Management of Patients with Complications of Heart Disease (Chapter 29)

The nurse is gathering data from a client recently admitted to the hospital. The nurse asks the client about experiencing orthopnea. What question would the nurse ask to obtain this information?

"Are you only able to breathe when you are sitting upright?"

A total artificial heart (TAH) is an electrically powered pump that circulates blood into the pulmonary artery and the aorta, thus replacing the functions of both the right and left ventricles. What makes it different from an LVAD

An LVAD only supports a failing left ventricle

Which New York Heart Association classification of heart failure has a poor prognosis and includes symptoms of cardiac insufficiency at rest?

IV

A nurse is assessing a client with congestive heart failure for jugular vein distension (JVD). Which observation is important to report to the physician?

JVD is noted 4 cm above the sternal angle

The nurse identifies which symptom as a characteristic of right-sided heart failure?

Jugular vein distention (JVD)

A patient has been experiencing increasing shortness of breath and fatigue. The physician has ordered a diagnostic test in order to determine what type of heart failure the patient is having. What diagnostic test does the nurse anticipate being ordered?

an echocardiogram

A client is returning from the operating room after inguinal hernia repair. The nurse notes that he has fluid volume excess from the operation and is at risk for left-sided heart failure. Which sign or symptom indicates left-sided heart failure?

bibasilar crackles

Which is a key diagnostic indicator of heart failure?

brain natriuretic peptide (BNP)

The nursing instructor is teaching their clinical group how to assess a client for congestive heart failure. How would the instructor teach the students to assess a client with congestive heart failure for nocturnal dyspnea?

by questioning how many pillows the client normally uses for sleep

A client has been prescribed furosemide (Lasix) 80 mg twice daily. The cardiac monitor technician informs the nurse that the client has started having rare premature ventricular contractions followed by runs of bigeminy lasting 2 minutes. During the assessment, the nurse determines that the client is asymptomatic and has stable vital signs. Which of the following actions should the nurse perform next?

check the client's potassium level

The nurse identifies which symptom as a manifestation of right-sided heart failure (HF)?

congestion in the peripheral tissues

A patient is undergoing a pericardiocentesis. Following withdrawal of pericardial fluid, which of the following indicates that cardiac tamponade has been relieved?

decrease in central venous pressure (CVP)

Which of the following body system responses correlates with systolic heart failure (HF)?

decrease in renal perfusion

A nurse is caring for a client with left-sided heart failure. To reduce fluid volume excess, the nurse should anticipate using:

diuretics

The nurse assessing a client with an exacerbation of heart failure identifies which symptom as a cerebrovascular manifestation of heart failure (HF)?

dizziness

The nurse is obtaining data on an older adult client. What finding may indicate to the nurse the early symptom of heart failure?

dyspnea on exertion

A client has been having cardiac symptoms for several months and is seeing a cardiologist for diagnostics to determine the cause. How will the client's ejection fraction be measured?

echocardiogram

The diagnosis of heart failure is usually confirmed by which of the following?

echocardiogram

The nursing instructor is discussing heart failure with their clinical group. The instructor talks about heart failure in terms of a decreasing ejection fraction of the heart. What diagnostic test is used to measure the ejection fraction of the heart?

echocardiogram

Which diagnostic study is usually performed to confirm the diagnosis of heart failure?

echocardiogram

A patient with acute pericarditis is exhibiting distended jugular veins, tachycardia, tachypnea, bradycardia, and muffled heart sounds. The senior nursing student recognizes these symptoms occur when

excess pericardial fluid compresses the heart and prevents adequate diastolic filling

A client with congestive heart failure is admitted to the hospital after reporting shortness of breath. How should the nurse position the client in order to decrease preload?

head of the bed elevated to 45 degrees and lower arms supported by pillows

The nurse is preparing to administer hydralazine and isosorbide dinitrate (Dilatrate). When obtaining vital signs, the nurse notes that the blood pressure is 90/60. What is the priority action by the nurse?

hold the medication and call the physician

A nurse reviews the patient's chart. The doctor noted in the progress notes that he suspected the patient was experiencing decreased left ventricular function. The nurse knows to look for documentation of all of the following to validate that diagnosis except:

increased stroke volume

What mechanical device increases coronary perfusion and cardiac output and decreases myocardial workload and oxygen consumption in a client with cardiogenic shock?

intra-aortic balloon pump

A client in the hospital informs the nurse he "feels like his heart is racing and can't catch his breath." What does the nurse understand occurs as a result of a tachydysrhythmia?

it reduces ventricular ejection volume

A new client has been admitted with right-sided heart failure. The nurse knows to look for which of the following assessment findings when assessing this client?

jugular venous distention

The clinical manifestations of cardiogenic shock reflect the pathophysiology of heart failure (HF). By applying this correlation, the nurse notes that the degree of shock is proportional to which of the following?

left ventricular function

In a client with chronic bronchitis, which sign would lead the nurse to suspect right-sided heart failure?

leg edema

Which feature is the hallmark of systolic heart failure?

low ejection fraction (EF)

A client has been rushed to the ED with pulmonary edema and is going to need oxygen immediately. Which oxygen delivery system should be used first?

mask

The nurse is working in a long-term care facility with a group of older adults with cardiac disorders. Why would it be important for the nurse to closely monitor an older adult receiving digitalis preparations for cardiac disorders?

older adults are at increased risk for toxicity

The client with cardiac failure is taught to report which symptom to the physician or clinic immediately?

persistent cough

The nurse is preparing to administer furosemide to a client with severe heart failure. What lab study should be of most concern for this client while taking furosemide?

potassium level of 3.1

A client is admitted to the hospital with systolic left-sided heart failure. The nurse knows to look for which of the following assessment findings for this client?

pulmonary congestion

Which of the following would be inconsistent as a lifestyle change directive for the patient diagnosed with heart failure?

push fluids

A patient has been diagnosed with systolic heart failure. The nurse would expect the patient's ejection fraction to be at which level?

severely reduced (EF is normal in diastolic failure but reduced in systolic failure)

Which is a potassium-sparing diuretic used in the treatment of heart failure (HF)?

spironolactone

A nurse is administering lanoxin, which she knows increases contractility as well as cardiac output. Contractility refers to which of the following?

the force of the contraction related to the status of the myocardium

A nurse suspects that a client has digoxin toxicity. The nurse should assess fo

vision changes

Which nursing intervention should the nurse perform when a client with valvular disorder of the heart has a heart rate less than 60 beats/min before administering beta-blockers?

withhold the drug and inform the primary health care provider