PrepU Quiz 9

The nurse is assisting the client to manage the cardiovascular risk factors of hyperlipidemia and hypertension. The client asks the nurse what type of a diet would be best to follow. What is the best response by the nurse?

A diet low in sodium, fat, and cholesterol Diets that are restricted in sodium, fat, and cholesterol are commonly prescribed to manage the cardiovascular risk factors of hypertension and hyperlipidemia. The lowered sodium, fat, and cholesterol diets aid with decreasing water retention and fatty substances. Cardiovascular risk factors do not involve potassium levels and limiting fruits and fluids. Cardiovascular risks factors are lowered by eating fruits and vegetables to lower cholesterol levels.

A client who has recently been diagnosed with chronic heart failure is being taught by the nurse how to live successfully with the chronic condition. The client's ability to meet this goal will primarily depend on the client's ability to do which of the following?

Adapt a lifestyle to accommodate the client's symptoms Successful management of chronic conditions depends largely on the client's ability to adapt in order to accommodate symptoms. However, telling the client to lower expectations is a simplistic and negative interpretation of this reality. Rapport is beneficial, but not paramount. A cure is not normally an option.

The nurse is providing education about angina pectoris to a hospitalized client who is about to be discharged. What instruction does the nurse include about managing this condition? Select all that apply.

Balance rest with activity Stop smoking Carry nitroglycerin at all times Managing angina pectoris at home includes balancing rest with activity, participating in a regular daily program of activities that do not induce angina pain, stopping smoking, carrying nitroglycerin at all times, and following a diet low in saturated fat.

A nurse teaches a client with angina pectoris that he or she needs to take up to three sublingual nitroglycerin tablets at 5-minute intervals and immediately notify the health care provider if chest pain doesn't subside within 15 minutes. What symptoms may the client experience after taking the nitroglycerin?

Headache, hypotension, dizziness, and flushing. Headache, hypotension, dizziness, and flushing are classic adverse effects of nitroglycerin, a vasodilator. Vasodilators, beta-adrenergic blockers, and calcium channel blockers are three major classes of drugs used to treat angina pectoris. Nausea, vomiting, depression, fatigue, and impotence are adverse effects of propranolol, a beta-adrenergic blocker. Sedation, nausea, vomiting, constipation, and respiratory depression are common adverse effects of morphine, an opioid analgesic that relieves pain associated with acute myocardial infarction. Flushing, dizziness, headache, and pedal edema are common adverse effects of nifedipine, a calcium channel blocker.

During the admission history the client reports to the nurse of taking the usual dose of warfarin the previous day. What is an appropriate nursing action?

Notify the surgeon that the client took warfarin the day before surgery. Warfarin (Coumadin), an anticoagulant, places the client at risk for excessive bleeding during the intraoperative and postoperative periods.

A hospitalized client with heart failure puts on the call light and states, "I've become very short of breath, and I've been coughing up this pink frothy sputum." The nurse immediately suspects which of the following complications?

Pulmonary edema When the left ventricle fails, blood backs up into the pulmonary system. Large quantities of frothy sputum, which is sometimes blood-tinged, may be produced, indicating severe pulmonary congestion or pulmonary edema.

The nurse is educating the patient about administering nitroglycerin prior to discharge from the hospital. What information should the nurse include in the instructions?

Take a nitroglycerin and repeat every 5 minutes if the pain is not relieved until a total of 3 are taken. If pain is not relieved, activate the emergency medical system. The nurse should recommend that the patient note how long it takes for the nitroglycerin to relieve the discomfort. Advise the patient that if pain persists after taking three sublingual tablets at 5-minute intervals, emergency medical services should be called.

The nurse is working with a client who had an MI and is now active in rehabilitation. The nurse should teach this client to cease activity if which of the following occurs?

The client experiences chest pain, palpitations, or dyspnea. Any activity or exercise that causes dyspnea and chest pain should be stopped in the client with CAD. Heart rate must not exceed the target rate, but an increase above resting rate is expected and is therapeutic. In most clients, a respiratory rate that exceeds 30 breaths/min is not problematic. Similarly, oxygen saturation slightly below 96% does not necessitate cessation of activity.

When assessing a client diagnosed with angina pectoris, it is most important for the nurse to gather what information?

The client's symptoms and the activities that precipitate attacks The nurse must gather information about the client's symptoms and activities, especially those that precede and precipitate attacks of angina pectoris. The client's coping, understanding of the disease, and status following attacks are all important to know, but causative factors are a primary focus of the assessment interview.

The nurse is preparing to administer digoxin to a client with heart failure. The nurse obtains an apical pulse rate for 1 minute and determines a rate of 52 beats/minute. What is the first action by the nurse?

Withhold the medication and notify physician of heart rate Digitalis drugs are withheld if the heart rate is less than 60 or more than 120 beats/minute until a physician is consulted. The other choices would have the nurse administer the drug, which would not be the standard of practice.