Cardiovascular part II(Heart Failure, myocardial infarction, dysrhythmias)

A nurse is caring for a client with heart failure. The nurse knows that the client has left-sided heart failure when the client makes which statement?

"I sleep on three pillows each night."

A nurse is caring for a client who is recovering from a myocardial infarction (MI). The cardiologist refers him to cardiac rehabilitation. Which statement by the client indicates an understanding of cardiac rehabilitation?

"Rehabilitation will help me function as well as I physically can."

An obese male client with history of heart failure is prescribed a beta blocker. Which of the following is important to teach regarding home drug therapy? Select all that apply.

"Take your medication at the same time daily." "Contact the health care provider if you have difficulty getting or maintaining an erection." "Change positions between sitting and standing carefully." "Check your pulse for a full minute before administering your medication." SUBMIT ANSWER

Which client statement should the nurse evaluate as indicating the client's correct understanding of the causes of coronary artery disease (CAD)?

"The leading cause of CAD is atherosclerosis."

A client admitted to the emergency department with atrial fibrillation has a heart rate of 160 bpm. The nurse should implement which prescription first?

Administer oxygen via nasal cannula.

A nurse is caring for a client with type 2 diabetes who has had a myocardial infarction (MI) and is reporting nausea, vomiting, dyspnea, and substernal chest pain. Which is the priority intervention?

Control the pain and support breathing and oxygenation.

A client has been diagnosed with right-sided heart failure. The nurse should assess the client further for:

Dependent edema.

The nurse is reviewing the electrocardiogram of a client who has elevated ST segments visible in leads II, III, and aVf. Which choice is the nurse's best action?

Notify the healthcare provider.

A client has been admitted to the coronary care unit. The nurse observes third-degree heart block at a rate of 35 bpm on the client's cardiac monitor. The client has a blood pressure of 90/60 mm Hg. What should the nurse do first?

Prepare for transcutaneous pacing.

A client with left-sided heart failure complains of increasing shortness of breath and is agitated and coughing up pink-tinged, foamy sputum. The nurse should recognize these findings as signs and symptoms of

acute pulmonary edema

A client has atrial fibrillation. The nurse should monitor the client for which condition?

cerebrovascular accident

A client is diagnosed with myocardial infarction. Which data collection findings indicate that the client has developed left-sided heart failure? Select all that apply.

cough orthopnea crackles

An older adult is admitted to the hospital with nausea and vomiting. The client has a history of heart failure and is being treated with digoxin. The client has been nauseated for a week and began vomiting 2 days ago. Laboratory values indicate hypokalemia. Because of these clinical findings, the nurse should assess the client carefully for:

digoxin toxicity

A client calls the nurse to the room, reporting substernal chest pain that radiates to the jaw. The nurse records a rhythm strip and monitors the client's vital signs. Which graphic highlights the portion of the client's ECG complex that may become elevated above the baseline, indicating myocardial infarction (MI)?

elevated ST

Prior to administering tissue plasminogen activator (t-PA), the nurse should assess the client for which contradiction to administering the drug?

history of cerebral edema

The nurse is caring for a client in the coronary care unit when the cardiac monitor reveals ventricular fibrillation. The nurse should anticipate which intervention?

immediate defibrillation

A nurse is performing a cardiac assessment on an elderly client. Which finding warrants further investigation?

irregularly irregular heart rate

The nurse is admitting a client with substernal chest pain. Which diagnostic tests does the nurse anticipate the client will receive to confirm or rule out a diagnosis of myocardial infarction (MI)? Select all that apply.

serum troponin serum myoglobin

A nurse is awaiting the arrival of a client from the emergency department with a diagnosis of anterior wall myocardial infarction. In caring for this client, the nurse would be alert for which signs and symptoms of left-sided heart failure? Select all that apply.

tachycardia crackles dyspnea

After receiving the shift report, a registered nurse in the cardiac step-down unit must prioritize the client care assignment. The nurse has an ancillary staff member available to help care for the clients. Which of these clients should the registered nurse assess first?

the client with heart failure who is having some difficulty breathing

A client is to have a treadmill stress test. Prior to the stress test, the nurse reviews the results of the laboratory reports. The nurse should report which elevated laboratory value to the health care provider (HCP) before the stress test?

troponin level

The nurse is teaching a client with a demand pacemaker. What should the nurse tell the client about how the device functions by providing stimuli to the heart muscle:? The pacemaker will provide a stimulus

when the heart rate falls below a specified level.

A client is admitted to the hospital through the emergency department with chest pain. Which intervention is the priority?

assessing troponin 1 levels

The nurse observes the cardiac rhythm (see ECG strip)(Vtach) for a client who is being admitted with a myocardial infarction. What should the nurse do first?

check pulse

A client comes to the emergency department reporting severe substernal chest pain radiating down the left arm. The client is admitted to the coronary care unit with a diagnosis of myocardial infarction (MI). Which should the nurse do first when the client is admitted to the coronary care unit?

Begin telemetry monitoring.

A client comes to the emergency department complaining of chest pain. An electrocardiogram (ECG) reveals myocardial ischemia and an anterior-wall myocardial infarction (MI). Which ECG characteristic does the nurse expect to see?

elevated ST segment

While auscultating the heart sounds of a client with heart failure, the nurse hears an extra heart sound immediately after the second heart sound (S2). The nurse should document this as

a third heart sound (S3).

During a shift report for a client with heart failure, the nurse going off shift reports that the client had sinus bradycardia during the shift and a creatinine of 3.5 mg/dL. Which action does the nurse perform when administering digoxin to this client?

assess the digoxin level