Med Surd Exam 4 (Cardiovascular) prep U questions
Following a percutaneous transluminal coronary angioplasty, a client is monitored in the postprocedure unit. The client's heparin infusion was stopped 2 hours earlier. There is no evidence of bleeding or hematoma at the insertion site, and the pressure device is removed. With regards to partial thromboplastin time (PTT), when should the nurse plan to remove the femoral sheath?
50 seconds or less.
The nurse is performing a respiratory assessment for a patient in left-sided heart failure. What does the nurse understand is the best determinant of the patient's ventilation and oxygenation status?
Arterial blood gases
A client with left-sided heart failure is in danger of impaired renal perfusion. How would the nurse assess this client for impaired renal perfusion?
Assess for elevated blood urea nitrogen levels.
The nurse knows that electrocardiogram (ECG) characteristics of atrial fibrillation include what?
Atrial rate of 300 to 400
Which is a key diagnostic indicator of heart failure?
Brain natriuretic peptide (BNP)
A patient has had cardiac surgery and is being monitored in the intensive care unit (ICU). What complication should the nurse monitor for that is associated with an alteration in preload?
Cardiac tamponade
Which is a cerebrovascular manifestation of heart failure?
Dizziness
The nurse is preparing a client for upcoming electrophysiology (EP) studies and possible ablation for treatment of atrial tachycardia. What information will the nurse include in the teaching?
During the procedure, the dysrhythmia will be reproduced under controlled conditions.
The nurse is caring for a client with atrial fibrillation. What procedure would be recommended if drug therapies did not control the arrhythmia?
Elective cardioversion
The nurse is caring for a client with a history of heart failure and a sudden onset of tachypnea. What is the nurse's priority action?
Elevate the head of the bed.
The nurse is teaching a client who is experiencing dizziness to rise slowly from a sitting or lying position. What is the rationale for the teaching?
Gradual changes in position provide time for the heart to increase rate of contraction to resupply oxygen to the brain.
When administering benazepril with spironolactone, the nurse should be aware that which electrolyte imbalance may occur?
Hyperkalemia
Following a left anterior myocardial infarction, a client undergoes insertion of a pulmonary artery catheter. Which finding most strongly suggests left-sided heart failure?
Increased pulmonary artery diastolic pressure
A client has been recently placed on nitroglycerin. Which instruction by the nurse should be included in the client's teaching plan?
Instruct the client on side effects of flushing, throbbing headache, and tachycardia.
Which nursing intervention is required to prepare a client with cardiac dysrhythmia for an elective electrical cardioversion?
Instruct the client to restrict food and oral intake
The nurse teaches the client which guidelines regarding lifestyle modifications for hypertension?
Maintain adequate dietary intake of fruits and vegetables
Ejection Fraction
Measure of ventricular contractility - % of end diastolic blood volume ejected with each heart beat.
BNP med for severe compensated heart failure
Natrecor
The nurse observes a client with an onset of heart failure having rapid, shallow breathing at a rate of 32 breaths/minute. What blood gas analysis does the nurse anticipate finding initially?
Respiratory alkalosis
The nurse is placing electrodes for a 12-lead electrocardiogram (ECG). The nurse would be correct in placing an electrode on which area for V1?
Right side of sternum, fourth intercostal space
The nurse is caring for a client prescribed bumetanide for the treatment of stage 2 hypertension. Which finding indicates the client is experiencing an adverse effect of the medication?
Serum potassium value of 3.0 mEq/L
A client with heart failure asks the nurse how dobutamine affects the body's circulation. What is the nurse's best response?
The medication increases the force of the myocardial contraction.
A client with a history of heart failure is returning from the operating room after inguinal hernia repair and the nurse assesses a low pulse oximetry reading. What is the most important nursing intervention?
Titrate oxygen therapy.
Which term refers to preinfarction angina?
Unstable angina
A client is at risk for excess fluid volume. Which nursing intervention ensures the most accurate monitoring of the client's fluid status?
Weighing the client daily at the same time each day
What nursing intervention will decrease preload?
administration of a vasodilating drug
The nurse is caring for a client who is displaying a third-degree AV block on the EKG monitor. What is the priority nursing intervention for the client?
alerting the healthcare provider of the third-degree heart block
A client is beginning to have more breathlessness with aortic stenosis. What is the treatment does the nurse anticipate for the client?
balloon valvuloplasty
The nurse is caring for a client with a blood pressure of 210/100 mm Hg in the emergency room. What is the most appropriate route of administration for antihypertensive agents?
continuous IV infusion
The nurse is assessing a client admitted with cariogenic shock. What medication will the nurse titrate to improve blood flow to vital organs?
dopamine
A client presents to the ED with a myocardial infarction. Prior to administering a prescribed thrombolytic agent, the nurse must determine whether the client has which absolute contraindication to thrombolytic therapy?
prior intracranial hemorrhage
