CARDIOVASCULAR DISORDERS

Discharge instructions for a post-op client taking warfarin sodium need further teaching if patient says:

"I will take enteric-coated aspirin for my headaches because it is coated."

Nurse is planning to administer hydrochlorothiazide to a pt; What is a concern related to administration of this medication?

Hypokalemia, hyperglycemia, sulfa allergy

Pt diagnosed with thrombophlebitis 1 day ago has sudden chest pain and SOB; client visibly anxious. Which is a life-threatening complication that could be occurring?

Pulmonary embolism

24 yrs old man seeks medical attention for claudication in the arch of the foot. Nurse notes superficial thrombophlebitis of the lower leg. What should be checked in the medical history?

Smoking history

To use a cardiac defibrillator on a client, what action to check cardiac rhythm?

Applying adhesive patch electrodes to the skin and moving away from the client.

Home health nurse visiting pt with elevated triglyceride levels and a serum cholesterol level of 398ms/dL. The pt is taking cholestyramine; what statement indicates further teaching?

"I'll continue my nicotinic acid from the health food store."

Nurse is caring for a pt with heart failure. Pt suddenly develops extreme dyspnea, tachycardia, and lung crackles. Nurse suspects pulmonary edema, what interventions to be prescribed after RN is notified?

-Administer oxygen -Inserting a Foley catheter -Administering furosemide -Administer morphine sulfate intravenously

Hospitalized client with CAD complains substernal chest pain. Nurse administers nitroglycerin, 0.4 mg, sublingually after checking HR and BP. After 5 minutes client states that chest still hurts. What are appropriate actions to take?

-Check the client's pain level -Check the client's BP -Administer a second nitroglycerin, 0.4 mg sublingually

Primary Care Provider is going to perform carotid massage on a client with rapid rate AFIB. What interventions are anticipated?

-Client placed on a cardiac monitor. -Rhythm strips should be obtained before, during, and after the procedure. -Monitor the VS, cardiac rhythm, and level of consciousness after the procedure.

Pt receiving digoxin daily; s/s that indicate digoxin toxicity:

-visual disturbances -N/V -Serum digoxin level of 2.3ng/mL (2.93 nmol/L)

Heparin sodium is prescribed; which lab results indicates a therapeutic level?

Activated partial thromboplastin time (aPTT) of 55 seconds.

A postcardiac surgery client with a blood urea nitrogen (BUN) level of 45 mg/dL and a serum creatinine level of 2.2 mg/dL has a total 2-hour urine output of 25 mL. The nurse understands that the client is at risk for which?

Acute Kidney Injury

Nurse is caring for a client on a cardiac monitor who is alone in a room at the end of the hall. The client has a short burst of VT, followed by VF; client loses consciousness. What's the intervention?

Call for help and initiate cardiopulmonary resuscitation (CPR).

A client is wearing a continuous cardiac monitor which begins to alarm. No EKG complexes on the screen; whats the first action?

Check the client status and lead placement.

A client with MI suddenly becomes tachycardic, shows signs of air hunger, coughing frothy pink tinged sputum, What do you expect to hear?

Crackles

Nurse collecting data on client with right sided heart failure. Nurse should expect to note which specific characteristic of this condition:

Dependent edema

Monitoring pt taking propranolol; What data collection indicates a potential serious complication:

Development of audible expiratory wheezes.

Nurse assisting with caring for client immediately after insertion of permanent demand pacemaker via right subclavian vein. Prevent dislodgement by:

Limiting movement and abduction of the right arm.

Pt diagnosed with acute myocardial infarction and receiving tissue plasminogen activator, alteplase; what is a priority nursing intervention?

Monitor for signs of bleeding.

Nurse has reinforced instructions to the client with Raynaud's disease about self-management of the disease process. Nurse determines that the client needs further teaching after hearing:

Moving to a warmer climate should help.

Nurse is checking the neurovascular status of a client 4 hours pospresribedt aortoiliac bypass graft. The affected leg is warm withredness and edema. Pedal pulse is palpable and unchanged from admission. What's the clients neurovascular status?

Normal, caused by increased blood flow through the leg.

Nurse is preparing to ambulate a post-op cardiac surgery; which enables client to *best* tolerate the ambulation:

Premedicate the client with an analgesic before ambulating.

Nurse is monitoring a client following cardioversion; which observation is highest priority?

Status of airway

Isosorbide mononitrate is prescribed for a pt with angina pectoris. Pt says medication is causing a chronic headache. What's the nurses suggestion?

Take the medication with food.