MS Ch 26 & 27

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The nurse is instructing on home care after placement of an automatic implanted cardioverter defibrillator (AICD). Which statement, made by the client, needs clarification by the nurse?

"I need to stay away from microwaves."

Which ethnic background would the nurse screen for hypertension at an early age?

African American

The nurse is in the mall and observes a client slump to the floor. The nurse assesses the client and notes no pulse. The nurse calls for assistance to others in the mall and requests which piece of equipment?

An automatic external defibrillator

Which of the following medication classifications is more likely to be expected when the nurse is caring for a client with atrial fibrillation?

Anticoagulant

A pacemaker is the treatment of choice for what cardiac dysrhythmia?

Complete heart block

A client has just been diagnosed with prehypertension. What would the nurse instruct this client to do to restore his blood pressure below hypertensive levels?

Decrease sodium intake

The nurse obtains a blood pressure of 136/86 mm Hg on morning assessment of a client with history of hypertension. Which pressure is of most concern when considering ventricular relaxation?

Diastolic

Which of the following diagnostic tests may reveal an enlarged left ventricle?

Echocardiography

A client, newly prescribed a low-sodium diet due to hypertension, is asking for help with meal choices. The client provides four meal choices, which are favorites. Which selection would be best?

Fresh vegetables are low in sodium with diced tomatoes (fresh) and chicken is a good low-sodium, high vegetable and protein selection. Cheese and soup (tomato and creamed) are high in sodium. Processed meats such as a hot dog and condiments such as ketchup are high in sodium

Your client has returned to the floor with a transthoracic pacemaker ready to be connected. You know that a transthoracic pacemaker is a temporary pacemaker used in what situation?

Open heart surgery

Which of the following is the nurse most correct to recognize as a direct effect of client hypertension?

Renal dysfunction resulting from atherosclerosis

The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety?

Sit on the edge of the chair and rise slowly

You are caring for a client diagnosed with secondary hypertension. What would be a predisposing condition for this diagnosis?

Use of oral contraceptives

A client is unconscious on arrival to the emergency department. The nurse in the emergency department identifies that the client has a permanent pacemaker due to which characteristic?

Spike in the rhythm strip

The nurse is employed in a physician's office and is caring for a client present for an annual exam. A blood pressure of 124/84 mm Hg is documented. Following revised guidelines for identifying hypertension, which educational pamphlet is help?

Stress reduction to lower prehypertensive state

What is blood pressure?

The force produced by the volume of blood in arterial walls Blood pressure = cardiac output x peripheral resistance

The nurse is caring for a client with essential hypertension. The nurse reviews lab work and assesses kidney function. Which action of the kidney would the nurse evaluate as the body's attempt to regulate high blood pressure?

The kidney excretes sodium and water.

Which of the following client scenarios would be correct for the nurse to identify as a client with secondary hypertension?

A client diagnosed with kidney disease

The nurse is assigned the following client assignment on the clinical unit. For which client does the nurse anticipate cardioversion as a possible medical treatment?

A client with atrial dysrhythmias

A female client, aged 82 years, visits the clinic for a blood pressure (BP) check. Her hypertension is not well controlled, and a new blood pressure medicine is prescribed. What is important for the nurse to teach this client about her blood pressure medicine?

A possible adverse effect of blood pressure medicine is dizziness when you stand.

The nurse is reviewing morning lab work for a client with dysrhythmias and notes a digoxin level of 0.5 ng/mL. Which nursing action is correct?

Administer the 9 AM digoxin dose and notify the physician

The nurse and a dietitian are instructing the client on a low-sodium diet needed to lower the blood pressure. Which question, asked by the nurse, is most important?

Asking the client how food is prepared, gives the nurse and dietitian the ability to judge the sodium content. If the client opens cans of food, typically, there will be elevated sodium content. If the client uses prepared foods or eats out regularly, there is sodium in the content. If the client uses fresh ingredients, sodium content is minimal. Asking about who eats with the client and their eating patterns are not as helpful in determining sodium content.

A client presents to the emergency department via ambulance with a heart rate of 210 beats/minute and a sawtooth waveform pattern per cardiac monitor. The nurse is most correct to alert the medical team of the presence of a client with which disorder?

Atrial flutter

You are teaching a health class at the local YMCA. What body system would you explain regulates arterial blood pressure?

Autonomic nervous system

The nurse is creating a community teaching demonstration focusing on the cause of blood pressure. When completing the visual aid, which body structures represent the mechanism of blood pressure?

Heart and blood vessels

You enter your client's room and find him pulseless and unresponsive. What would be the treatment of choice for this client?

Immediate defibrillation

The nurse is caring for a client with a dysrhythmia. While assessing the data in the history of the chart, the nurse anticipates the cause of the dysrhythmia to be which of the following?

Ischemic heart disease

The staff educator is teaching a class in dysrhythmias. What statement is correct about defibrillation?

It is used to eliminate ventricular dysrhythmias.

The nurse is screening a client at a health fair for hypertension. Which assessment data, provided by the client, would prompt the nurse to stress physician involvement? Select all that apply.

When assessing the client for symptoms of hypertension, the nurse should recognize that the client may note fatigue, headache, insomnia, and blurred vision. Other symptoms include dizziness, nervousness, nosebleeds, angina, and dyspnea. Constipation and dysuria are not signs of hypertension.


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