OB final

A client with a recent history of atrial fibrillation has been prescribed warfarin. What action will the nurse take to confirm safe dosing?

Review the client's international normalized ratio (INR). Warfarin doses are adjusted on the basis of the client's INR. Blood levels are not taken for the drug, and the client's heart rate is not the indicator of efficacy or safety.

A client comes to the clinic reporting fever, chills, and sore throat and is diagnosed with streptococcal pharyngitis. A nurse knows that early diagnosis and effective treatment is essential to avoid which preventable disease?

Rheumatic fever

The nurse is auscultating the heart of a client diagnosed with mitral valve prolapse. Which is often the first and only manifestation of mitral valve prolapse?

extra heart sound

A nurse is assigned to the medical intensive care unit. The nurse auscultates a water-hammer pulse. What will the sound resemble?

quick, sharp strokes that suddenly collapse

What is the most common cause of mitral stenosis?

rheumatic endocarditis

The nurse is caring for a client who has been diagnosed with aortic stenosis. The client is prescribed digoxin. What is the rationale for the medication?

left ventricular dysfunction

Which nursing intervention should a nurse perform to reduce cardiac workload in a client diagnosed with myocarditis?

maintain bed rest

Which nursing intervention should a nurse perform to reduce cardiac workload in a client diagnosed with myocarditis?

miantain bedrest

A client with infective endocarditis (IE) and a fever is admitted to the intensive care unit. Which of these physician orders should the nurse implement first?

order blood cultures from two sites

A client comes into the emergency department reporting about chest pain that gets worse when taking deep breaths and lying down. After ruling out a myocardial infarction, a nurse would assess for which diagnosis?

pericarditis

The instructor is talking with a nursing student who is caring for a client with pericarditis. The instructor asks the student to name the main characteristic of pericarditis. What should be the student's answer?

precordial pain

A client with a forceful, pounding heartbeat is diagnosed with mitral valve prolapse. Which client statement indicates to the nurse a need for additional teaching?

"I can still drink coffee and tea." Caffeine is a stimulant, which can exacerbate palpitations, and should be avoided by a client with symptomatic mitral valve prolapse. High fluid intake helps maintain adequate preload and cardiac output. Aerobic exercise helps increase cardiac output and decrease heart rate. Protein-rich foods aren't restricted but high-calorie foods are.

The nurse instructs a client recovering from mechanical valve replacement surgery. Which client statement indicates that teaching has been effective?

"I will not drive until informed by my health care provider."

A nurse is caring for a client newly diagnosed with mitral valve prolapse. The health care provider indicates the client has probably had this condition for years. What factor is important for the nurse to consider when teaching the client about valvular disease?

"The client with mitral valve prolapse probably had no health symptoms."

A nurse is caring for four clients on the cardiac unit. Which client has the greatest risk for contracting infective endocarditis?

A client 4 days postoperative after mitral valve replacement

When a patient is taking an immunosuppressant following heart transplantation, the nurse would determine which of the following as the MOST important intervention?

Assess vital signs every 4 hours.

A client is diagnosed with mitral regurgitation. What does the nurse consider with the mechanics of cardiac hemodynamics?

Blood flows backward from the left ventricle into the left atrium during systole.

A nurse is caring for a client with aortic stenosis whose compensatory mechanisms of the heart have begun to fail. The nurse will monitor the client carefully for which initial symptoms?

Exertional dyspnea, orthopnea, pulmonary edema

A young parent brings a 4-year-old child to the pediatric clinic with a mild fever and a red, spotty rash that is beginning to fade. The child's heart rate is rapid, and the rhythm is abnormal. The parent states the child has been healthy until about 3 weeks ago, when the child had a sore throat. The nurse suspects rheumatic carditis. What organism causes rheumatic carditis?

Group A beta-hemolytic strep

An adult client with a tentative diagnosis of infective endocarditis is admitted to an acute care facility. The medical history reveals diabetes mellitus, hypertension, and pernicious anemia. The client underwent an appendectomy 20 years earlier and an aortic valve replacement 2 years before this admission. What history finding is a major risk factor for infective endocarditis?

History of aortic valve replacement

A nurse is caring for a client with end-stage cardiomyopathy and the client's spouse asks the nurse to clarify one of the last treatment options available that the health care provider mentioned earlier. What option will the nurse most likely discuss?

Left ventricular assist device

The nurse is reviewing the lab work of a client diagnosed with infective endocarditis. Which diagnostic study confirms the diagnosis?

Positive blood culture

A patient with pericarditis is experiencing cardiac tamponade. Which collaborative intervention should the nurse anticipate for this patient?

Prepare for pericardiocentesis.

A nurse is caring for a client with pericarditis and auscultates a pericardial friction rub. What action does the nurse ask the client to do to distinguish a pericardial friction rub from a pleural friction rub?

The nurse asks the client to hold the breath during auscultation.

The nurse is performing a medication review of a client diagnosed with myocarditis. What medication may have precipitated the client to have myocarditis?

azathioprine

The nurse is caring for a patient diagnosed with pericarditis. What serious complication should this patient be monitored for?

cardiac tamponade

A nurse evaluates a client and suspects pericarditis. What indicator is considered the most characteristic symptom of pericarditis?

chest pain

The nurse determines that a patient has a characteristic symptom of pericarditis. What symptom does the nurse recognize as significant for this diagnosis?

contant chest pain

A client is admitted to the hospital with possible acute pericarditis and pericardial effusion. The nurse knows to prepare the client for which diagnostic test to confirm the client's diagnosis?

echocardiography

A client is diagnosed with infective endocarditis. What laboratory values will the nurse assess? Select all that apply.

elevated WBC elevated C-reactive protein elevated ESR

The nurse suspects a client has developed pericarditis after a week of cold-like symptoms. Which of the client's signs and symptoms indicate pericarditis?

fever, chest discomfort, and elevated erythrocyte sedimentation rate (ESR)

A nurse reviewing a client's echocardiogram report reads the following statements: "The heart muscle is asymmetrically thickened and the overall size and mass are increased, especially along the septum. The ventricular walls are thickened, reducing the size of the ventricular cavities. Several areas of the myocardium show evidence of scarring." The nurse knows these manifestations are indicative of which type of cardiomyopathy?

hypertrophic

The nurse completes an assessment of a client admitted with pericarditis. What client symptom will the nurse correlate with the diagnosis of pericarditis?

reports of constant chest pain

The nurse is teaching a school community parent group about heart wellness. What risk factor is a common leading cause for mitral stenosis?

rheumatic fever

A nurse is caring for a client with acute mitral regurgitation related to an acute myocardial infarction. The nurse knows to monitor the client carefully for symptoms of which initial complication or result?

severe heart failure

Which of the following clinical manifestations would the nurse expect to find in the client diagnosed with aortic regurgitation?

visible neck pulsations