Exam 2 Med Surg

A client with angina is beginning nitroglycerin usage. The nurse has educated the client on common side effects. Which statement by the client indicates understanding? "I should expect to feel tingling in my hands and feet." " A headache and/or dizziness is common." " I will experience blurred or double vision." "Ringing in the ears is expected."

" A headache and/or dizziness is common." Headache and dizziness commonly occur when nitroglycerin is taking at the beginning of therapy. However, the client usually develops a tolerance. Nervousness, paresthesia, drowsiness, blurred vision, tinnitus, and diplopia don't occur as a result of nitroglycerin therapy.

The nurse has just admitted a client for cardiac surgery. The client tells the nurse that she is afraid of dying while undergoing the surgery. Select the best response from the nurse: "Can you tell me more about why you are afraid?" " I will call your spouse/partner to come to discuss your concerns further." "Don't worry, fear is normal before major surgery." "Everything will be okay, your surgeon is very skilled."

"Can you tell me more about why you are afraid?" An assessment of anxiety levels is required in the client to assist in identifying fears and developing coping mechanisms for those fears. The nurse should never give false hope, tell the client they Will be fine, or tell them not to worry when they express fear and anxiety.

You are working in the emergency department and caring for a middle-aged female client with sudden onset of dyspnea. The woman is obese but claims an unremarkable health history and denies chest pain. Which statement would be the most appropriate for you to ask next? Did you eat a large lunch today?" " Are you feeling anxious?" "Do you have any discomfort around your shoulder blade?" "Have you had any recent cold symptoms?"

"Do you have any discomfort around your shoulder blade?" Women often present with symptoms different from those seen in men during a MI, with vague complaints such as fatigue, shoulder blade discomfort, abdominal pain, and/or shortness of breath. The next question should further evaluate the potential for MI- which is a potentially life-threatening condition.

A nurse who works in a busy emergency department provides care for numerous clients who present with complaints of chest pain. Which of the following question is most likely to help the nurse differentiate between chest pain that is attributed to angina and chest pain that is due to myocardial infarction (MI)? "Does resting and remaining still help your chest pain to decrease?" "Have you ever been diagnosed with high blood pressure or diabetes?" "When was the first time that you recall having chest pain?" "Does your chest pain make it difficult to move around like you normally would?

"Does resting and remaining still help your chest pain to decrease?" In most cases, chest pain due to MI is not relieved by rest. Chest pain from angina usually abates with rest. Questions about risk factors and original onset of the client's pain do not help differentiate the etiology of the client's chest pain.

The nurse is caring for a client who is being discharged after valve replacement surgery. The client has a new mechanical valve, and the nurse is reviewing the instructions for the client's follow-up care. The nurse determines the client understands an important aspect of responsibility in the care of this valve when the client makes which of the following statements. I will need to take anticoagulant medication for the rest of my life." "I won't take any anticoagulant medication or blood thinners because they could cause a problem with my new valve." "I will remind the doctor to give me a prescription for anticoagulant medication every time I go to the dentist." "I will take warfarin sodium for two months, and get my blood drawn every week until I stop taking it."

"I will need to take anticoagulant medication for the rest of my life." Mechanical valves require anticoagulant medications because of the risk of thrombus formation. If a valve is replaced with tissue, anticoagulant therapy may be required during the immediate postoperative period but not lifelong. It is recommended to take antibiotics prior to dental care.

The home care nurse is caring for a client with cardiomyopathy whose symptoms have worsened over the last year. On the first visit, the client reports extreme fatigue and dyspnea with any activity and is irritable and withdrawn. What is the best response by the nurse? "Let's see what we can do to increase your energy/" "It must be difficult to experience these changes." "Sometimes these symptoms improve with time." "Have you tried resting frequently?"

"It must be difficult to experience these changes." Prognosis is often poor with advanced cardiomyopathy, and little can be done to increase the client's activity level. The symptoms usually become worse as the disease progresses. Irritability and withdrawal can be signs of feelings of inadequacy or despair. Validating the difficulty of the client's experience is an intervention to create an environment of acceptance and empathy.

A client who is recovering from coronary artery bypass graft (CABG) is anxious about resuming normal levels of activity and mobility, citing fear of putting undue strain on his heart, as well as being able to safely mobilize. Consequently, the client has expressed his intention to remain on bed rest for several days. How should the nurses respond to this client's concerns about activity and mobility? "There are actually a lot of benefits of moving early and often. When mobilizing we will be with you to keep you safe." "Actually, your plan of care already includes several days of bed rest to make sure that your heart is fully recovered." "It would be ideal if you could do some light mobilizing soon, but you can let us know when you would like to begin this." "You'll have to get permission from your cardiologist if you want to stay in bed for longer than normal."

"There are actually a lot of benefits of moving early and often. When mobilizing we will be with you to keep you safe."

You have just received the report on the medical-surgical unit. Which client should you see first? A 47-year-old with a B-type natriuretic peptide (BNP) of 800 pg/mL A 72-year-old client one-day postoperative surgery A 30-year-old client with a hematocrit of 28.4mg/dL A 90-year-old client with muscle weakness and pneumonia.

A 47-year-old with a B-type natriuretic peptide (BNP) of 800 pg/mL Any client with a BNP of 800pg.ml is in CHF, and should be assessed first for respiratory and cardiac complications. A 90-year-old with weakness and pneumonia does not take priority over the client with the elevated BNP. The hematocrit in the 30 year old is low but not life-threatening. The 72 year old post op is at risk for post-op complications, this client can wait until the client with CHF is assessed.

The nurse has finished reviewing the shift report on a cardiac unit. The nurse should plan to see which client first? A client with hypertropic cardiomyopathy who is reporting dyspnea A client who had a cardiac catheterization and will be ambulating for the first time A client taking antibiotics for endocarditis who has sudden anxiety and dyspnea A client who is recovering from coronary artery bypass grafting (CABG) surgery with a temperature of 101 F (38.3 C)

A client taking antibiotics for endocarditis who has sudden anxiety and dyspnea

The nurse is evaluating the condition of a client after a pericardiocentisis performed to treat cardiac tamponade. Which observation would indicate that the procedure was effective? Muffled heart sounds A rise in blood pressure Jugular vein distention Client expresses dyspnea

A rise in blood pressure Following a pericardiocentesis the client usually expresses immediate relief. Heart sounds are no longer muffled or distant and blood pressure increases, Distended neck veins are a sign of increased venous pressure, which occurs with cardiac tamonade.

A nurse has been providing care for an older adult client who has a number of comorbid medical conditions. The nurse has been performing frequent assessments throughout the morning due to the client's pallor, decreased level of consciousness, and unstable vital signs. During the nurse's most recent assessment, the client has lost consciousness and the carotid pulse is not palpable. What is the nurse's priority action? Applying oxygen by face mask Performing a rapid head-to-toe assessment Initiating cardiopulmonary resuscitation Activating the hospital's code syste

Activating the hospital's code system Once LOC has been established , the resuscitation priority for the adult in most cases is placing a phone call to activate the code team or emergency medicat system (EMS). This should precede the initiation of CPR. Supplemental oxygen and further assessment are appropriate but these would not be prioritzed over calling a code.

The client who had a synthetic valve replacement a year ago is hospitalized with unstable angina. IV heparin and nitroglycerine infusions were started, but then nitroglycerin was discontinued after the client's pain resolved The HCP prescribes to start oral warfarin 5 mg at 1900 hours. Which is the nurse's best action? Administer the warfarin as prescribed Call the HCP to question starting warfarin Discontinue heparin and then give the warfarin Hold warfarin until heparin is discontinued

Administer the warfarin as prescribed Both heparin and warfarin are anticoagulants, but their actions are different. Oral warfarin requires 3-5 days to reach effective levels. It is usually while the client is still on heparin. Warfarin should be given as prescribed.

The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea, tachycardia, and lung crackles and the nurse suspects pulmonary edema. The nurse immediately asks another nurse to contact the health care provider and prepares to implement with priority interventions? select all that apply. Administering oxygen Inserting a foley catheter Administering furosemide Administering morphine sulfate intravenously Placing the client in a low Fowler's side-lying position

Administering oxygen Administering furosemide Administering morphine sulfate intravenously

A client with a history of rheumatic heart disease knows that she is at risk for bacterial endocarditis when undergoing invasive procedures. Prior to a scheduled cystoscopy, the nurse should ensure that the client knows the importance of taking which of the following drugs? Enoxaparin Metoprolol Azathioprine Amoxicillin

Amoxicillin Although rare, bacterial endocarditis may be life threatening. A key strategy is primary prevention in high-risk clients (i.e., those with rheumatic heart disease, mitral valve prolapse, or prosthetic heart valves). Antibiotic prophylaxis is recommended for high-risk clients immediately before and sometimes after certain procedures. Amoxicillin is the drug of choice. None of the other listed drugs is an antibiotic.

A client has returned to the nursing unit after having a percutaneous coronary intervention (PCI) in the hospital's cardiac characterization laboratory. The nurse who is providing care for this client should prioritize what assessment? Assessing the client's capillary refill time and skin integrity Assessing the client for signs and symptoms of hemorrhage Assessing the client for signs and symptoms of acute renal failure Assessing the client for signs and symptoms of infection

Assessing the client for signs and symptoms of hemorrhage Monitoring the client for bleeding post PCI is a priority. Kidney function, peripheral circulation, and infection are also valid assessment parameters but the significant risk of bleeding associated with PCI necessitates that assessments related to this problem be prioritized.

The nurse is participating in the care conference for a client with Acute Coronary Syndrome. What goal should guide the care team's selection of assessments, interventions, and treatments? Maximizing cardiac output while minimizing heart rate Decreasing energy expenditure of the myocardium Balancing myocardial oxygen supply with demand Increasing the size of the myocardial muscle

Balancing myocardial oxygen supply with demand Balancing myocardial oxygen supply with demand (e.g., as evidenced by the relief of chest pain) is the top priority in the care of the client with ACS. Treatment is not aimed directly at minimizing heart rate because some clients experience bradycardia. Increasing the size of the myocardium is never a goal. Reducing the myocardium's energy expenditure is often beneficial, but this must be balanced with productivity.

A client with a myocardial infarction suddenly becomes tachycardia shows signs of air hunger and begins coughing frothy pink-tinged sputum. Which finding would the nurse anticipate when auscultating the client's breath sounds? Stridor Crackles Scattered ronchi Diminished breath sounds

Crackles Pulmonary edema is characterized by extreme breathlessness, dyspnea, air hunger, and the production of frothy, pink-tinged sputum. Auscultation of the lungs reveals crackles. Ronchi and diminished breath sounds are not associated with pulmonary edema. Stridor is the crowing sound associated with laryngospasm or edema of the upper airway.

The nurse has completed a head-to-toe assessment of a client who was admitted for treatment of heart failure. Which of the following assessment findings should signal to the nurse a possible exacerbation of the client's condition? Crackles are audible on chest auscultation. The client's blood pressure is 144/99. The client has put out 600 mL of dilute urine over the past 8 hours. Blood glucose testing reveals a glucose level of 158 mg/dL.

Crackles are audible on chest auscultation. Clients with HF often exhibit crackles, which are produced by the sudden opening of edemotous small airways and alveoli that have been adhered together by exudate. Theses may be heard at the end of inspiration and are not cleared with coughing. A widening pulse pressure, increased BP, and production of dilute urine are not charactoristic of HF. Changes in blood glucose levels are not normally symptomatic of HF.

The nurse is assessing the client with an anterior-lateral MI. The nurse should add decreased cardiac output to the client's plan of care when which finding is noted? Pain radiates up left arm to neck Presence of an S4 heart sound Crackles auscultated in both lung bases. Vesicular breath sounds over lung lobes

Crackles auscultated in both lung bases.

The nurse working on the coronary care unit is caring for a client with ACS. How can the nurse best meet the client's psychosocial needs? Reinforce the fact that treatment will be successful Facilitate a referral to a chaplain or spiritual leader Increase the client's participation in rehabilitation activities Directly address the client's anxieties and fears

Directly address the client's anxieties and fears Alleviating anxiety and decreasing fear are important nursing functions that reduce the sympathetic stress response. Referrals to spiritual care may or may not be appropriate, and this does not relieve the nurse of responsibility for addressing the client's psychosocial needs. Treatment is not always successful, and false hope should never be fostered. Participation in rehabilitation may alleviate anxiety for some clients, but it may exacerbate it for others.

A client has been experiencing progressive dyspnea and activity intolerance in recent months and is currently undergoing a diagnostic workup for heart failure (HF). During echocardiography, systolic HF could be differentiated from diastolic HF by appraising the client's: Sinus rhythm Ejection fraction (EF) Stroke volume Left ventricular wall thickness

Ejection An assessment of the EF is performed to assist in determining the type of HF. EF , an indication of the volume of blood ejected with each contraction, is calculated by subtracting the amount of blood at the end of systole from the amount at the end of diastole and calculating the pecentage of blood that is ejected. The type of HF that a client is experiencing cannot be determined solely by assessing heart rate or wall thickness, Stroke volume is a component of ejection fraction

A client has been admitted to the emergency department with reports of chest pain for the past 2 hours. There are no clear changes on the ECG. The nurse should expect which laboratory tests to be more specific indicators of a myocardial infarction(MI)? Select all that apply. Elevated potassium level Decreased myoglobin level Elevated creatinine kinase level Decreased white blood count Elevated troponin level

Elevated creatinine kinase level Elevated troponin level

The client has just returned to the floor after balloon valvuloplasty of the aortic valve and the nurse is planning appropriate assessments. The nurse should assess for indications of what potential complications? Select all that apply. Emboli Mitral valve damage Ventricular dysrhythmia Atrial-septal defect Plaque formation

Emboli Mitral valve damage Ventricular dysrhythmia

The nurse is caring for a client diagnosed with infective endocarditis. The client has a history of intravenous (IV) illicit drug use. Physical exam is likely to reveal which of the following? select all that apply. Fever Murmur Pericardial friction rub Splinter hemorrhages Petechiae

Fever Murmur Splinter hemorrhages Petechiae Common signs and symptoms of endocarditis include fever, malaise, new or changed murmur, weight loss, splinter hemorrhages, petechiae . Janeway lesions and Osler's nodes. Pericardial rub is associated with pericarditis.

A client who has recently recovered from a systemic viral infection is undergoing diagnostic testing for myocarditis. Which of the nurse's assessment findings is most consistent with myocarditis? Sudden changes in level of consciousness (LOC) Peripheral edema and pulmonary edema Pleuritic chest pain Flulike symptoms

Flulike symptoms

The nurse is watching the telemetry monitor at the nurse's station and notices a client enter into asystole. What is the nurse's priority action? Call code per hospital policy Notify the provider Go to the client's room to check the client Ask the LPN or UA to go check on the client

Go to the client's room to check the client The asystole reading on the monitor could be the removal of leads from the client. Without seeing the client, calling the provider or a code would be preemptive. It is not appropriate to delegate to an LPN or UA the duty of assessing a client, it is not within their scope of practice to assess. First priority action is to check on the client.

A nurse is planning and providing the nursing care of a client with heart failure (HF). What will be the overall nursing goals of management for this client? Select all that apply. Improve functional status Increase cardiac contractility Extend survival Decrease pulmonary venous pressure Relieve the client's symptoms

Improve functional status Extend survival Relieve the client's symptoms Overall nursing goals of management for HF are to relieve client symptoms, improve functional status and quality of life, and extend survival. The goals of nursing management of the client with HF do not include increasing cardiac contractility or decreasing pulmonary venous pressure.

The nurse is assessing a client who has splinter hemorrhages of the nail beds and reports a fever. The nurse should identify these findings as manifestations of which of the following disorders? Pericarditis Infective endocarditis Myocarditis Rheumatic endocarditis

Infective endocarditis findings associated with infectious endocarditis include splinter hemorrhages and fevern

The triage nurse in the emergency department assesses a 71-year-old male client who has presented with complaints of mid-sternal chest pain that has lasted for 5 hours. The care team suspects myocardial infarction (MI). The nurse is aware that, because of the length of time the client has been experiencing symptoms, the following may have happened to the myocardium. May have developed an increased area of infarction. Will probably not have more damage than if he came in immediately. Can have restoration of the area of dead cells with proper treatment. Has been damaged already, so immediate treatment is no longer necessary.

May have developed an increased area of infarction. When client experiences lack of oxygen to the myocardium cells during an MI, the sooner treatment is initiated the more likely the treatment will prevent or minimize myocardial tissue necrosis. Despite the length of time the symptoms have been present, treatment needs to be initiated immediately to minimize further damage.

An older adult client has been admitted to a medical unit, and the nurse is conducting a comprehensive assessment of the client in order to plan care appropriately. Which of the nurse's following assessments directly relate to the known risk factors for cardiovascular disease? Select all that apply. Measuring the client's random glucose level. Assessing the client's oxygen saturation levels by pulse oximetry. Measuring the client's blood pressure. Auscultating the client's lungs Measuring the client's temperature orally

Measuring the client's blood pressure. Measuring the client's random glucose level.

A client is admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is scheduled for cardiac catheterization Which medication would need to be withheld for 24 hours before the procedure and for 48 hours after the procedure? Glipizide Metformin Repaglinide Regular insulin

Metformin Metformin needs to be withheld 24 hours before and 48 hours after cardiac catheterization because of the injection of contrast medium during the procedure. If the contract medium affects kidney function, with metformin in the system the client would be at increased risk for lactic acidosis. The medication in the remaining options do not need to be withheld 24 hours before and 48 hours after cardiac catheterization.

The nurse is monitoring a client with acute pericarditis for signs of cardiac tamponade. Which assessment finding indicates the presence of this complication? Flat neck veins A pulse of 60 bpm Muffled or distant heart sounds Wheezing on auscultation of the lungs

Muffled or distant heart sounds Assessment findings assoicated with cardiac tamponade include: tachycardia, distant or muffled heart sounds, jugular vein distention with clear lung sounds, and a falling blood pressure accompanied by pulsus paradoxus (a drop in inspiratory BP greater than 10 mmHg. Brady cardia is not a sign of tamponade.

During a head-to-toe assessment of a client awaiting surgical valve replacement, the nurse notices fever, worsening heart murmur, Petechiae on the trunk, splinter hemorrhages, and Janeway lesions on both palms. What is the nurse's priority action? Administer oxygen via nasal cannula at 4 liters per minute Notify physician Call the rapid response team to assist per hospital policy Document the findings of the assessment within one hour of discover

Notify physician This client is showing signs of endocarditis, and is at risk due to valve dysfunction. The nurse must notify the provider ASAP, to allow for early intervention. Oxygen will not help inflammation/infection of the endocardium. The rapid response team is not necessary as this is not a rapidly deteriorating condition such as respiratory failure. Documentation is important, but not until the provider is notified.

The nurse is caring for a client with a history of endocarditis. What topic should the nurse prioritize during health promotion education? Oral hygiene Physical activity Dietary guidelines Fluid intake

Oral hygiene For clients with endocarditis, regular professional oral care combined with personal oral care may reduce the risk of bacteremia. In most cases, diet and fluid intake do not need to be altered. Physical activity has broad benefits, but it does not directly prevent complications of endocarditis.

A client, 10 days post-op abdominal surgery, is admitted to emergency after developing unrelieved chest pain that was present for approximately 20 minutes before presenting to the emergency department. The client has been subsequently diagnosed with myocardial infarction (MI). The health care provider has submitted new orders. Which intervention should the nurse prioritize? Morphine sulfate Oxygen Lung sounds Establish IV

Oxygen

The client is admitted with acute coronary syndrome. Which should be the nurse's priority assessment? Pain Blood pressure Heart rate Respiratory rate

Pain

The EMS team has just brought to the ED a client with suspected pulmonary edema.As the primary nurse receiving the client which manifestations would you anticipate? Select all that apply. bradyypnea Persistent cough Increased urinary output pink frothy sputum Orthopnea

Persistent cough pink frothy sputum Orthopnea

A client is being treated for the new-onest of heart failure with a sodium-controlled diet, digoxin, and furosemide. The ECG monitor shows me U wave. Based on this new finding, the nurse determines that it is important to check which laboratory test result? Calcium Sodium Potassium Magnesium

Potassium

A client presents to the ED in distress and complains of crushing chest pain. What is the nurse's priority for assessment? Prompt initiation of an ECG Auscultation of the client's point of maximal impulse (PMI) Rapid assessment of the client's peripheral pulses Palpation of the client's cardiac apex

Prompt initiation of an ECG The 12-lead ECG provides information that assists in ruling out or diagnosing an acute MI. It should be obtained within 10 minutes from the time a client reports pain or arrives in the ED. Each of the other listed assessments is valid, but ECG monitoring is the most time-dependent priority.

A client has been admitted to the medical unit because of an acute exacerbation of heart failure. Over the past hour, the client has become increasingly restless, tachypneic, and short of breath, and pulse oximetry reveals SaO2 of 78%. Which of the following is the priority intervention? Providing reassurance to calm the client and slow the client's respiratory rate Protecting the client's airway and taking measures to promote gas exchange Monitoring the client's cardiac function Obtaining a complete set of vital signs

Protecting the client's airway and taking measures to promote gas exchange Protecting the client's airway and breathing is always the priority over further assessment and providing reassurance to the client. ABC's

The nurse plans teaching for a 20-year-old newly diagnosed with hypertrophic cardiomyopathy. The client is on the college soccer team. Which information should be the nurse's priority when teaching the client? Provide pamphlets on genetic testing to avoid passing on an inherited disease. Reinforce the need to continue exercise with soccer to strengthen the heart Provide information about CPR to persons living with the client. Counsel on foods for consuming on a low-fat,low-cholesterol diet.

Provide information about CPR to persons living with the client. Because sudden death is a large risk factor for those under 30 years of age, the nurse should provide information about having others living with the client trained in CPR as a preventative measure.

A client's electrocardiogram (ECG )and presentation are suggestive of a myocardial infarction (MI), and treatment has been promptly initiated. The nurse who is part of the client's care team should anticipate and facilitate which of the following interventions? Providing the client with supplemental oxygen Administering morphing by IV Administering oral warfarin Administering nitroglycerin Administering a bolus of 0.9% NaCl

Providing the client with supplemental oxygen Administering morphing by IV Administering nitroglycerin The primary treatments for acute MI involve (MONA) morphine, oxygen, nitrates, and aspirin. A bolus of normal saline and warfarin are not typical treatments.

A 58-year-old client's electrocardiogram (ECG) and presentation are suggestive of myocardial infarction (MI), and treatment has been promptly initiated. The nurse who is part of the client's care team should anticipate and facilitate which of the following interventions? Providing the client with supplementary oxygen Administering morphine by IV Administering oral warfarin Administering a bolus of 0.9% NaCl Teaching the client deep breathing and coughing techniques

Providing the client with supplementary oxygen Administering morphine by IV Providing the client with supplementary oxygen

A client in the PACU was just extubated, 5 hours after the conclusion of a coronary artery bypass graft (CABG). How can the nurse best promote adequate gas exchange for this client Apply continuous positive airway pressure (CPAP) as prescribed. Perform deep suctioning q 1 h. Reposition the client frequently. Administer nebulized bronchodilators and corticosteroids as prescribed.

Reposition the client frequently. When the client's condition stabilizes and they have been extubated, body position is changed every 1-2 hours. Frequent changes of client position provide for optimal pulmonary ventilation and perfusion by allowing the lungs to expand more fully. Suctioning carries the risk of trauma and should be avoided unless necessary. CPAP, bronchodilators, and corticosteroids are not normally used post-operatively.

A client has undergone a successful heart transplant and has been discharged home with a medication regimen that includes cyclosporine and tacrolimus. In light of this client's medication regimen, what nursing diagnosis should be prioritized? Risk for injury Risk for infection Risk for peripheral neurovascular dysfunction Risk for unstable blood glucose

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. These drugs do not create a heightened risk of injury, neurovascular dysfunction, or unstable blood glucose levels.

The client with a history of left anterior descending (LAD) 90% blockage has crushing chest pain that is unrelieved by taking sublingual nitroglycerin. Which ECG finding is MOST concerning and should alert the nurse to immediately notify the provider? Q waves Flipped T waves Peaked T waves ST-segment elevation

ST-segment elevation Q wave= MI over 24 hours old Flipped T= myocardial ischemia Peaked T= may indicate hyperkalemia (are concerning but elevate ST is highest )

You are caring for a client with a history of angina and is currently being treated for possible myocardial infarction (MI). Which of the following will help the nurse distinguish between stable angina and MI? Stable angina can be relieved with rest and nitroglycerin The pain of the MI resolves in less than 15 minutes The type of activity that causes an MI can be identified. Stable angina can occur for longer than 30 minutes

Stable angina can be relieved with rest and nitroglycerin Stable angina can be relieved with rest and nitroglycerin Pain with MI usually lasts longer than 30min and requires stronger pain interventions such as opioids There is no specific type of activity that causes MI, it can occur even at rest The pain with stable angina usually occurs for 15 minutes or less

A 67 year old male client with a high body mass index, and a history of hypertension made an appointment with his primary provider because of sudden, severe, and unprecedented fatigue over the past several days. The provider referred the client to the emergency department, where the client underwent assessment for acute coronary syndrome. Assessment of the man's cardiac biomarkers revealed normal levels of myoglobin and CK-MB but elevated levels of troponin I. What conclusion is suggested by these data results? The man is having an acute myocardial infarction (MI) The man is at high risk of MI The man had an MI in the recent past The man had an MI several months ago

The man had an MI in the recent past

A client returned to the cardiac care unit after undergoing cardioversion. When prioritizing care for this client during the immediate recovery period, the nurse should prioritize assessment related to: Thromboembolisms Acute renal failure Visual and auditory disturbances Infectious cardiac disorders

Thromboembolisms When the heart returns to a normal sinus rhythm after cardioversion, the atria beat forcefully. If a clot has formed in the atria, systemic emboli may resulty, thus anticoagulant is needed if the arrhythmia has lasted over 48 hours. The nurse is alert for systemic signs of embolization such as sudden onset S.O.B, with pulmonary emboi or neurological changes.Sensory changes, renal failure, and infection are unlikely complications of cardioversion.

Thrombolytic therapy is being prepared for administration to an older client who has presented to the emergency department with an ST-segment elevation MI (STEMI). The nurse recognizes that the primary goal of this intervention is: To restore the flow of blood through the coronary arteries. To restore function to infarcted myocardial cells. To relieve the client's symptoms of chest pain and dyspnea To prevent rupture of atheromas.

To restore the flow of blood through the coronary arteries. The purpose of thrombolytics is to dissolve and lyse the thrombus in the coronary artery (thrombolysis), allowing blood to flow through the coronary artery again (reperfusion), minimizing the size of the infarction, and preserving ventricular function. Thrombolytics are not primary pain-control measure, and function can not be restored to infarcted cardiac cells.

The nurse is teaching the client newly diagnosed with chronic stable angina. Which instructions on measures to prevent future angina should the nurse incorporate? Select all that apply. Increase isometric arm exercises to build endurance. Wear a face mask when outdoors in cold weather. Take nitroglycerin before a stressful event even if pain free Perform most exertional exercises in the morning. Discontinue use of all tobacco products if you use those

Wear a face mask when outdoors in cold weather. Take nitroglycerin before a stressful event even if pain free Discontinue use of all tobacco products if you use those. 2- blood vessels constrict in response to cold and increase the workload of the heart 3- Nitroglycerin produces vasodilation and improves blood flow to the coronary arteries and should be taken before exertional or stressful activities 5- Nicotine stimulates catecholamine release, producing vasoconstriction and an increased HR - should be stopped.

The nurse is providing discharge teaching to a client diagnosed with heart failure. Which statement by the client demonstrates understanding regarding the monitoring of fluid balance? "I will___________ take and record my blood pressure at the same time every day." check my pulses on both my wrists each day." take and record my weight every morning s soon as I wake up." monitor my bowel movements to avoid constipation.

take and record my weight every morning s soon as I wake up." Daily weights at the same time every day can be a good indicator of fluid balance. Assessing radial pulses and monitoring the blood pressure may be done but they do not provide information about fluid balance.