Health Assessment Case 7: Jared Griffin (PRE)

The nurse is gathering subjective data from a patient during a cardiovascular assessment. Which question is particularly appropriate for the nurse to ask when the patient states, 'My heart seems to skip beats'?

'Do you have periods of time when you experience uncommon fatigue?'

The nurse is providing care for a patient whose partner says, 'We're told that he occasionally has an irregular heartbeat. Is that bad?' Which response should the nurse make to best address the partner's concern?

'It's normal to experience occasional irregular beats.'

When preparing a patient for an electrocardiogram (ECG), the nurse will include which information? (Select all that apply.)

'Sticky-backed electrodes will be attached directly to the skin on your arms, legs, and chest.', 'It is important for you to remain as still and relaxed as possible during the test.', 'Please lie on your back for the length of the test, which is 5 to 10 minutes.', 'The test is painless.'

Preparing for an electrocardiogram (ECG) is a priority nursing intervention for which patient(s)? (Select all that apply.)

A patient reporting, 'I feel like my heart is skipping beats.', A patient experiencing diaphoresis and arm pain., A patient who just had a pacemaker placed., A patient newly diagnosed with mild hypokalemia., A patient admitted with a myocardial infarction (MI).

The life partner of a patient diagnosed with atrial fibrillation (AF) asks the nurse, 'Can you tell me why this condition is a problem?' What is the nurse's best response?

It can result in a stroke, thromboembolism, and heart failure.

A patient is diagnosed with atrial fibrillation (AF) based on an electrocardiogram (ECG). Which of the following nursing assessment findings could also be demonstrated by a patient experiencing AF? (Select all that apply.)

Jugular vein distension, History of chest pain, Tachycardia, Irregular pulse

The medical record states that the patient's pulse is 'small and weak.' Which characteristic(s) will the nurse expect to detect when performing a cardiovascular assessment on this patient? (Select all that apply.)

Slow upstroke, Diminished pulse pressure, A prolonged systolic peak

The nurse is preparing a patient for a cardiovascular assessment. When providing the patient with information concerning the examination, which physical positions will the nurse indicate will be used during the examination? (Select all that apply.)

Supine, Left lateral, Sitting upright