Cardio EAQ HW #1
A client is admitted to the hospital with a large leg ulcer, and a femoral angiogram is performed. What should the nurse do after this procedure?
Apply pressure to the catheter insertion site Pressure promotes coagulation and prevents the complication of bleeding.
A nurse in the cardiovascular clinic reviews a client's ECG. What should the nurse do?
Document that the rhythm is normal
A thallium scan is scheduled for a client who had a myocardial infarction. What should the nurse explain to the client regarding the reason the scan has been prescribed?
That it establishes the viability of myocardial muscle A thallium scan is a radionuclear study that establishes the viability of myocardial tissue
A client with a history of hypertension has a blood pressure of 180/102 mm Hg. When the nurse asks whether the client has been taking any medications, the client replies, "I took the blood pressure pills the healthcare provider prescribed for a few weeks, but I didn't feel any different, so I decided I'd only take them when I feel sick." What is the best initial response by the nurse?
"It is important to take your medications daily to achieve optimal results."
A client who is suspected of having had a silent myocardial infarction has an electrocardiogram (ECG) prescribed by the primary healthcare provider. While the nurse prepares the client for this procedure, the client asks, "Why was this test prescribed?" Which is the best reply by the nurse?
"This test will reflect any heart damage." Changes in an ECG will reflect the area of the heart that is damaged because of hypoxia.
A client with angina pectoris is scheduled for a stress echocardiogram. What should the nurse tell the client that an echocardiogram is?
A noninvasive approach to assess cardiovascular status. A stress echocardiogram is noninvasive and uses echoes from pulsed high-frequency sound waves to locate and study the movements and dimensions of cardiac structures; it assesses myocardial disease, valve function, congenital heart defects, blood flow abnormalities, and systemic and pulmonic hypertension. A stress echocardiogram assesses structural defects as well as blood flow abnormalities. A stress echocardiogram is valuable in diagnosing and indicating treatment for a variety of conditions involving the heart's structure and function. A stress echocardiogram is not an invasive examination.
Upon auscultating the chest of a client with dyspnea, orthopnea, and fatigue, the nurse hears a high-pitched diastolic murmur and an Austin Flint murmur. Which condition might the nurse suspect?
Aortic valve regurgitation Aortic valve regurgitation manifests in the following symptoms: fatigue; orthopnea; dyspnea; water-hammer pulse; diminished S1, S3, or S4; high-pitched diastolic murmur; and Austin Flint murmur.
A client undergoes cardiac catheterization via the femoral artery. What is the most important nursing action after the procedure?
Assess the groin for bleeding. Most complications after cardiac catheterization involve the puncture site; included are localized hemorrhage and hematomas, as well as thrombosis of the femoral artery. Providing a bed cradle is not necessary after cardiac catheterization. Although checking for a pulse deficit is important, it is not the priority assessment. The client should remain supine to avoid disturbing the insertion site.
The client reports a "fluttering in my chest." The nurse analyzes the client's heart rhythm and notices that there are three P waves for each QRS complex. The waves have a sawtooth appearance. The atrial rate is 240 beats per minute, but the ventricular rate is only 80 beats per minute. The nurse notifies the primary healthcare provider for which rhythm?
Atrial flutter Atrial flutter arises from a single irritable focus in the atria. The atrial focus fires at an extremely rapid, regular rate between 200 and 350 beats per minute. The P waves are called flutter waves and may have a sawtooth appearance.
Two hours after a cardiac catheterization that was accessed through the right femoral route, an adult client complains of numbness and pain in the right foot. What action should the nurse take first?
Check the client's pedal pulses. These symptoms are associated with compromised arterial perfusion. A thrombus is a complication of a femoral arterial cardiac catheterization and must be suspected in the absence of a pedal pulse in the extremity below the entry site.
Four clients with cardiac arrhythmias are prescribed different medications. Which client should be monitored for fatigue?
Client C Verapamil is a calcium channel blocker that can cause fatigue, so client C should be monitored for fatigue.
After undergoing a cardiac catheterization, the client complains of tingling sensations in the affected leg. What should the nurse do to determine the cause of the tingling?
Compare femoral, popliteal, and pedal pulses in both legs. Tingling indicates decreased arterial circulation to the extremity; it may be caused by an embolus distal to the arterial insertion site. Checking all pulses will help locate an embolus.
The nurse is caring for a client who is scheduled for an electrophysiology study (EPS) because of persistent ventricular tachycardia. Before the procedure the client is to receive a beta-blocker. What client's response during the procedure best indicates that the beta-blocker is working effectively?
Decreased heart rate A decreased heart rate or sinus bradycardia is the expected response to a beta-blocker. Beta-blockers inhibit the activity of the sympathetic nervous system and of adrenergic hormones, decreasing the heart rate, conduction velocity, and workload of the heart.
Which clinical indicators is the nurse most likely to identify when taking the admission history of a client with right ventricular failure? Select all that apply.
Edema Ascites Heart failure is the failure of the heart to pump adequately to meet the needs of the body, resulting in a backward buildup of pressure in the venous system. Clinical manifestations include edema, ascites, hepatomegaly, tachycardia, and fatigue.
A client with a history of angina is scheduled for a cardiac catheterization. Catheter entry will be through the femoral artery. What should the nurse tell the client to expect?
Experience a feeling of warmth during the procedure. A warm flushing sensation that lasts approximately 30 seconds will occur when the contrast medium is injected.
To manage heart failure a client has been taking several medications, including furosemide 40 mg by mouth twice a day. The client develops severe muscle cramps and fatigue, and laboratory tests confirm the presence of hypokalemia. Potassium chloride intravenously (IV) and ECG monitoring have been prescribed. Which ECG change associated with hypokalemia should the nurse expect to observe?
Flattened T waves A flattened T wave is associated with hypokalemia. A depressed T wave indicates a problem with ventricular repolarization, a process involved in muscle contraction. Adequate potassium levels are needed for efficient muscle contraction.
A client with a history of heart failure and atrial fibrillation reports a nine-pound (four kilogram) weight gain in the last two weeks. Which factor does the nurse consider as the most likely cause of this sudden weight gain?
Fluid retention
During a yearly physical examination a complete blood count (CBC) is performed to determine a client's hematological status. The nurse recalls that the CBC is composed of several tests, one of which is the level of what?
Hemoglobin (Hb) A CBC includes red blood cell (RBC) count and RBC indices, white blood cell (WBC) count and WBC differential count, hemoglobin (Hb), hematocrit (Hct), and platelet count.
When obtaining a health history, the nurse is informed that a client has been taking digoxin. What therapeutic effect of digoxin does the nurse expect?
Increased contractile force of the myocardium Digoxin produces a positive inotropic effect that increases the strength of myocardial contractions and thus cardiac output.
A client with angina pectoris is scheduled for a stress echocardiogram. What does the nurse explain the echocardiogram is?
Noninvasive approach to assess cardiovascular status. A stress echocardiogram is noninvasive and uses echoes from pulsed high-frequency sound waves to locate and study the movements and dimensions of cardiac structures; it assesses myocardial disease, valve function, congenital heart defects, blood flow abnormalities, and systemic and pulmonic hypertension.
Which clinical indicator is the nurse most likely to identify when completing a history and physical assessment of a client with complete heart block?
Syncope With complete atrioventricular block, the ventricles take over the pacemaker function in the heart but at a much slower rate than that of the sinoatrial (SA) node. As a result, there is decreased cerebral circulation, causing syncope.
A client with a long history of cardiovascular problems, including angina and hypertension, is scheduled to have a cardiac catheterization. During preprocedure teaching, what does the nurse explains to the client as the major purpose for catheterization?
To visualize the disease process in the coronary arteries. Angina usually is caused by narrowing of the coronary arteries; the lumen of the arteries can be assessed by cardiac catheterization.
A client is admitted with the diagnosis of possible myocardial infarction, and a series of diagnostic tests are prescribed. Which blood level should the nurse expect will increase first if this client has had a myocardial infarction?
Troponin T (cTnT) Troponin T has an extraordinarily high specificity for myocardial cell injury. Cardiac troponins elevate sooner and remain elevated longer than many of the other enzymes that reflect myocardial injury.
A nurse is conducting cholesterol screening for a manufacturing corporation during a health fair. A 50-year-old man who is 6 feet tall and weighs 293 pounds puts out his cigarette and asks the nurse how to modify his risk factors for coronary artery disease. On which risk factors should the nurse help the client focus? Select all that apply.
Weight Smoking Obesity is a modifiable risk factor that is associated with coronary artery disease (CAD); an increased fat intake contributes to an increased serum cholesterol and atherosclerosis. Smoking, which constricts the blood vessels, is a modifiable risk factor for CAD. Family history is not a modifiable risk factor for CAD because one cannot control heredity. The incidence of CAD does increase with age. However, age is not a modifiable risk factor. Height is unrelated to the incidence of CAD.
The client's blood test results show a ferritin level of 3 ng/mL and a hemoglobin level of 5 mg/dL. Which triage priority tag would the nurse state is appropriate for the client?
Yellow Tag. Ferritin of 3 ng/mL (normal: 10-150 ng/mL) and hemoglobin of 5 mg/dL (normal: 13.5-17.5 g/dL) indicates severe iron deficiency anemia. A client with severe anemia has to undergo rapid treatment to replenish the stores of iron and, therefore, a yellow tag is given to the client. A red tag is indicated for a client with life-threatening complications who needs immediate treatment. A black tag is given to a client who is expected to die. A green tag is appropriate for minor conditions that do not require immediate treatment.
