Adult Health Chapter 23, 24, 25 Exam 3 PrepU
A client with known coronary artery disease reports intermittent chest pain, usually on exertion. When teaching the client about nitroglycerin administration, which instruction should the nurse provide?
"Be sure to take safety precautions because nitroglycerin may cause dizziness when you stand up." "I should sit down or lie down before taking the nitroglycerin."
In which type of cardiomyopathy does the heart muscle actually increase in size and mass weight, especially along the septum?
Hypertrophic
A client with endocarditis is being discharged home. What statement indicates effectiveness of client teaching about preventing recurrence of the infection?
I will ask for antibiotics whenever I have dental work done."
A client admitted to the coronary care unit (CCU) diagnosed with a STEMI is anxious and fearful. Which medication will the nurse administer to relieve the client's anxiety and decrease cardiac workload?
IV morphine
The nurse is creating a plan of care for a client diagnosed with cardiomyopathy. What priority goal should underlie most of the assessments and interventions that are selected for this client?
Improved cardiac output
A client diagnosed with a myocardial infarction (MI) is being moved to the rehabilitation unit for further therapy. Which statement reflects a long-term goal of rehabilitation for the client with an MI?
Improvement in quality of life
An ED nurse is assessing a 71-year-old female client for a suspected MI. When planning the assessment, the nurse should be cognizant of what signs and symptoms of MI that are particularly common in female clients? Select all that apply. Shortness of breath Chest pain Anxiety Indigestion Nausea
Indigestion Nausea
The nurse is taking a health history on a new patient. The patient reports experiencing pain in the left lower leg and foot when walking, but claims that the pain is relieved with rest. The nurse notes that the patient's left lower leg is slightly edematous and hairless. What should the nurse suspect that the patient may be experiencing?
Intermittent claudication A muscular, cramp-type pain in the extremities consistently reproduced with the same degree of exercise or activity and relieved by rest is experienced by patients with peripheral arterial insufficiency. Referred to as intermittent claudication, this pain is caused by the inability of the arterial system to provide adequate blood flow to the tissues in the face of increased demands for nutrients and oxygen during exercise.
A client who suffered blunt chest trauma in a motor vehicle accident reports chest pain during deep inspiration. On auscultation, the nurse detects a pericardial friction rub — a classic sign of acute pericarditis. To relieve this chest pain, which position should the nurse encourage the client to assume?
Leaning forward while sitting
Ralph Wilson, is a 52-year-old client in the hospital unit where you practice nursing. He is being treated for myocarditis. Which of the following nursing interventions should you perform to reduce cardiac workload in a client with myocarditis?
Maintain the client on bed rest
Which nursing intervention should a nurse perform to reduce cardiac workload in a client diagnosed with myocarditis?
Maintain the client on bed rest
A client with type 2 diabetes and hypertension (HTN) has a routine follow-up appointment after a cardiac stent placement. On assessment the nurse notes the client weighs 250 lb/113.4 kg with a waist circumference of 40 inches/101.6 cm, blood pressure is 162/84 mm Hg, and fasting blood glucose is 220 mg/dl. Based on these findings, which syndrome should the nurse most suspect?
Metabolic syndrome A cluster of metabolic abnormalities known as metabolic syndrome is a major risk factor for cardiovascular disease. This diagnosis is made when the client has 3 of the 5 risk factors. These factors include a waist circumference of greater than 35.4 inches/89.9 cm, elevated triglycerides, reduced high-density lipoprotein cholesterol, HTN with a systolic blood pressure above 130 mm Hg, and fasting glucose greater than 100 mg/dL or drug treatment for elevated glucose.
Which discharge instruction for self-care should the nurse provide to a client who has undergone a percutaneous transluminal coronary angioplasty (PTCA) procedure?
Monitor the site for bleeding or hematoma. The nurse provides certain discharge instructions for self-care, such as monitoring the site for bleeding or the development of a hard mass indicative of hematoma. A nurse does not advise the client to clean the site with disinfectants or refrain from sexual activity for 1 month.
A client has been admitted with an aortic valve stenosis and has been scheduled for a balloon valvuloplasty in the cardiac catheterization lab later today. During the admission assessment, the client tells the nurse he has thoracolumbar scoliosis and is concerned about lying down for any extended period of time. What is a priority action for the nurse?
Notify the surgeon immediately Most often used for mitral and aortic valve stenosis, balloon valvuloplasty is contraindicated for clients with left atrial or ventricular thrombus, severe aortic root dilation, significant mitral valve regurgitation, thoracolumbar scoliosis, rotation of the great vessels, and other cardiac conditions that require open heart surgery.
A nurse is assessing a client's right lower leg, which is wrapped with an elastic bandage. Which signs and symptoms suggest circulatory impairment?
Numbness, cool skin temperature, and pallor
The school nurse is providing care to a child with a sore throat. With any sign of throat infection, the nurse stresses which of the following?
Obtaining a throat culture
The nurse is caring for a client with a history of endocarditis. Which topic would the nurse prioritize during health promotion education?
Oral hygiene For clients with endocarditis, regular professional oral care combined with personal oral care may reduce the risk of bacteremia
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 primary symptom of pericarditis is pain, which is assessed by evaluating the client in various positions.
A patient in the recovery room after cardiac surgery begins to have extremity paresthesia, peaked T waves, and mental confusion. What type of electrolyte imbalance does the nurse suspect this patient is having?
Potassium Hyperkalemia (high potassium) can result in the following ECG changes: tall peaked T waves, wide QRS, and bradycardia. The nurse should be prepared to administer a diuretic or an ion-exchange resin (sodium polystyrene sulfonate [Kayexalate]); IV sodium bicarbonate, or IV insulin and glucose.
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).
A nurse is conducting a health history on a client with a primary diagnosis of mitral stenosis. Which disorder reported by the client is the most common cause of mitral stenosis?
Rheumatic endocarditis
What is the most common cause of mitral stenosis?
Rheumatic endocarditis
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
A nurse is obtaining a history from a new client in the cardiovascular clinic. When investigating for childhood diseases and disorders associated with structural heart disease, which finding should the nurse consider significant?
Rheumatic fever
Which of the following is the most effective intervention for preventing progression of vascular disease?
Risk factor modification
The nurse is providing discharge teaching for a client with rheumatic endocarditis but no valvular dysfunction. On which nursing diagnosis should the nurse focus her teaching?
Risk for infection
A client is being discharged home after a heart transplant. The nurse is preparing to provide medication education on cyclosporine and tacrolimus. Which nursing diagnosis would be prioritized for this client?
Risk for infection Immunosuppressants decrease the body's ability to resist infections, and a satisfactory balance must be achieved between suppressing rejection and avoiding infection.
The nurse is caring for a client who returned from the tropics a few weeks ago and has sought care with signs and symptoms of lymphedema. The nurse's plan of care should prioritize which issue?
Risk for infection related to lymphedema
The nurse is caring for a client presenting to the emergency department (ED) reporting chest pain. Which electrocardiographic (ECG) finding would be most concerning to the nurse?
ST elevation The first signs of an acute MI are usually seen in the T wave and the ST segment. The T wave becomes inverted; the ST segment elevates (it is usually flat). An elevated ST segment in two contiguous leads is a key diagnostic indicator for MI (i.e., ST-elevation MI).
Which symptom occurs in the client diagnosed with mitral regurgitation when pulmonary congestion occurs?
Shortness of breath
A physician admits a client to the health care facility for treatment of an abdominal aortic aneurysm. When planning this client's care, which goal should the nurse keep in mind as she formulates interventions?
Stabilizing heart rate and blood pressure and easing anxiety
The nurse is teaching a client scheduled for an autograft aortic valve replacement. What statements are true about autograft replacement process? Select all that apply. Anticoagulation is necessary. The grafts are obtained by excising the client's own pulmonic valves and a portion of the pulmonary artery. The autograft is an alternative for children and women of child-bearing age. Aortic valve autografts have remained viable for more than 20 years. Mitral valve replacements are done with an autograft.
The grafts are obtained by excising the client's own pulmonic valves and a portion of the pulmonary artery. The autograft is an alternative for children and women of child-bearing age. Aortic valve autografts have remained viable for more than 20 years. Autografts are obtained by excising the patient's own pulmonic valve and a portion of the pulmonary artery for use as the aortic valve. The autograft is an alternative for children and women of child-bearing age. Aortic valve autografts have remained viable for more than 20 years. Anticoagulation is unnecessary because the valve is the patient's own tissue and is not thrombogenic. Mitral valves are not replaced as autografts because of durability.
A nurse is admitting a client to the medical unit who has a history of peripheral artery disease (PAD). While providing the health history, the client reports smoking about two packs of cigarettes a day, having a history of alcohol abuse, and not exercising. Which topic would be the priority health education for this client?
The nicotine in cigarettes, which is a powerful vasoconstrictor and may cause or aggravate PAD
A nurse and a nursing student are performing a physical assessment of a client with pericarditis. The client has an audible pericardial friction rub on auscultation. When leaving the room, the student asks the nurse what causes the sound. The nurse's best response is which of the following?
The pericardial surfaces lose their lubricating fluid because of inflammation and rub against each other."
Family members bring a client to the ED with pale cool skin, sudden midsternal chest pain unrelieved with rest, and a history of coronary artery disease (CAD). How should the nurse best interpret these initial data?
The symptoms indicate an acute coronary episode and should be treated as such.
The nurse is teaching a client diagnosed with aortic stenosis appropriate strategies for attempting to relieve the symptom of angina without resorting to taking medications. What should the nurse teach the client?
To rest and relax before taking nitroglycerin
What symptoms should the nurse assess for in a client with lymphedema as a result of impaired nutrition to the tissue?
Ulcers and infection in the edematous area In a client with lymphedema, the tissue nutrition is impaired because of the stagnation of lymphatic fluid, leading to ulcers and infection in the edematous area.
A nurse is assessing a new client who is diagnosed with peripheral artery disease (PAD). The nurse cannot feel the pulse in the client's left foot. How should the nurse proceed with assessment?
Use Doppler ultrasound to identify the pulses.
A home health nurse is seeing an elderly male client for the first time. During the physical assessment of the skin on the lower legs, the nurse notes edema, brown pigmentation in the gaiter area, pedal pulses, and a few irregularly shaped ulcers around the ankles. From these findings, the nurse knows that the client has a problem with peripheral circulation. Which of the following does the nurse suspect?
Venous insufficiency Symptoms of venous insufficiency include present pedal pulses, edema, pigmentation in gaiter area, and a reddish blue color.
A client is admitted to the emergency department with chest pain and doesn't respond to nitroglycerin. The health care team obtains an electrocardiogram and administers I.V. morphine. The health care provider also considers administering alteplase. This thrombolytic agent must be administered how soon after onset of myocardial infarction (MI) symptoms?
Within 6 hours
The nurse is explaining the cause of angina pain to a client. What will the nurse say most directly caused the pain?
a lack of oxygen in the heart muscle cells Angina pectoris refers to chest pain that is brought about by myocardial ischemia. It is the result of cardiac muscle cells being deprived of oxygen due to the progressive symptoms of coronary artery disease.
The laboratory values for a client diagnosed with coronary artery disease (CAD) have just come back from the lab. The client's low-density lipoprotein (LDL) level is 112 mg/dL. The nurse recognizes that this value is
above the optimal range.
A client is diagnosed with pericarditis. What symptom will be the nurse's priority for treatment?
acute pain
A client with CAD thinks diltiazem (Cardizem) has been causing nausea. Diltiazem (Cardizem) is categorized as which type of drug?
calcium-channel blocker
A client with systemic lupus erythematosus reports palpitations, dyspnea on exertion, and leg swelling. The client's symptoms may indicate:
cardiomyopathy.
The public health nurse is participating in a health fair and interviews a client with a history of borderline hyperlipidemia who is currently smoking one pack of cigarettes per day. Based on these data, the nurse would expect the focus of treatment most likely to be which of the following?
diet therapy and smoking cessation.
Which population is at greatest risk of developing CAD? female smokers males with high meat consumption premenopausal females male nonsmokers
female smokers
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) The classic signs and symptoms of pericarditis include fever, positional chest discomfort, nonspecific ST-segment elevation, elevated ESR, and pericardial friction rub.
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. What is considered to be one of the last treatments for end-stage cardiomyopathy?
heart transplantation
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 In hypertrophic cardiomyopathy (HCM), the heart muscle asymmetrically increases in size and mass, especially along the septum.
While receiving treatment in hospital for a DVT, a client has several interventions ordered. Complete rest, anticoagulant therapy, and procedures to determine the location and size of the thrombus are all utilized to decrease the danger from the blood clot. Continuous warm, wet packs are ordered to:
improve circulation.
The nurse is admitting a client with an elevated creatine kinase-MB isoenzyme (CK-MB). What is the cause for the elevated isoenzyme?
myocardial necrosis An increase in CK-MB is related to myocardial necrosis.
A client with severe angina pectoris and ST-segment elevation on an electrocardiogram is being seen in the emergency department. In terms of diagnostic laboratory testing, it's most important for the nurse to advocate ordering a:
troponin level. Troponin is a myocardial cell protein that is elevated in the serum when myocardial damage has occurred during a myocardial infarction (MI).
A client is a candidate for percutaneous balloon valvuloplasty, but is concerned about how this procedure will affect the client's busy work schedule. Which guidance would the nurse provide to the client?
"Clients usually remain at the hospital for 24 to 48 hours."
An asymptomatic client questions the nurse about the diagnosis of mitral regurgitation and inquires about continuing an exercise routine. Which is the most appropriate response by the nurse?
"Continue the exercise routine unless symptoms such as shortness of breath or fatigue develop."
The nurse obtains a health history from a client with a prosthetic heart valve and new symptoms of infective endocarditis. Which question by the nurse is most appropriate to ask?
"Have you been to the dentist recently?" Invasive procedures, particularly those involving mucosal surfaces (e.g., those involving manipulation of gingival tissue or periapical regions of teeth), can cause a bacteremia, which rarely lasts more than 15 minutes.
The nurse determines that a client recently diagnosed with subacute bacterial endocarditis understands discharge teaching upon which client statement?
"I have to call my doctor so I can get antibiotics before seeing the dentist."
When teaching a client with rheumatic carditis and a history of recurrent rheumatic fever, which statement by the client indicates that teaching has been successful?
"I may have to take prophylactic antibiotics for up to 10 years."
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 client needs to have a cardiac valve replacement. The nurse offers client education about the procedures involved—including the benefits and risks. Which client statement indicates the need for more education?
"I'm anxious because I'll need to have cardiopulmonary bypass." Cardiopulmonary bypass is not normally required for valve replacement, though it is kept available as an option should the need arise. Minimally invasive techniques generally involve less pain, trauma, and blood loss than alternative techniques.
The nurse is teaching a client who is being discharged post vein stripping for varicose veins. Which client statement indicates the client requires additional self-care instructions?
"So it's OK for me to return to my job right away as a hairdresser." Following vein stripping, clients should avoid standing or sitting for prolonged periods.
When assessing a client who reports recent chest pain, the nurse obtains a thorough history. Which client statement most strongly suggests angina pectoris?
"The pain occurred while I was mowing the lawn." Decreased oxygen supply to the myocardium causes angina pectoris. Lawn mowing increases the cardiac workload, which increases the heart's need for oxygen and may precipitate this chest pain.
A client who had a prosthetic valve replacement was taking warfarin to reduce the risk of postoperative thrombosis. The client visited the nurse at a clinic once a week. What INR level would alert the nurse to notify the health care provider?
3.8 Warfarin patients usually have individualized target international normalized ratios (INRs) between 2 to 3.5 to maintain adequate anticoagulation.
A 75-year-old is to have a carotid artery stent placed in the morning. Which of the following is an appropriate nursing action when caring for older patients scheduled to undergo cardiac surgery?
Administer narcotics with caution.
The nurse is creating a plan of care for a client diagnosed with acute coronary syndrome (ACS). What nursing action should be included in the client's care plan?
Administer supplementary oxygen, as needed.
A nurse plans to have an education session with a client with cardiomyopathy and the client's spouse about ways to increase activity tolerance. What instructions would the nurse provide?
Alternate active periods with rest periods.
Which would the nurse stress as a periodic lifelong necessity for a client managing infective endocarditis?
Antibiotic therapy
A client is admitted to the ED reporting chest pain. The client states that they developed unrelieved chest pain approximately 20 minutes before coming to the hospital. To minimize cardiac damage, the nurse will prepare to administer which prescription(s) to the client? Select all that apply.
Aspirin Morphine Sulphate Oxygen
A client who has undergone a femoral to popliteal bypass graft surgery returns to the surgical unit. Which assessments should the nurse perform during the first postoperative day?
Assess pulse of affected extremity every 15 minutes at first.
A nurse is caring for a client receiving warfarin therapy following a mechanical valve replacement. The client had a prothrombin time and International Normalized Ratio (INR) drawn before breakfast. The laboratory report shows the client's INR reading was 4. What is the nurse's first priority ?
Assess the client for bleeding and notify the health care provider of the results.
A nurse is caring for a client who is exhibiting signs and symptoms characteristic of a myocardial infarction (MI). Which statement describes priorities the nurse should establish while performing the physical assessment?
Assess the client's level of pain and administer prescribed analgesics.
A patient with a diagnosis of deep vein thrombosis (DVT) is being treated with unfractionated heparin, which is being administered intravenously. The nurse who is providing care for this patient should consequently prioritize what assessments?
Assessing the patient for internal or external hemorrhage IV heparin administration creates a significant risk of bleeding. Consequently, assessments for hemorrhage would be prioritized over fluid balance, oxygenation, and pain, although each of these assessment domains is necessary.
A client with mitral valve stenosis is receiving health education at an outpatient clinic. To minimize the client's symptoms, the nurse would teach the client to take which action?
Avoid activities that cause an increased heart rate.
Which of the following assessment results is considered a major risk factor for PAD? LDL of 100 mg/dL BP of 160/110 mm Hg Cholesterol of 200 mg/dL Triglyceride level of 150 mg/dL
BP of 160/110 mm Hg Hypertension is considered a major risk factor for PAD. Blood pressure should be less than 130/90 mm Hg. The other laboratory results are within the recommended range of normal to high normal.
A nurse is caring for a client who had an aortic balloon valvuloplasty. The nurse should inspect the surgical insertion site closely for which complication(s)?
Bleeding and infection Possible complications of an aortic balloon valvuloplasty include aortic regurgitation, emboli, ventricular perforation, rupture of the aortic valve annulus, ventricular dysrhythmia, mitral valve damage, infection, and bleeding from the catheter insertion sites.
A client with an occluded coronary artery is admitted and has an emergency percutaneous transluminal coronary angioplasty (PTCA). The client is admitted to the cardiac critical care unit after the PTCA. The complications for which the nurse should monitor the client include which of the following?
Bleeding at insertion site Complications of PTCA may include bleeding at the insertion site, abrupt closure of the artery, arterial thrombosis, and perforation of the artery.
A client has been admitted to the medical unit with signs and symptoms suggestive of endocarditis. The health care provider's choice of antibiotics would be primarily based on what diagnostic test?
Blood cultures To help determine the causative organisms and the most effective antibiotic treatment for the client, blood cultures are taken. A CBC can help establish the degree and stage of infection, but not the causative microorganism.
An older adult client has been diagnosed with acute aortic regurgitation (AR). What change in blood flow should the nurse expect to see on this client's echocardiogram?
Blood to flow back from the aorta to the left ventricle
The nurse is caring for a patient diagnosed with pericarditis. What serious complication should this patient be monitored for?
Cardiac tamponade The inflammatory process of pericarditis may lead to an accumulation of fluid in the pericardial sac (pericardial effusion) and increased pressure on the heart, leading to cardiac tamponade (see Chapter 29).
Which nursing intervention should a nurse perform when a client with cardiomyopathy receives a diuretic?
Check regularly for dependent edema
A client with a history of atrial fibrillation has experienced a TIA. What does the nurse expect will be the priority preventative medical treatment(s) to reduce the risk of a cerebrovascular accident (CVA)? Select all that apply. Cholesterol-lowering drugs Anticoagulant therapy Monthly prothrombin levels Carotid endarterectomy Percutaneous transluminal angioplasty
Cholesterol-lowering drugs Anticoagulant therapy To manage atherosclerosis and the consequences of cardiac arrhythmias, especially atrial fibrillation, cholesterol-lowering drugs and prophylactic anticoagulant or antiplatelet therapy are prescribed.
A client had a percutaneous transluminal coronary angioplasty (PTCA). What medication will the nurse administer to prevent thrombus formation in the stent?
Clopidogrel Because of the risk of thrombus formation following a coronary stent placement, the patient receives antiplatelet medications, such as clopidogrel or aspirin.
The nurse determines that a patient has a characteristic symptom of pericarditis. What symptom does the nurse recognize as significant for this diagnosis?
Constant chest pain
A client who is postoperative day 1 following a coronary artery bypass graft (CABG) has produced 20 mL of urine in the past 3 hours and the nurse has confirmed the patency of the urinary catheter. What is the nurse's most appropriate action?
Contact the client's primary care provider and continue to assess fluid balance and renal function.
A patient has had a successful heart transplant for end-stage heart disease. What immunosuppressant will be necessary for this patient to take to prevent rejection?
Cyclosporine
The nurse is reviewing the echocardiography results of a client who has just been diagnosed with dilated cardiomyopathy (DCM). What changes in heart structure is this client experiencing? Dilated ventricles with atrophy of the ventricles Dilated ventricles without hypertrophy of the ventricles Dilation and hypertrophy of all four heart chambers Dilation of the atria and hypertrophy of the ventricles
Dilated ventricles without hypertrophy of the ventricles DCM is characterized by significant dilation of the ventricles without significant concomitant hypertrophy and systolic dysfunction. The ventricles do not atrophy in clients with DCM.
Which is a characteristic of arterial insufficiency?
Diminished or absent pulses
The nurse is admitting a patient to the cardiac care unit with complaints of dyspnea on exertion and fatigue. The patient's electrocardiogram (ECG) shows dysrhythmias associated with left ventricular hypertrophy. What diagnostic tool would be the most helpful in diagnosing cardiomyopathy?
Echocardiogram
The nurse is admitting a client reporting dyspnea on exertion and fatigue. The client's ECG shows arrhythmias that are sometimes associated with left ventricular hypertrophy. What diagnostic tool would be most helpful in diagnosing cardiomyopathy?
Echocardiogram The echocardiogram is one of the most helpful diagnostic tools because the structure and function of the ventricles can be observed easily. The ECG is also important, and can demonstrate arrhythmias and changes consistent with left ventricular hypertrophy. Cardiac catheterization specifically addresses coronary artery function, and arterial blood gases evaluate gas exchange and acid balance. Stress testing is not normally used to differentiate cardiomyopathy from other cardiac pathologies.
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 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 Echocardiography is useful in detecting the presence of pericardial effusions associated with pericarditis.
A client comes to the emergency department reporting 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
A client reporting heart palpitations is diagnosed with atrial fibrillation caused by mitral valve prolapse. To relieve the symptoms, the nurse should teach the client which dietary intervention?
Eliminate caffeine and alcohol
A client with advanced venous insufficiency is confined to bed rest following orthopedic surgery. How can the nurse best in the client's lower extremities?
Ensure that the client's heels are protected and supported. If the client is on bed rest, it is important to relieve pressure on the heels to prevent pressure ulcerations, since the heels are among the most vulnerable body regions
The nurse has just admitted a client for cardiac surgery. The client tearfully describes feeling afraid of dying while undergoing the surgery. What is the nurse's best response?
Explore the factors underlying the client's anxiety.
Which class of medication lyses and dissolves thrombi?
Fibrinolytic
A client with lower extremity edema is diagnosed with lymphedema. For which medication will the nurse prepare teaching for this client?
Furosemide
A client is diagnosed with rheumatic endocarditis. What bacterium is the nurse aware causes this inflammatory response?
Group A, beta-hemolytic streptococcus
The nurse is discussing risk factors for developing CAD with a patient in the clinic. Which results would indicate that the patient is not at significant risk for the development of CAD?
High-density lipoprotein (HDL), 80 mg/dL
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 heart valve prosthesis such as an aortic valve replacement is a major risk factor for infective endocarditis.
