golfer, but has been recently diagnosed with thoracic outlet syndrome?

don't elevate your arms above your head

which signs and symptoms with the nurse expect to assess when a client is diagnosed with aortic stenosis?

dyspnea on exertion Angina Harsh systolic crescendo, decrescendo murmur Orthopnea

Which essential nursing teaching with the nurse provide for a client being discharged with chronic venous insufficiency

elevate your legs at least 20 minutes 4 to 5 times a day Avoid crossing legs at all times Avoid standing, still for any length of time Avoid tight restrictive pants, girdles, or garters

which nursing actions have priority, when a client with acute superventricular tachycardia is to be administered adenosine by the healthcare provider? Select all that apply.

ensure that emergency equipment is at the bedside Follow the drug injection with a normal saline bolus Monitor the client for bradycardia, nausea and vomiting

what actions with the nurse take when the monitor technician states that a clients telemetry ECG signal transmission is not very clear? Select all that apply.

ensure that the gel on each electrode is moisten fresh Clean the skin and clip hairs if necessary Make sure that the skin is free of lotions or any other substance Check to be sure that electrodes are not placed over scar tissue

aortic stenosis symptoms

exertional dyspnea exercise intolerance palpitations syncope s/s heart failure/pulmonary edema

Which client parameters will the nurse report to the healthcare provider is consistent with the quick sequential organ failure assessment, indicating the possible presence of sepsis or septic shock

eyes are open, but does not respond to questions Respiratory rate of 28 Systolic blood pressure of, 92

what signs and symptoms with the nurse expect to assess in a client with sinus tachycardia? Select all that apply.

fatigue Shortness of breath Decrease oxygen saturation Decrease blood pressure Anginal pain

heart failure symptoms

fatigue rest or dyspnea exertion orthopnea paroxysmal nocturnal dyspnea edema cough weight gain/loss anorexia bloating somnolence cheyne stokes breathing

which triad of symptoms with the nurse assessed for in a woman at risk for cardiovascular disease? Select all that apply.

feeling of abdominal fullness Chronic fatigue, despite adequate rest Dyspnea or inability to catch her breath

Which observations with the nurse expect when a client develops mediastinitis after CABG surgery

fever continuing beyond on the first four days after surgery Bogginess of the sternum Redness and drainage from the suture site Induration or swelling at the suture site

which statements about intravascular ultrasonography are accurate? Select all that apply.

flexible catheter with a miniature transducer is introduced at the distal tip to view the coronary arteries The catheter has a transducer which emits sound waves that reflect off the plaque and the arterial wall, to create an image of the blood vessel Intravascular ultrasonography can be used in vessels as small as 2 mm to access the nature of plaques or vessel condition, following an intervention

Which nonsurgical management techniques with the nurse expect when caring for a client with DVT

gradual increase in ambulation as tolerated by the client Elevation of legs, when in bed or sitting in a chair Knee or thigh, high compression stockings Anticoagulant drugs, as prescribed

Which alternative therapies may be helpful in reducing a clients anxiety about progressive activity, postoperatively, and during rehabilitation

guided imagery Progressive muscle relaxation Music therapy Pet therapy

Arrhythmogenic right ventricular cardiomyopathy

heart muscle gets replaced by fat causes arrhythmias to occur 2nd leading cause of sudden cardiac death in ages under 65 managed with beta blockers

cardiac output

heart rate x stroke volume

Widening pulse pressure indicates

hemorrhage

left side of the heart

high pressure

which assessment factors for a 62-year-old client with the nurse recognize as modifiable risk factors for heart disease? Select all that apply.

history of smoking Obesity Sedentary lifestyle

Which findings with the nurse expect to assess when a client presents with a thoracic aortic aneurysm

hoarseness Shortness of breath Difficulty swallowing Visible mass above the substernal notch

Which treatment best applies to the care of a client newly diagnosed with ineffective endocarditis?

hospitalization for initial IV anabiotic's followed by continued IV anabiotic's at home

which questions with the nurse ask a client when a client is admitted reporting chest pain? Select all that apply.

how long does the pain last and how often does it occur? Where does the pain occur And what does it feel like? have you had other symptoms that occur with the chest pain and what are they? What activities were you doing when the pain occurred? Is this episode of chest pain different from other episodes you have had?

what risk factors for atrial fibrillation with the nurse monitor for in a client? Select all that apply.

hypertension Diabetes Excessive alcohol intake Mitral valve disease

Which symptoms would indicate to the nurse that a client aneurysms had a ruptured

hypotension Diaphoresis Decreased level of consciousness Loss of pulses distal to rupture Scant urine output

for which client problems associated with hypovolemic shock with the nurse, specifically prepared to administer a blood product rather than IV crystalloids

hypoxemia Low H&H

what priority teaching with the nurse provide for a client who will be discharged with a prescription for atorvastatin

immediately report any muscle cramping to your healthcare provider

mitral regurgitation

inadequate closure of mitral valve backward flow into left atrium

Which changes in vital signs of a client in the early postoperative period indicates to the nurse that the client may be in the initial stage of hypovolemic shock

increased heart rate Increase respiratory rate Increase diastolic blood pressure

positive inotrope

increases contractility (digoxin)

Which intervention with the nurse perform to protect a client from a sternal wound infection after a CABG surgery

instruct the client to shower with 4% chlorhexidine gluconate Prepare the surgical site by clipping hair than applying chlorhexidine with isopropyl alcohol Administer IV antibiotics, one hour prior to the surgical procedure

which statements pertaining to the use of an Unna boot for a client are accurate

it is constructed from gauze and zinc oxide A premade venous return in prevents stasis It forms a sterile environment for the ulcer The client is instructed to report any increase in pain

which essential points with the nurse include when teaching a client with angina about nitroglycerin tablets

keep your nitroglycerin tablet pills with you at all times You can tell the tablets are active when you feel a tingling after placing one under your tongue Keep the tablets in a glass light resistant container

which mechanisms regulate and mediate blood pressure? Select all that apply.

kidneys Autonomic nervous system Endocrine system

which descriptions are characteristics of class III antidysrhythmic drugs? Select all that apply.

lengthen absolute refractory period Include bradycardia as a side effect for some drugs Prolong repolarization

which techniques with the medical surgical nurse use when inspecting a clients precordium? Select all that apply.

look at the chest from the side, at a right angle, and downward over areas of the precordium, where vibrations are visible No any movement over the aortic pulmonic and tricuspid areas Observe for the location of the point of maximal impulse, and note any shifts

right side of the heart

low pressure

which information would the nurse be sure to include when teaching a client with peripheral arterial disease about methods to promote vasodilation

maintain a warm environment at home Wear socks are insulated shoes at all times Prevent cold exposure to the affected limb Completely abstain from smoking or chewing tobacco Avoid emotional stress and excessive caffeine

Which pays for seizure medication with the nurse teach about before discharge to a client who had a percutaneous coronary intervention

metoprololm Aspirin Clopidogrel Isosorbide dinitrate

which type of heart vascular disease does the nurse suspect when a client's assessment reveals pitting edema

mitral valve stenosis and regurgitation

heart failure risk factors

myocardial infarction myocarditis untreated tachycardias diabetes congenital heart disease sleep apnea excessive alcohol use drug use obesity

Which condition is indicated when the nurse notes ST segment elevation, or one to two small blocks on a clients ECG

myocardial injury or ischemia

About which associated symptoms with the nurse ask a client with a history of intermittent episodes of chest pain

nausea Shortness of breath Dizziness Diaphoresis

which assessment findings would cause the nurse to suspect cardiac tamponade in a client? Select all that apply.

neck vein, distention Paradoxical pulse Muffled heart sounds Tachycardia

which drug with the nurse expect to administer to a client with raynauds or buergers disease

nifedipine

which drugs with the nurse prepares are administered to a client with heart failure who has developed pulmonary edema? Select all that apply.

nitroglycerin sublingual Furosemide IV NITROGLYCERIN IV

Which features with the nurse recognize as indicating that a client had a venous ulcer

no claudication or rest pain Ulcer located in the ankle area Brown pigmentation Ulcer bed is pink Pulses are present

Which our post administration, nursing responsibilities, when caring for a client who is receiving thrombolytic therapy

observe all IV sites for bleeding and patency Test store, urine and emesis for occult blood Monitor, clotting, study values Observe for signs of internal bleeding

What nursing actions are included in the routine post procedural care for a client after percutaneous vascular intervention

observe for bleeding at the puncture site Perform frequent distal pulse checks on both limbs Administer antiplatelet therapy as prescribed Monitor for signs of shock Check vital signs frequently as ordered

which are characteristics a nurse would expect in a client with Raynauds disease

occurs more often in young women Clients experience, cold intolerance Causes red white blue skin color changes on exposure to cold or stress

Which client with valvular heart disease would benefit from the nonsurgical invasive procedure, balloon valvuloplasty

older adult who is not a surgical candidate

when do you check troponin levels?

on admission and then 2 hours later

When will the telemetry unit nurse use temporary transcutaneous pacing for a client? Select all that apply.

only has a temporary emergency measure until invasive pacing method can be started Only until the clients heart rhythm returns to normal When invasive pacing is not immediately available

Which specific clients of them, and go to the nurse that septic shock may be present

oozing of blood at the IV site

S/S of left sided heart failure

orthopnea tachycardia fatigue pulmonary congestion cough crackle wheezes tachypnea blood tinged sputum

which findings does the nurse expect when assessing a client with ineffective endocarditis?

osler nose on palms of hands and soles of feet Splinter hemorrhages Janeway lesions on the hands and feet Anorexia and weight loss

which assessment findings indicate to the nurse that a client has stage III peripheral arterial disease

pain is described as numbness, burning toothache type pain Pain is relieved by placing the extremity in a dependent position. Pain usually occurs in the distal part of the extremity. Pain while resting, commonly awakens, the client at night

which assessment data would the nurse expect for a client diagnosed with angina? select all that apply

pain relieved at rest Sudden onset of pain Substernal paying that may spread across chest back and arms Pain that usually last less than 15 minutes

Which techniques with the nurse use when performing an initial cardiovascular assessment on a middle-age client

palpate all of the major pulses sites Auscultate bruits in the radial and brachial artery palpate and compare temperature differences in the lower extremities Check the client for orthostatic hypotension Perform bilateral, but separate palpation on the carotid arteries

What is the best technique for assessing a client right lower leg for arterial insufficiency

palpate the peripheral arteries, using a head to toe approach with saw the side comparison

What is the nurse expect when I client states I get short of breath whenever a lie down for several hours

paroxysmal nocturnal dyspnea

which are proposed criteria for diagnosis of a client with acute pericarditis

pericardial chest pain Presence of a pericardial friction rub New ST elevation in all ECG leads or PR segment depression New or worsening pericardial effusion

Which conditions with the nurse suspect when I clients telemetry ECG rhythm strip shows ST elevation of 1.5 mm.

pericarditis Myocardial infarction Hyperkalemia

S/S of right sided heart failure

peripheral edema JVD hepatomegaly peripheral vascular congestion anorexia weight gain

which statements about permanent pacemakers are accurate? Select all that apply.

permanent pacemakers are available as pacemaker/defibrillator devices Biventricular pacemakers allow synchronized depolarization of the ventricles Permanent pacemakers are used to treat disorders such as complete heart block The pulse generator for a permanent pacemaker is usually implanted in the left subclavian area

What is the best method for the nurse to use when auscultating a clients pericardial friction rub with a stethoscope?

place the diaphragm at the left lower sternal border

which statements about coronary artery disease in women are accurate?

postmenopausal women in their 70s have the same incidence of myocardial infarction as men Women have smaller, coronary arteries, and frequently have plaque that breaks off and travels into the small vessels to form an embolus The older a woman is the more likely she is to have coronary artery disease Women whose parents had coronary artery disease are more susceptible to the disease Mini women experience, a typical angina as indigestion pain between shoulder's aching jaw, and a choking sensation

which cardiovascular assessment changes would the nurse expect in an older client? select all that apply

presence of murmurs Atrial dysrhythmias Increase dizziness Positive orthostatic blood pressure

what are the purposes for a client with venous stasis ulcer to be prescribed the topical Accuzyme

promote healing Chemically debride the ulcer Eliminate necrotic tissue

which nursing interventions promotes clients compliance with antihypertensive therapy

provide oral and written instructions related to a prescribe medication's Stress that suddenly stopping beta blockers can cause angina or heart attack Suggest that the client have a home scale for weight monitoring teach clients to report unpleasant side effects to the primary healthcare provider

what is the nurse suspect when assessment of a client with heart failure reveals pulses that alternate in strength

pulsus alternans

Which are potential benefits of a client receiving the drug digoxin?

reduce heart rate Increase contractility Slowed conduction through the AV node Inhibition of sympathetic activity with enhanced parasympathetic activity

for which change in condition with the nurse to do a client who is discharged and at continued risk for fluid loss to check for daily at home

reduced urine output and lightheadedness

diastolic

relaxation

A client with chronic stable angina now has chest pressure call clammy skin blood pressure of 150/90 heart rate of 100 bpm and respiratory rate of 32 breaths per minute what are the priorities of collaborative care for this client

relieve chest pain Improve Coronary artery perfusion Draw troponins blood labs Improve myocardial oxygenation

Where will the nurse place the leads on a client for a five lead continuous monitoring system? select all that apply

right arm electrode just below the right clavicle Left arm electrode just below the left clavicle Left leg electrode on the lowest palpable rib on the left midclavicular line Fifth electrode placed to obtain one of the six chest leads

coronary arteries

send blood to the heart

what possible causes with the nurse consider when assessing a client and finding a hyperkinetic pulse? Select all that apply.

sepsis Pain Fever Anxiety Thyrotoxicosis

which advantages with the nurse, teach a client about with regard to robotic heart surgery

shorter hospital stay of just 2 to 3 days Decrease pain due to smaller incisions Ability to reach otherwise inaccessible blockage sites

which assessment findings would suggest to the nurse that a client who received a heart transplant was experiencing organ rejection

shortness of breath Hypotension Decreased activity tolerance Fluid gain Atrial fibrillation or flutter

Which changes in condition with the nurse teach a client who is being discharged after successful management of sepsis to check daily as an indicator of a new or ongoing infection

shortness of breath Temperature elevation Cloudy foul smelling urine New onset of a productive cough Paleness or blue tinge to mouth membranes Redness and tenderness of an open skin lesion

What is the nurse instruct the client with pericarditis to do to make him or her will feel more comfortable?

sit up and lean forward

what effect does the nurse expect a class IV drug to have on a clients cardiac conduction system

slow the flow of calcium into the cell during depolarization to depress automaticity

which interventions with the nurse expect to include in the care of a client with pulmonary edema caused by heart failure? Select all that apply.

sodium restriction Position clients in semi fowler or high fowler Administration of loop diuretics

which beta blocker drug approved for treating dysrhythmias is also a class III antidysrhythmic drug

sotalol

restrictive pericarditis

stiff ventricle, cannot fill properly during diastole this causes increased intracranial pressure LV failure will result in pulmonary vascular congestion RV failure will result in venous vascular congestion

when a client is hypovolemic, which tissue reacts and sends fewer impulses to the CNS

stretch receptors

paroxysmal nocturnal dyspnea

sudden awakening from sleeping with shortness of breath

Which urgent intervention is required when the nurse reviews the results of diagnostic testing for a client with aortic stenosis and discovers that the surface area of the valve is less than 1 cm?

surgical aortic heart valve replacement

what is the definitive treatment for chronic constrictive pericarditis?

surgical removal of pericardium

aortic stenosis diagnosis

systolic ejection murmur stress test echo heart cath

Acute Mitral Regurgitation

systolic murmur hypotension tachycardia vasoconstriction dysrhythmias pulmonary edema cardiogenic shock

aortic regurgitation symptoms

tachycardia /hypotension peripheral vasoconstriction cyanosis diastolic murmur pulsus paradoxus pulmonary edema cardiogenic shock

Which essential preoperative teaching with the nurse provide to a client scheduled for CABG surgery using the traditional procedure

there will be a sternal incision There will as many as three chest tubes in place after surgery An indwelling urinary catheter will be in place to drain urine An endotracheal tube will prevent talking immediately after surgery

Narrowing pulse pressure indicates

theres a problem with the pump

hypertonic cardiomyopathy

thickening of left ventricle most common cause of sudden cardiac death in young adults avoid nitrates beta blockers and calcium channel blockers

Which subjective symptom will the nurse expect to find in a client during the compensatory stage of hypovolemic shock

thirst

Which laboratory value test elevation does the nurse consider most significant in the diagnosis of a client myocardial infarction

troponin T and I

which actions by an older adult are likely to cause the experience of syncope? Select all that apply.

turning the head Performing a Valsalva maneuver Shrugging shoulders

Which diagnostic test would confirm an abdominal aortic aneurysm?

ultrasound CT

Which vital sign change in a client with hypovolemic shock indicates to the nurse at the therapy is effective

urine output increases from 5 mL per hour to 25 mL per hour

SGLT-2 inhibitors

used for type 2 diabetics, not used for type 1 Canagliflozin Dapagliflozin Empagliflozin

which are the characteristics that the nurse would expect when a client is diagnosed with mitral valve prolapse? Select all that apply.

valve leaflets in large and bulge up into the left atrium during systole Most clients are asymptomatic, and this abnormality is benign Many clients have normal heart rate and blood pressure a midsystolic click and late systolic murmur is best heard at Apex of the heart

which dysrhythmia does the nurse consider life-threatening because it causes the ventricles to quiver and results in the absence of cardiac output for a client

ventricular fibrillation

for which cardiac dysrhythmias would an automatic external defibrillator, instruct the nurse to immediately defibrillate an unconscious client at an outpatient clinic? Select all that apply.

ventricular fibrillation Pulseless, ventricular tachycardia

Right ventricular failure

weakened right ventricle is unable to effectively pump blood to the pulmonary system Causes: RV infarction PE Mitral valve disease Pulmonary hypertension ARDS/COPD OSA Fluid overload Inflammatory effects of cardiopulmonary bypass during surgery

When a client admits that he or she sometimes has trouble catching his or her breath, which question, would the nurse ask to obtain more information about the client symptoms?

what was your most strenuous activity during the first week?

which assessment findings with the nurse expect to find in a client with left heart failure? Select all that apply.

wheezes or crackles S3 heart sound Paroxysmal nocturnal dyspnea Oliguria during the day

Which priority information would the nurse be sure to provide for a client who is scheduled for mitral valve replacement with a xenograft valve?

your xenograft valve will need to be replaced in about 7-10 years

The nurse is caring for a client with heart rate of 143 beats/min. Which assessment data will the nurse anticipate? (Select all that apply.)

Chest discomfort Hypotension Palpitations

A client has just returned from coronary artery bypass graft surgery. Which assessment data requires immediate nursing action?

Chest tube drainage 175 mL last hour

The nurse is teaching a client about the purpose of electrophysiology studies (EPS). Which teaching will the nurse include?

"This test evaluates you for potentially fatal cardiac rhythms."

The nurse is teaching a client about the risk for bradydysrhythmias. What teaching will the nurse include?

"Use a stool softener."

Based on the assessment data, which client will the nurse identify as having a higher risk for development of sepsis and septic shock? (Select all that apply.)

A 40-year-old female with a history of a double lung transplant 4 years ago. A 38-year-old male with HIV who has a low viral load. A 54-year-old female with breast cancer who is receiving chemotherapy. A 44-year-old male client who has a history of alcoholism and diabetes mellitus. An 86-year-old male with acute onset confusion.

Which client has a risk for hypovolemic shock?

A client with esophageal varices

The nurse is caring for a client in phase 1 cardiac rehabilitation. Which activity does the nurse suggest?

Placing a chair in the shower for independent hygiene

When caring for a client who is obtunded and admitted with shock of unknown origin, which action will the nurse take first?

Check the airway and respiratory status.

The nurse is caring for a client with heart failure in a cardiac clinic. What assessment data indicates that the client has demonstrated a positive outcome related to the addition of metoprolol to the medication regimen?

Client states, "I can sleep on one pillow."

Which client is best to assign to an LPN/LVN working on the telemetry unit?

Client with dilated cardiomyopathy who uses oxygen for exertional dyspnea.

Which client demonstrates the highest risk for hypovolemic shock?

Client with severe ascites

A client with heart failure reports a 7.6-lb (3.4 kg) weight gain in the past week. What intervention does the nurse anticipate from the primary health care provider?

Daily weight monitoring

How does the nurse caring for a client with septic shock recognize that severe tissue hypoxia is present?

Lactate 81 mg/dL (9.0 mmol/L)

The nurse is teaching the client dietary methods to reduce LDL levels. What teaching will the nurse include? (Select all that apply.)

Limit trans-fat intake. Emphasize the intake of whole grains. Nuts are a good snack food. Try to purchase skinless chicken to cook with.

Which client has the highest risk for cardiovascular disease?

Man who smokes and whose father died at 49 of myocardial infarction (MI).

The nurse is teaching a class on the management of sepsis. What teaching will the nurse include regarding the Hour-1 sepsis management bundle? (Select all that apply.)

Measure lactate levels. Administer broad spectrum antibiotics. Begin rapid administration of crystalloids for hypotension. A bundle is a group of two or more interventions that has been shown to be effective when applied in a sequence.

Which action will the nurse delegate to experienced assistive personnel (AP) working in the cardiac catheterization laboratory?

Obtain client vital signs and a resting electrocardiogram (ECG).

Which nursing action may be delegated to assistive personnel (AP) working on the medical unit?

Obtain daily weights for several clients with class IV heart failure.

The nurse receives a report that a client with a pacemaker has experienced loss of capture. What assessment data would the nurse anticipate?

Pacemaker spikes are noted, but no P wave or QRS complex follows.

A client with peripheral arterial disease (PAD) has a percutaneous vascular intervention. What is the priority nursing assessment?

Pedal pulses

A client recovering from cardiac angiography develops slurred speech. What will the nurse do first?

Perform a neurologic assessment and notify the primary care provider.

Which intervention best assists the client with acute pulmonary edema in reducing anxiety and dyspnea?

Place the client in high-Fowler position with the legs down.

The nurse is caring for a client with heart failure in the coronary care unit. The client is exhibiting signs of air hunger and anxiety. Which nursing intervention will the nurse perform first for this client?

Position the client to alleviate dyspnea.

Which problem places a client at highest risk for sepsis?

Post kidney transplant

The nurse is reviewing the medical record of a client admitted with heart failure. Which laboratory result warrants a call to the primary health care provider by the nurse for further instructions?

Potassium 3.0 mEq/L (3.0 mmol/L)