CVD Quiz 1
A nurse in an emergency department is planning care for a client who is having an acute myocardial infarction(MI). The nurse should plan to administer which of the following medications after the initial acute phase to manage the client's pain and anxiety? Nitroglycerin Aspirin Oxygen Morphine
Morphine A. Incorrect: Nitroglycerin can help relieve angina pain, but as an acute MI progresses, it is ineffective for managing pain and anxiety.B. Incorrect: Aspirin can help in the immediate treatment of an acute MI, but it is not the medication of choice for managing pain and anxiety.C. Incorrect: Oxygen can help in the immediate treatment of an acute MI, but it is not the medication of choice for managing pain and anxiety.D. Correct: Morphine is the medication of choice for managing the pain and anxiety of an acute MI. By reducing preload and afterload, it decreases the work of the heart.
A nurse is assessing a toddler who has heart failure. Which of the following findings should the nurse expect? Weight loss Increased urine output Bradycardia Orthopnea
Orthopnea A. Incorrect: A toddler who has heart failure is more likely to have weight gain than weight loss due to systemic venous congestion.B. Incorrect: A toddler who has heart failure is more likely to have decreased, rather than increased, urine output due to impaired cardiac function and decreased cardiac output.C. Incorrect: A toddler who has heart failure is more likely to have tachycardia, rather than bradycardia, as a result of sympathetic stimulation of the heart.D. Correct: A toddler who has heart failure has increased venous return to the heart and lungs, which leads to pulmonary congestion. The congestion causes orthopnea, or difficulty breathing, while lying down. Having the toddler sit up decreases venous return, as well as pressure the abdominal organs have on the diaphragm. This decrease in pressure improves breathing and oxygenation.
The nurse is assessing the client diagnosed with congestive heart failure. Which signs/symptoms would indicate that the medical treatment has been effective? The clients peripheral pitting edema has gone from 3+ to 4+. The client is able to take the radial pulse accurately. The client is able to perform ADLs without dyspnea. The client has minimal jugular vein distention.
The client is able to perform ADLs without dyspnea. C. being able to perform activities of daily living (ADLs) without shortness of breath (dyspnea) would indicate the client's condition is imporving. The client's heart is a more effective pump and can oxygenate the body better without increasing fluid in the lungs. A. Pitting edema changing from 3+ to 4+ indicates a worsening of the CHF. B. The client's ability to take the radial pulse would evaluate teaching, not medical treatment. D. Any jugular vein distention indicates that the right side of the heart is failing, which would not indicate effective medical treatment.u C. being able to perform activities of daily living (ADLs) without shortness of breath (dyspnea) would indicate the client's condition is improving. The client's heart is a more effective pump and can oxygenate the body better without increasing fluid in the lungs.
The client has just returned from a cardiac catheterization. Which assessment data would warrant immediate intervention from the nurse? The client's BP is 110/70 and pulse is 90. The client's groin dressing is dry and intact. The client refuses to keep the leg straight. The client denies any numbness and tingling
The client refuses to keep the leg straight. If the client bends the leg, it could cause the insertion site to bleed. This is arterial blood and the client could bleed to death very quickly, so this requires immediate intervention. A. These vital signs are within normal limits and would not require any immediate intervention. B. The groin dressing should be try and intact. D. The nurse must do neurovascular assessment; pain, weak pulse or pulseless, or leg become white or cold, or parethesia would warrant immediate intervention, but no numbness and tingling is a good sign.
The client with Raynaud's disease is seen in a vascular clinic 6 weeks after nifedipine has been prescribed. The nurse evaluates that the medication has been effective when which findings are noted? The client's blood pressure is 110/68 mm Hg. The client states experiencing less pain and numbness. The client states that tolerance to heat is improved. The client walks without intermittent claudication.
The client states experiencing less pain and numbness. Raynaud's disease is a disease in which cutaneous arteries in the extremities have recurrent episodes of vasospasm that result in pain and numbness. Nifedipine (Procardia), a calcium-channel blocker, cause vasodilation, thus reducing pain and numbness. Test-Taking Tips: Nifedipine (Procardia), amlodipine (Novasc), Diltiazem (Cardizem) are calcium channel blockers. They can cause vasodilation and are used to relieve the symptoms of Raynaud's disease and Buerger's disease.
A nurse is monitoring a client who is taking propranolol (Inderal). Which assessment data would indicate a potential serious complication associated with propranolol? The development of complaints of insomnia The development of audible expiratory wheezes A baseline blood pressure of 150/80 mm Hg following by a blood pressure of 138/72 mm Hg after two doses of the medication A baseline resting heart rate of 88 beats/min followed by a resting heart rate of 72 beats/min after two doses of the medication
The development of audible expiratory wheezes Propranolol is a beta blocker. Hypotension, bradycardia and bronchoconstriction are side effects of beta blockers. Option C and option D are the expected effects of the treatment after two doses of the medication. Both BP and HR are still within normal limits. However, option B is the correct answer because audible expiratory wheezing is a sign of bronchoconstriction which is a potential serious complication caused by beta blocker. It needs to be treated immediately.
Postoperatively, a nurse is caring for a client who had a percutaneous insertion of an inferior vena cava filter and was on heparin therapy before surgery. The nurse would inspect the surgical site most closely for evidence of which of the following? Bleeding and infection Thrombosis and infection Bleeding and wound dehiscence Wound dehiscence and evisceration
bleeding and infection After inferior vena cava filter insertion, the nurse inspects the surgical site for bleeding, and signs and symptoms of infection. Otherwise, care is the same as for any other postoperative client. Test-taking strategy: Use the process of elimination. Because inferior vena cava filters are inserted percutaneously through a deep vein, option C and D are eliminated because no abdominal incision is made. From the remaining options, nothing that the client has been on anticoagulant therapy before surgery because of the high risk of pulmonary embolism will direct you to option A. Review care of the client following insertion of a vena cava filter if you had difficulty with this question.
A client is admitted to an emergency room with chest pain that is being ruled out for myocardial infarction. Vital signs are as follows: at 11 AM, pulse (P), 92 beats/min, respiratory rate (RR), 24 breaths/min, BP, 128/82 mm Hg; 11:30 AM, P, 104 beats/min, RR, 28 breaths/min, BP, 104 mm Hg; 11:45 AM, P, 118 beats/min, RR, 32 breaths/min, BP, 88/58 mm Hg. The nurse should alert the physician because these changes are most consistent with which of the following complications? Cardiogenic shock cardiac tamponade pulmonary embolism dissecting thoracic aortic aneurysm
cardiogenic shock Cardiogenic shock occurs with severe damage (more than 40%) to the left ventricle. Classic signs include hypotension, a rapid pulse that becomes weaker, decreased urine output, and cool, clammy skin. Respiratory rate increases as the body develops metabolic acidosis from shock. Cardiac tamponade is accompanied by distant, muffled heart sounds and prominent neck vessels. pulmonary embolism presents suddenly with severe dyspnea accompanying the chest pain. dissecting aortic aneurysms usually are accompanied by back pain. test taking strategies: use the process of elimination. Recalling that the early serious complications of myocardial infarction include dysrhythmias, cardiogenic shock, and sudden death will direct you to option A. No information in the question would guide you to select option B, C, D. review the complications of myocardial infarction if you had difficulty with this question.
Which intervention should the nurse implement when administering a loop diuretic to a client diagnosed with coronary artery disease? Assess the client's radial pulse serum potassium level glucometer reading pulse oximeter reading
serum potassium level Loop diuretics cause potassium to be lost in the urine output. Therefore, the nurse should assess the client's potassium level, and if the client is hypokalemic, the nurse should question administering this medication. A. The nurse should always assess the apical (not radial) pulse, but the pulse is not affected b y a loop diuretic. . B. Loop diuretics cause potassium to be lost in the urine output. Therefore, the nurse should assess the client's potassium level, and if the client is hypokalemic, the nurse should question administering this medication.C. The glucometer provides a glucose level, which is not affected by a loop diuretic. D. The pulse oximeter reading evaluates periipheral oxygenation and is not affected by a loop diuretic.
A client is on enalapril (Vasotec) for the treatment of hypertension. The nurse teaches the client that he should seek emergent care if experiences which adverse effect? Nausea Insomnia Dry cough Swelling of the tongue and rash
swelling of the tongue and rash Rationale: Enalapril (Vasotec) is an angiotensin-converting enzyme inhibitor. Angioedema is an adverse effect. Swelling of the tongue and lips can result in airway occlusion. Nausea, insomnia, and a cough can occur as side (Not adverse) effects of the medication. Test-taking strategy: Note the strategic word adverse.Use the ABCs-airway, breathing, and circulation-- to direct you to option D. Review the adverse effects of this medication if you have difficulty with this question.
A client is scheduled for a cardiac catheterization using a radiopaque dye. Which of the following assessment is most critical before the procedure? Intake and output Height and weight Allergy to iodine or shellfish Baseline peripheral pulse rates
Allergy to iodine or shellfish Checking the allergy to iodine or shellfish is part of the pre-catheterization nursing care. Because the dye used during a cardiac catheterization contains iodine, the physician must be aware of this client's reaction to iodine (shellfish).If you have trouble with this question, you may also like to review the content related to other nursing care before, during and after catheterization. Other options are all routine nursing cares for all patients.
A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refusedbreakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? Check the client's vital signs. Request a dietitian consult. Suggest that the client rests before eating the meal. Request an order for an antiemetic.
Check the client's vital signs. A. Correct: It is possible that the client's nausea is secondary to digoxin toxicity. By obtaining vital signs,the nurse can assess for bradycardia, which is a symptom of digoxin toxicity. The nurse should withhold the medication and call the provider if the client's heart rate is less than 60 bpm.B. Incorrect: While the dietitian might be able to assist the client with making appropriate food choices, this is not the first action the nurse should take.C. Incorrect: While this intervention might be appropriate, this is not the first action the nurse should take.D. Incorrect: While this intervention might relieve the client's nausea, this is not the first action the nurseshould take.
A nurse in the emergency room is caring for a client who presents with manifestations that indicate a myocardial infarction. Which of the following prescriptions should the nurse take first? Attach the leads for a 12-lead ECG. Obtain a blood sample. Initiate oxygen therapy. Insert the IV catheter.
Initiate oxygen therapy A. Incorrect: It is important to determine the client's heart rhythm and allow for appropriate treatment;however, another action is the nurse's priority.B. Incorrect: It is important to obtain blood samples in order to determine the client's cardiac enzyme levels;however, another prescription should be implemented by the nurse first.C. Correct: The greatest risk to the client's safety is myocardial ischemia and cellular death; therefore, the priority action the nurse should take is to administer oxygen to help minimize this possibility.D. Incorrect: Gaining intravenous access is important because it allows for the delivery of medications quickly; however, another action is the nurse's priority.
A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which of the following is a priority nursing intervention? Monitor for renal failure Monitor psychosocial status Monitor for signs of bleeding Have heparin sodium available
Monitor for signs of bleedings this question is testing the nursing care of the thrombolytic therapy. Tissue plasminogen activator, alteplase (Activase, tPA) and streptokinase (Streptase) are one kind of thrombolytic drugs. Monitoring complications of hemorrhage and allergic reactions to the thrombolytic drugs is the number one nursing priority although renal failure could happen with severe hemorrhage.
A nurse is caring for a client who receives furosemide to treat heart failure. Which of the following laboratory values should the nurse monitor for this client due to this medication? Potassium Albumin Cortisol Bicarbonate
Potassium A. Correct: Furosemide is a loop diuretic that promotes the excretion of potassium. The nurse should monitor the client's potassium level to watch for hypokalemia.B. Incorrect: Furosemide does not affect albumin levels.C. Incorrect: Furosemide does not affect cortisol levels, although it can lower serum sodium levels.D. Incorrect: Furosemide does not affect bicarbonate levels.
A client with angina has a 12-lead electrocardiogram (ECG) taken during an episode of chest pain. A nurse examines the tracing for which electrocardiographic change causes by myocardial infarction? Tall peak T wave Prolonged PR interval Widened QRS complex ST segment elevation or depression
ST segment elevation or depression Only option D indicates the EKG changes of the myocardial ischemia/injury/tissue damage.Ischemia causes inversion of the T wave. Cardiac muscle injury causes elevation of the ST segment (Fireman's hat). Deep Q waves develop because of the necrotic tissue. If you have trouble with this question, please review the content related to the sequential ECG changes in angina and myocardial infarction.
The nurse is developing a discharge teaching plan for the client diagnosed with congestive heart failure. Which interventions should be included in the plan? SELECT ALL THAT APPLY Notify the health care provider of a weight gain of more than one pound in a week. Teach the client how to count the radial pulse when taking digoxin. Instruct the client to remove the saltshaker from the dinner table. Encourage the client to monitor urine output for change in color to become dark. Discuss the importance of taking the loop diuretic furosemide (Lasix) at bedtime.
Teach the client how to count the radial pulse when taking digoxin & Instruct the client to remove the saltshaker from the dinner table B. The client should not take digoxin if the radial pulse is less than 60. C. The client should be on a low sodium diet to prevent water retention. A. The client should notify the HCP fow eight gain of more than two or three pounds in one day. D. The color of the urine should not change to a dark color, if anything, it might become lighter and the amount will increase with diuretics. E. Instruct the client to take the diuretic in the morming to prevent nocturia. B. The client should not take digoxin if the radial pulse is less than 60. C. The client should be on a low sodium diet to prevent water retention.
A nurse in an emergency department is caring for a client who reports substernal chest pain and dyspnea. The client is vomiting and is diaphoretic. Which of the following laboratory tests are used to diagnose a myocardial infarction? (Select all that apply.) Troponin I Troponin T Plasma low-density lipoproteins (LDL) CPK Myoglobin
Troponin I Troponin T CPK Myoglobin Troponin I is correct. Troponin I is a myocardial muscle protein that is released when there isinjury to cardiac muscle. Levels are elevated as early as 2 to 3 hr following a myocardial infarction.Troponin T is correct. Troponin T is a myocardial muscle protein that is released when there is injury to cardiac muscle. Levels are elevated as early as 2 to 3 hr following amyocardial infarction.Plasma low-density lipoproteins (LDL) is incorrect. Elevation of plasma low-density lipoproteins indicates a client's risk for coronary artery disease. An increase in LDLlevels does not diagnose myocardial infarction.CPK is correct. CPK, or creatine phosphokinase, is an enzyme that is elevated in the presence of muscle injury. Although CPKis not specific for myocardial damage, it is used in conjunction with other diagnostic tests to support a diagnosis of myocardial infarction. A CPK isoenzyme, CK-MB, is specific to cardiac muscle and a significant elevation in this isoenzyme indicates a myocardial infarction has occurred. Myoglobin is correct. Elevation of myoglobin indicates myocardial injury. Myoglobin levels will significantly increase within approximately 3 hours following myocardial infarction.This test is used in conjunction with other diagnostic tests to support a diagnosis of myocardial infarction.
A nurse in an emergency department is assessing a client who is having a suspected acute myocardial infarction(MI). Which of the following manifestations should the nurse expect to find for a client experiencing an acute MI?(Select all that apply.) Orthopnea Headache Nausea Tachycardia Diaphoresis
Nausea Tachycardia Diaphoresis Orthopnea is incorrect. Orthopnea is a manifestation of heart failure, which can develop from anMI but is not a common manifestation of an acute MI. A client experiencing an MI typically manifests dyspnea.Headache is incorrect. Chest pain and sometimes jaw, back, and shoulder pain are manifestations of an acute MI.Nausea is correct. Nausea and vomiting are manifestations of an acute MI.Tachycardia is correct. Tachycardia and dysrhythmias are manifestations of an acute MI. Tachycardia can also occur as a result of the client's anxiety.Diaphoresis is correct. Profuse sweating and anxiety are manifestations of an acute MI.
After a myocardial infarction, a client has concerns about when it is safe to resume sexual activity. The most appropriate response by the nurse is "You should really talk to your doctor about that." "Continue with the sexual practice with which you are most comfortable." "You need to first undergo a cardiac stress test." "When you're able to climb two flights of stairs comfortably."
"When you're able to climb two flights of stairs comfortably." Sexual activity is reasonable if the patient can exert enough energy to ride a stationary bicycle or is able to climb two flights of stairs comfortably or walk at a comfortable pace without experiencing angina, excessive breathlessness, ECG changes signifying lack of oxygen to the heart muscle, arrhythmias, or a rise in blood pressure.
A nurse is reinforcing teaching with a client regarding reduction of risk factors for coronary artery disease. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.) "I must stop smoking." "I should limit my exercise." "I will stop consuming alcohol." "I need to monitor my weight." "I am limiting my intake of fast foods."
"I must stop smoking.", "I need to monitor my weight." & "I am limiting my intake of fast foods." "I must stop smoking." is correct. Nicotine in tobacco causes peripheral vasoconstriction, which increases blood pressure, cardiac afterload, and oxygen consumption. Alterations in blood vessels contribute to atherosclerosis and the formation of clots. Smoking cessation can decrease the risk of coronary artery disease by as much as 80%. Clients also should avoidsecondhand smoke."I should limit my exercise." is incorrect. A sedentary lifestyle or lack of exercise can lead to obesity, which is a significant contributing factor to the development of hypertension and heart disease. Less active individuals have a 30-50% increased incidence of developing hypertension. Regular physical activity helps to maintain body weight, decrease the risk of hypertension, and optimize lipid levels. Physical activity and dietary modification have been positively associated with decreasing lipid and cholesterol levels."I will stop consuming alcohol." is incorrect. The client does not have to stop consuming alcohol. Consuming less than3 oz per day can assist in decreasing the risk of coronary artery disease. However, consuming more than 3 oz per day has been associated with an increased risk of cardiac disease."I need to monitor my weight." is correct. Obesity or an increase in weight is a significant factor in developing coronary artery disease. Weight management is vital to decreasing the risk of coronary artery disease."I am limiting my intake of fast foods." is correct. Fast foods typically are prepared with high sodium and high fat, which increase the risk of atherosclerosis and coronary artery disease. An elevated cholesterol and serum lipid level predisposes a client to coronary artery disease. To promote cardiovascular health, clients should select healthier food options, such as fruits and vegetables.
A nurse is teaching the partner of a client who had an acute myocardial infarction (MI) about the reason blood was drawn from the client. Which of the following statements should the nurse make regarding cardiac enzymes studies? "These tests help determine the degree of damage to the heart tissues." "Cardiac enzymes will identify the location of the MI." "These tests will enable the provider to determine the heart structure and mobility of the heart valves." "Cardiac enzymes assist in diagnosing the presence of pulmonary congestion."
"These tests help determine the degree of damage to the heart tissues." A. "These tests help determine the degree of damage to the heart tissues."Rationale: Cardiac enzyme studies are obtained because the degree of enzyme elevation reflects the degree of damage to the myocardium. The enzymes most commonly measured are CPK and troponin. These enzymes have a characteristic rise and fall pattern after an MI. It may take 4 hr or more after the onset of manifestations for the test to become abnormal and up to 24 hr for the level to peak. Eventually, the levels in the blood fall back to normal. Consequently, serial blood tests must be taken from the client to document and evaluate enzyme levels.B. "Cardiac enzymes will identify the location of the MI."Rationale: The nurse should inform the partner and the client of the protocols and prescriptions for the client who has an MI to decrease anxiety. The nurse should include that the 12-lead electrocardiogram may be used to determine the location of the MI in the teaching.C. "These tests will enable the provider to determine the heart structure and mobility of the heart valves."Rationale: An echocardiogram is a diagnostic tool used to determine the heart structure and mobility of the heart valves. It can be used to diagnose cardiomyopathy, valvular disorders, aneurysms and left ventricular function.D. "Cardiac enzymes assist in diagnosing the presence of pulmonary congestion."Rationale: Pulmonary congestion, a complication of MI, is suspected when crackles or rales are auscultated in the chest. Should this occur, the nurse should inform the client and partner that itis diagnosed by chest x-ray.
A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin sodium (Coumadin). The client's prothrombin time (PT/INR) is 18 seconds, with a control of 11 seconds. How would the nurse interpret these results? Client needs to have test repeated Client's results are within the therapeutic range Client's results are higher than the therapeutic range Client's results are lower than the needed therapeutic level
Client's results are lower than the needed therapeutic level The PT/INR of the therapeutic range for Coumadin should be 2-3 times the controls.Therefore the control PT time is 11 seconds. The therapeutic range of PT/INR should be 22 seconds (11x2) to 33 seconds (11x3). Therefore, option D is the correct answer.
A client is receiving thrombolytic therapy with a continuous infusion of stretokinase (Streptase). The client suddenly becomes extremely anxious and complains of itching. A nurse hears stridor and on examination of the client notes generalized urticaria and hypotention. Which of the following should be the priority action of the nurse? Administer oxygen and protamine sulfate Stop the infusion and call the physician Cut the infusion rate in half and sit the client up in bed Administer diphenhydramine (Benadryl) and continue the infusion
Stop the infusion and call the physician Apparently, the patient is developing an allergic reaction to the thrombolytic drug-Streptase. "Stop the infusion and call the physician" is the first priority in this case. Protamine sulfate is the antidote for heparin. Urticaria, commonly referred to as hives, is a kind of skin rash notable for pale red, raised, itchy bumps.
The health care provider has ordered an angiotension-converting enzyme (ACE) inhibitor for the client diagnosed with congestive heart failure. which discharge instructions should the nurse include? Instruct the client to take a cough suppressant if a cough develops. Teach the client how to prevent orthostatic hypotension. Encourage the client to eat bananas to increase potassium level. Explain the importance of taking the medication with food.
Teach the client how to prevent orthostatic hypotension. B. Orthostatic hypotension may occur with ACE inhibitors as a result of vasodilation. Therefore, the nurse should instruct the client to rise slowly and sit on the side of the bed until equilibrium is restored. A. If a cough develops, the client should notify the health care provider because this is an adverse reaction and the HCP will discontinue the medication. C. ACE inhibitors may cause the client to retain potassium; therefore, the client should not increase potassium intake. D. An ACE inhibitor should e taken on an empty stomach (one hour before meals or two hours after a meal) to increase absorption of the medication. B. Orthostatic hypotension may occur with ACE inhibitors as a result of vasodilation. Therefore, the nurse should instruct the client to rise slowly and sit on the side of the bed until equilibrium is restored.
The nurse is caring for a client who has just undergone cardiac angiography. The catheter insertion site is free from bleeding or signs of hematoma. The vital signs and distal pulses remain in the normal range. The intravenous fluids were discontinued. The client is not hungry or thirsty and refuses any food or fluids, asking to be left alone to rest. Which of the following is the nurse's best response? "You are recovering well from the procedure and resting is a good idea." "You will need to do the leg exercises that you practiced before the procedure to keep good circulation to your legs. After you exercise, you can rest." "It's important for you to walk, so I will be back in 1 hour to walk with you." "It's important to drink fluids after this procedure, to protect your kidney function. I'll bring your pitcher of water, and I encourage you to drink."
"It's important to drink fluids after this procedure, to protect your kidney function. I'll bring your pitcher of water, and I encourage you to drink." Please review the pre-, during, and post- catheterization care.
A nurse is caring for an older adult client who has left-sided heart failure. Which of the following assessment findings should the nurse expect? Frothy sputum Dependent edema Nocturnal polyuria Jugular distention
A. Correct: Left-sided heart failure reduces cardiac output and raises pulmonary venous pressure.Manifestations include hacking cough, frothy sputum, wheezing, fatigue, and weakness.B. Incorrect: Right-sided failure has greater systemic effects because of increased venous pressures and congestion. Manifestations include dependent edema to the extremities and sacrum, enlarged liver and spleen, and ascites.C. Incorrect : Nocturnal polyuria indicates right-sided heart failure.D. Incorrect: Jugular distention indicates right-sided heart failure. The client might be hypertensive due to excessive fluid volume.
A nurse is providing discharge instructions for a client who has congestive heart failure. Which of the following client statements indicates to the nurse that the teaching was effective? I will read food labels and limit my sodium to 4 grams per day." "I should use naproxen to manage discomfort." "I plan to slow down if I am tired the day after exercising." "I will take my diuretic before sleep and drink fluids during the day."
"I plan to slow down if I am tired the day after exercising." A. Incorrect: Although it is especially important for clients who have heart failure to read the labels of fooditems in order to avoid large amounts of sodium, the nurse should instruct the client toconsume no more than 2 g of sodium per day. Excessive sodium intake increases fluidretention and the workload on the heart.B.Incorrect: A client who has heart failure should avoid the use of NSAIDs as these medications can causesodium retention. The nurse should recommend the use of acetaminophen for the treatment ofdiscomfort.C. Correct: Clients who experience chest pain or dyspnea while exercising or experience fatigue the next day are probably advancing the activity too quickly and should slow down.D. Incorrect: Diuretics are used in the treatment of heart failure to remove excess extracellular fluid from the body. Clients should be advised to take diuretics in the morning to avoid waking during the night for voiding. If the client is prescribed fluid restrictions, the nurse should assist him in planning fluid intake during the day.
The nurse is caring for a client diagnosed with a myocardial infarction who is experiencing chest pain. Which interventions should the nurse implement? Select all that apply. Administer morphine intramuscularly. Administer an aspirin orally. Apply oxygen via a nasal cannula. Place the client in a supine position. Administer nitroglycerin subcutaneously.
Administer an aspirin orally and Apply oxygen via a nasal cannula B. Aspirin is an antiplateletsmedication and should be administered orally. C. Oxygen will help decrease myocardial ischemia, thereby decreasing pain. A. Morphine should be administered intravenously, not intramuscularly. D. The supine position will increase respiratory effort, which will increase myocardial oxygen consumption; the client should be in the high-Fowler's or upright position. E. Nitroglycerin, a coronary vasodilator, is administered sublingually or introvenously, not subcutaneously. B. Aspirin is an antiplatelets medication and should be administered orally. C. Oxygen will help decrease myocardial ischem ia, thereby decreasing pain.
A nurse is caring for a client who has heart failure and a potassium level of 2.4 mEq/L. The nurse should identifywhich of the following medications as the cause of the client's low potassium level? Furosemide Nitroglycerin Metoprolol Spironolactone
Furosemide A. Correct: Furosemide is a loop (high-ceiling) diuretic that inhibits the reabsorption of sodium and chloride and results in diuresis, which decreases potassium through excretion in the distal nephrons. Hypokalemia is an adverse effect of furosemide. B. Incorrect: A potassium level of 2.4 mEq/L is not an adverse effect of nitroglycerin. Nitroglycerin is a vasodilator medication to treat angina.C. Incorrect: A potassium level of 2.4 mEq/L is not an adverse effect of metoprolol. Metoprolol is abeta-blocker that slows the heart rate and improves contractility of the heart muscle.D. Incorrect: Spironolactone is a potassium-sparing diuretic medication; therefore, hyperkalemia is an adverse effect of this medication.
