S4 Unit 2 questions 4

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The process that causes a heart cell to contract is known as?A. RepolarizationB. PolarizationC. Depolarization

depolarization

QRS interval in NSR (normal)

less than 12 seconds

PR interval in NSR (normal)

less than 20 seconds 0.12-0.2

True or False: If a patient has been in atrial fibrillation for more than 48 hours, anticoagulation is needed prior to a cardioversion due to blood clot risks.

true

True or False: Treatment for unstable atrial flutter is synchronized cardioversion.

true

what does A nonsustained episode of ventricular tachycardia while administering thrombolytic agents with a AMI indicate

ventricular tachycardia is a common reperfusion dysrhythmia and may indicate that the therapy is effective

The nurse is evaluating the effectiveness of preoperative teaching with a patient scheduled for coronary artery bypass graft (CABG) surgery using the internal mammary artery. Which patient statement indicates that additional teaching is needed? "They will circulate my blood with a machine during surgery." "I will have incisions in my leg where they will remove the vein." "They will use an artery near my heart to go around the area that is blocked." "I will need to take aspirin every day after the surgery to keep the graft open."

"I will have incisions in my leg where they will remove the vein."

In preparation for discharge, the nurse teaches a patient with chronic stable angina how to use the prescribed short-acting and long-acting nitrates. Which patient statement indicates that the teaching has been effective? "I will sit down before I put the nitroglycerin under my tongue." "I will check my pulse rate before I take any nitroglycerin tablets." "I will put the nitroglycerin patch on as soon as I get any chest pain." "I will remove the nitroglycerin patch before taking sublingual nitroglycerin."

"I will sit down before I put the nitroglycerin under my tongue." The patient should sit down before taking the nitroglycerin to decrease cardiac workload and prevent orthostatic hypotension. Transdermal nitrates are used prophylactically rather than to treat acute pain and can be used concurrently with sublingual nitroglycerin. Although the nurse should check blood pressure before giving nitroglycerin, patients do not need to check the pulse rate before taking nitrates.

A patient with ST-segment elevation in three contiguous electrocardiographic leads is admitted to the emergency department and diagnosed as having an ST-segment-elevation myocardial infarction (STEMI). Which question should the nurse ask to determine whether the patient is a candidate for thrombolytic therapy? "Do you have any allergies?" "Do you take aspirin daily?" "What time did your pain begin?" "Can you rate the pain on a 0 to 10 scale?"

"What time did your pain begin?" Thrombolytic therapy should be started within 6 hours of the onset of the myocardial infarction, so the time at which the chest pain started is a major determinant of the appropriateness of this treatment. The other information is not a factor in the decision about thrombolytic therapy.

After receiving change-of-shift report about the following four patients on the cardiac care unit, which patient should the nurse assess first? A 39-year-old patient with pericarditis who is complaining of sharp, stabbing chest pain. A 56-year-old patient with variant angina who is scheduled to receive nifedipine (Procardia). A 65-year-old patient who had a myocardial infarction (MI) 4 days ago and is anxious about today's planned discharge. A 59-year-old patient with unstable angina who has just returned after a percutaneous coronary intervention (PCI).

A 59-year-old patient with unstable angina who has just returned after a percutaneous coronary intervention (PCI). After PCI, the patient is at risk for hemorrhage from the arterial access site. The nurse should assess the patient's blood pressure, pulses, and the access site immediately. The other patients should also be assessed as quickly as possible, but assessment of this patient has the highest priority.

Which statements below best described a transesophageal echocardiogram (TEE) used in the treatment of atrial fibrillation? Select all that apply: A. It can be performed before a cardioversion to assess for blood clots in the heart. B. This procedure destroys electrical pathways in the heart to help return a patient's heart rhythm to normal. C. During this procedure, an ultrasound probe is inserted in the patient's mouth down through the esophagus where it takes ultrasound pictures of the heart. D. During the procedure, a transducer is placed on the chest that sends ultrasound waves through the skin so pictures can be obtained of the heart's blood flow.

A and C. A TEE can be performed before a cardioversion to assess for blood clots in the heart (for example before a cardioversion for the treatment of atrial fibrillation). In addition, during this procedure, an ultrasound probe is inserted in the patient's mouth down through the esophagus where it takes ultrasound pictures of the heart.

A patients BP is 130/88 and is complaining of chest pain. after administering the first dose of Nitroglycerin sublingual the patient's blood pressure is now 68/48. The patient is still having chest pain and T-wave inversion on the cardiac monitor. What is your next nursing intervention? A. Hold further doses of Nitroglycerin and notify the doctor immediately for further orders. B. Administer Morphine IV and place the patient in reverse Trendelenburg position. C. Administer Nitroglycerin and monitor the patient's blood pressure. D. All the options are incorrect

A. Nitroglycerin can cause hypotension, however, if there is a significant drop in blood pressure with SBP <90, further doses of Nitroglycerin should be held. The doctor should be notified for further orders, especially since the patient is still having chest pain and t-wave inversion. Morphine should NOT be given because it can cause hypotension.

Following an acute myocardial infarction, a previously healthy 63-yr-old develops heart failure. What medication topic should the nurse anticipate including in discharge teaching? beta Adrenergic blockers Digitalis and potassium therapy regimen Calcium channel blockers Angiotensin-converting enzyme (ACE) inhibitors

ACE inhibitor ACE inhibitor therapy is currently recommended to prevent the development of heart failure in patients who have had a myocardial infarction and as a first-line therapy for patients with chronic heart failure. Digoxin therapy for heart failure is no longer considered a first-line measure, and digoxin is added to the treatment protocol when therapy with other drugs such as ACE-inhibitors, diuretics, and -adrenergic blockers is insufficient. Calcium channel blockers are not generally used in the treatment of heart failure. The -adrenergic blockers are not used as initial therapy for new onset heart failure.

A patient with chronic heart failure who is taking a diuretic and an angiotensin-converting enzyme (ACE) inhibitor and who is on a low-sodium diet tells the home health nurse about a 5-lb weight gain in the past 3 days. What is the nurse's priority action? Teach the patient about restricting dietary sodium. Assess the patient for manifestations of acute heart failure. Ask the patient about the use of the prescribed medications. Have the patient recall the dietary intake for the past 3 days.

Assess the patient for manifestations of acute heart failure. The 5-lb weight gain over 3 days indicates that the patient's chronic heart failure may be worsening. It is important that the patient be assessed immediately for other clinical manifestations of decompensation, such as lung crackles. A dietary recall to detect hidden sodium in the diet, reinforcement of sodium restrictions, and assessment of medication compliance may be appropriate interventions but are not the first nursing actions indicated.

What complications can develop from uncontrolled atrial fibrillation that the nurse should monitor for? Select all that apply: A. Hypertension B. Stroke C. Heart failure D. Hyperglycemia

B and C. Remember from the lecture I discussed how atrial fibrillation leads to incomplete atrial contraction that causes the atria to quiver. This can lead to blood pooling in the atria. When blood pools it coagulates (hence forms clots). The clots can break off and travel through the body leading to a stroke. In addition, if the rate if too fast (not controlled) the heart's ability to pump blood throughout the body fails because it becomes overworked and tired. This leads to heart failure.

Your patient is experiencing Sinus Tachycardia with a rate of 160 bpm. Which findings below demonstrate the patient is experiencing a decrease in cardiac output? Select all that apply: A. Blood pressure 220/120 mmHg B. Blood pressure70/42 mmHg C. Crackles throughout the lung fields D. Decreased capillary refill time E. Cool extremities

B, C, and E. Option D is NOT the answer because INCREASED capillary refill time would present, NOT decreased and hypotension would be presenting NOT hypertension.

Your patient's ECG shows atrial flutter. What complication can arise from this type of rhythm? A. Pericarditis B. Stroke C. Hypoglycemia D. Endocarditis

B. Atrial flutter can increase the patient's risk of developing a blood clot which can lead to a stroke. This is because the atria are not fully contracting but quivering. The quivering leads blood to pool in the atria which can coagulate and form a clot. The clot can leave the heart and travel to the brain or lungs and cause a stroke or pulmonary embolism.

What other medications can be administered to a patient experiencing Ventricular fibrillation (V-fib) during a code resuscitation attempt? Select all that apply: A. Atropine B. Epinephrine C. Amiodarone D. Lidocaine

B. Epinephrine C. Amiodarone D. Lidocaine epinephrine is first choice

The patient's ECG shows a fib. The patient is symptomatic and experiencing shortness of breath and chest pain. The patient's blood pressure in 80/44 with the heart rate fluctuating between 130-150s. The nurse calls a rapid response and prepares the patient for? A. Ablation B. Synchronized cardioversion C. Defibrillation D. Pacemaker implantation

B. Synchronized cardioversion The patient is experiencing signs and symptoms of decreased cardiac output, which can occur when atrial fibrillation when this rhythm is fast (hence out of control). The patient needs to be cardioverted so the rhythm can return back to normal sinus rhythm.

A patient recovering from a myocardial infarction is complaining of the taste of blood in their mouth. On assessment, you note there is bleeding on the anterior gums. Which medication can cause this? A. Coreg B. Cardizem C. Lovenox D. Lipitor

C. Lovenox is an antithrombotic. An adverse side effect of this medication is bleeding. Coreg (beta-blocker), Cardizem (calcium channel blocker), and Lipitor (statin) do NOT cause excessive bleeding.

The patient is experiencing v tach. You assess the patient and find the patient is having no symptoms and a pulse is present. What type of treatment do you anticipate will be ordered for this patient? A. CPR B. Defibrillation C. Amiodarone IV D. Digoxin IV

C. Amiodarone IV The patient is experiencing ventricular tachycardia. Currently, the patient has no symptoms and a pulse is present. Therefore, the patient is stable. When stable with no symptoms and has a pulse an anti-arrhythmic med like amiodarone IV can be ordered. If the patient doesn't convert to sinus rhythm synchronized cardioversion may be used.

A patient with left-sided heart failure is having difficulty breathing. Which of the following is the most appropriate nursing intervention? A. Encourage the patient to cough and deep breathe. B. Place the patient in Semi-Fowler's position. C. Assist the patient into High Fowler's position. D. Perform chest percussion therapy.

C. Due to the patient being in fluid overload (especially with left-sided heart failure...remember the lungs are majorly affected in this type of heart failure), it is most appropriate to place the patient in High Fowler's position to help make breathing easier.

A patient with heart failure is taking Losartan and Spironolactone. The patient is having EKG changes that presents with tall peaked T-waves and flat p-waves. Which of the following lab results confirms these findings? A. Na+ 135 B. BNP 560 C. K+ 8.0 D. K+ 1.5

C. Losartan and Spironolactone can both cause an increased potassium level (hyperkalemia). Losartan is an ARB and Spironolactone is a potassium-sparing diuretic. Therefore, the EKG changes are a sign of a high potassium level (normal potassium level is 3.5-5.1).

These drugs are used as first-line treatment of heart failure. They work by allowing more blood to flow to the heart which decreases the work load of the heart and allows the kidneys to secrete sodium. However, some patients can develop a nagging cough with these types of drugs. This description describes? A. Beta-blockers B. Vasodilators C. Angiotensin II receptor blockers D. Angiotensin-converting-enzyme inhibitors

D. Angiotensin-converting-enzyme inhibitors

A patient is experiencing sinus bradycardia with a rate of 34 bpm and blood pressure of 78/42. The patient reports symptoms of chest pain, has cool and clammy skin, dyspnea, and feels like they may faint. The nurse prepares to administer Atropine per a standing physician's order for the patient's symptomatic bradycardia. How will the nurse administer this medication? A. 3 mg IV push every 3-5 minutes, max dose of 5 mg B. 2 mg IV push every 1-2 minutes, max dose of 3 mg C. 3-5 mg IV push every 1 minute, max dose 10 mg D. 1 mg IV push every 3-5 minutes, max dose of 3 mg

D: Atropine for symptomatic bradycardia should be given as 1 mg IV push every 3-5 minutes, max dose of 3 mg.

Which of the following are NOT typical signs and symptoms of right-sided heart failure? Select-all-that-apply: A. Jugular venous distention B. Persistent cough C. Weight gain D. Crackles E. Nocturia F. Orthopnea

bdf Persistent cough, crackles (also called rales), and orthopnea are signs and symptoms of LEFT-sided heart failure...not right-sided heart failure.

What should the PR Interval measure for Normal Sinus Rhythm? A. 0.35-0.44 seconds B. > 0.12 seconds C. 0.12-0.20 seconds D. > 0.20 seconds

c

A patient has a hr of 35, chest pain, cold, clammy and is given atropine. Atropine was ineffective for treating the bradycardia. The patient is still symptomatic with a rate 35 bpm. What other options could be considered for the patient? Select all that apply: A. Transcutaneous pacing B. Amiodarone Infusion C. Dopamine Infusion D. Epinephrine Infusion

acd

When admitting a patient with a non-ST-segment-elevation myocardial infarction (NSTEMI) to the intensive care unit, which action should the nurse perform first? Attach the heart monitor. Obtain the blood pressure. Assess the peripheral pulses. Auscultate breath sounds.

attach heart monitor Because dysrhythmias are the most common complication of myocardial infarction (MI), the first action should be to place the patient on a heart monitor. The other actions are also important and should be accomplished as quickly as possible.

A patient recovering from a myocardial infarction (MI) develops chest pain on day 3 that increases when taking a deep breath and is relieved by leaning forward. Which action should the nurse take as focused follow-up on this symptom? Assess both feet for pedal edema. Palpate the radial pulses bilaterally. Auscultate for a pericardial friction rub. Check the heart monitor for dysrhythmias.

auscltate for pericardial friction rub The patient's symptoms are consistent with the development of pericarditis, a possible complication of MI. The other assessments listed are not consistent with the description of the patient's symptoms.

Sinus bradycardia originates in what part of the electrical conduction system? A. AV node B. SA node C. Bundle Branches D. Bundle of His The answer is B: SA node

b

A patient is complaining of a nagging cough that is continuous. Which medication below can cause this side effect? A. Losartan B. Lisinopril C. Cardizem D. Lipitor

b ACE inhibitors, such as Lisinopril, can cause a nagging cough that is continuous. The patient may be switched to an ARB (angiotensin receptor blocker) if the cough is troublesome.

Sinus tachycardia originates from what part of the electrical conduction system? A. Bundle of His B. Bundle Branches C. AV Node D. SA Node

d

A patient is 36 hours status post a myocardial infarction. The patient is starting to complain of chest pain when they lay flat or cough. You note on auscultation of the heart a grating, harsh sound. What complication is this patient mostly likely suffering from? A. Cardiac dissection B. Ventricular septum rupture C. Mitral valve prolapse D. Pericarditis

d A complication of a myocardial infarction is PERICARDITIS, especially 24-36 hours post MI. This is because of neutrophils being present at the site which causes inflammation. The patient's signs and symptoms are classic pericarditis.

Your patient is experiencing extreme fatigue, hypotension, palpations, and shortness of breath. You obtain an ECG and discover a rhythm of sinus bradycardia with a rate of 40 bpm. What finding below could be causing this condition? A. Potassium level of 3.9 meq/L B. Lisinopril 10 mg BID PO C. Blood glucose 84 D. Digoxin 0.125 mg PO daily

d Digoxin slows down the heart rate and can lead to bradycardia.

A patient is on a Heparin drip post myocardial infarction. The patient has been on the drip for 4 days. You are assessing the patient's morning lab work. Which of the following findings in the patient's lab work is a potential life-threatening complication of Heparin therapy and requires intervention? A. K+ 3.7 B. PTT 65 seconds C. Hgb 14.5 D. Platelets 135,000

d Platelet value of <150,000 indicates thrombocytopenia and is found in patients with Heparin-Induced Thrombocytopenia. The potassium and hemoglobin level are normal. The PTT level is therapeutic (60-80 seconds) for Heparin and isn't a cause for concern.

After having a myocardial infarction (MI) and successful percutaneous coronary intervention, the patient states, "It was just a little chest pain. As soon as I get out of here, I'm going for my vacation as planned." Which reply would be most appropriate for the nurse to make? "What do you think caused your chest pain?" "Where are you planning to go for your vacation?" "Sometimes plans need to change after a heart attack." "Recovery from a heart attack takes at least a few weeks."

"What do you think caused your chest pain?" When the patient is experiencing denial, the nurse should assist the patient in testing reality until the patient has progressed beyond this step of the emotional adjustment to MI. Asking the patient about vacation plans reinforces the patient's plan, which is not appropriate in the immediate post-MI period. Reminding the patient in denial about the MI is likely to make the patient angry and lead to distrust of the nursing staff.

A patient is complaining of chest pain. On the bedside cardiac monitor you observe pronounce T-wave inversion. You obtain the patient's vital signs and find the following: Blood pressure 190/98, HR 110, oxygen saturation 96% on room air, and respiratory rate 20. Select-all-that-apply in regards to the MOST IMPORTANT nursing interventions you will provide based on the patient's current status: A. Obtain a 12-lead EKG B. Place the patient in supine position C. Assess urinary output D. Administer Nitroglycerin sublingual as ordered per protocol E. Collect cardiac enzymes as ordered per protocol F. Encourage patient to cough and deep breath G. Administer Morphine IV as ordered per protocol H. Place patient on oxygen via nasal cannula I. No interventions are needed at this time

A. Obtain a 12-lead EKG D. Administer Nitroglycerin sublingual as ordered per protocol E. Collect cardiac enzymes as ordered per protocol G. Administer Morphine IV as ordered per protocol H. Place patient on oxygen via nasal cannula

Which topic will the nurse plan to include in discharge teaching for a patient who has heart failure with reduced ejection fraction (HFrEF)? Need to begin an aerobic exercise program several times weekly Benefits and effects of angiotensin-converting enzyme (ACE) inhibitors Use of salt substitutes to replace table salt when cooking and at the table Importance of making an annual appointment with the health care provider

Benefits and effects of angiotensin-converting enzyme (ACE) inhibitors The core measures for the treatment of heart failure established by The Joint Commission indicate that patients with an ejection fraction below 40% should receive an ACE inhibitor to decrease the progression of heart failure. Aerobic exercise may not be appropriate for a patient with this level of heart failure. Salt substitutes are not usually recommended because of the risk of hyperkalemia. The patient will need to see the primary care provider more often than annually.

True or False: Atropine is the first-line treatment to help control the rate in a patient with atrial flutter.

FALSE. Atropine increases the heart rate, which is the opposite of what needs to happen in atrial flutter (the rate is too fast and irregular and needs to be slowed down). Calcium-channel blockers and beta-blockers are used to help control the rate in atrial flutter. These medications will help slow down the rate, which may help convert the patient back to normal sinus rhythm.

A patient in the intensive care unit who has acute decompensated heart failure (ADHF) reports severe dyspnea and is anxious, tachypneic, and tachycardic. Several drugs have been prescribed for the patient. Which action should the nurse take first? Give PRN IV morphine sulfate 4 mg. Give PRN IV diazepam (Valium) 2.5 mg. Increase nitroglycerin infusion by 5 mcg/min. Increase dopamine infusion by 2 mcg/kg/min.

Give PRN IV morphine sulfate 4 mg. Morphine improves alveolar gas exchange, improves cardiac output by reducing ventricular preload and afterload, decreases anxiety, and assists in reducing the subjective feeling of dyspnea. Diazepam may decrease patient anxiety, but it will not improve the cardiac output or gas exchange. Increasing the dopamine may improve cardiac output, but it will also increase the heart rate and myocardial oxygen consumption. Nitroglycerin will improve cardiac output and may be appropriate for this patient, but it will not directly reduce anxiety and will not act as quickly as morphine to decrease dyspnea.

While assessing an older adult patient, the nurse notes jugular venous distention (JVD) with the head of the patient's bed elevated 45 degrees. What does this finding indicate? Decreased fluid volume Jugular vein atherosclerosis Increased right atrial pressure Incompetent jugular vein valves

Increased right atrial pressure The jugular veins empty into the superior vena cava and then into the right atrium, so JVD with the patient sitting at a 45-degree angle reflects increased right atrial pressure. JVD is an indicator of excessive fluid volume (increased preload), not decreased fluid volume. JVD is not caused by incompetent jugular vein valves or atherosclerosis.

Which information about a patient receiving thrombolytic therapy for an acute myocardial infarction is most important for the nurse to communicate to the health care provider? An increase in troponin levels from baseline A large bruise at the patient's IV insertion site No change in the patient's reported level of chest pain A decrease in ST-segment elevation on the electrocardiogram

No change in the patient's reported level of chest pain Continued chest pain suggests that the thrombolytic therapy is not effective and that other interventions such as percutaneous coronary intervention may be needed. Bruising is a possible side effect of thrombolytic therapy, but it is not an indication that therapy should be discontinued. The decrease of the ST-segment elevation indicates that thrombolysis is occurring, and perfusion is returning to the injured myocardium. An increase in troponin levels is expected with reperfusion and is related to the washout of cardiac biomarkers into the circulation as the blocked vessel is opened.

The nurse plans discharge teaching for a patient with chronic heart failure who has prescriptions for digoxin (Lanoxin) and hydrochlorothiazide. Which instruction should the nurse include? Limit dietary sources of potassium. Take the hydrochlorothiazide at bedtime. Notify the health care provider if nausea develops. Take the digoxin if the pulse is below 60 beats/min.

Notify the health care provider if nausea develops. Nausea is a symptom of digoxin toxicity and should be reported so that the provider can assess the patient for toxicity and adjust the digoxin dose, if necessary. The patient will need to include potassium-containing foods in the diet to avoid hypokalemia. Patients should be taught to check their pulse daily before taking the digoxin and if the pulse is less than 60 beats/min, to call their provider before taking the digoxin. Diuretics should be taken early in the day to avoid sleep disruption.

After receiving change-of-shift report on a heart failure unit, which patient should the nurse assess first? Patient who is taking carvedilol (Coreg) and has a heart rate of 58. Patient who is taking digoxin and has a potassium level of 3.1 mEq/L. Patient who is taking captopril and has a frequent nonproductive cough. Patient who is taking isosorbide dinitrate/hydralazine (BiDil) and has a headache.

Patient who is taking digoxin and has a potassium level of 3.1 mEq/L. The patient's low potassium level increases the risk for digoxin toxicity and potentially life-threatening dysrhythmias. The nurse should assess the patient for other signs of digoxin toxicity and then notify the health care provider about the potassium level. The other patients also have side effects of their drugs, but their symptoms do not indicate potentially life-threatening complications

A patient with diabetes mellitus and chronic stable angina has a new order for captopril. Whatshould the nurse teach this patient about the primary purpose of captopril? Decreases the heart rate. Controls blood glucose levels. Prevents changes in heart muscle. Reduces the frequency of chest pain.

Prevents changes in heart muscle. The purpose for angiotensin-converting enzyme (ACE) inhibitors in patients with chronic stable angina who are at high risk for a cardiac event is to decrease ventricular remodeling. ACE inhibitors do not directly impact angina frequency, blood glucose, or heart rate.

The nurse is caring for a patient who was admitted to the coronary care unit following an acute myocardial infarction (AMI) and percutaneous coronary intervention the previous day. What should teaching for this patient include today? Typical emotional responses to AMI When cardiac rehabilitation will begin Pathophysiology of coronary artery disease Information regarding discharge medications

When cardiac rehabilitation will begin Early after an AMI, the patient will want to know when resumption of usual activities can be expected. At this time, the patient's anxiety level or denial will interfere with good understanding of complex information such as the pathophysiology of coronary artery disease. Teaching about discharge medications should be done closer to discharge. The nurse should support the patient by decreasing anxiety rather than discussing the typical emotional responses to myocardial infarction.

When teaching a patient with heart failure on a 2000-mg sodium diet, which foods should the nurse recommend limiting? Chicken and eggs Canned and frozen fruits Yogurt and milk products Fresh or frozen vegetables

Yogurt and milk products Yogurt and milk products (e.g., cheese) naturally contain a significant amount of sodium, and the intake of these should be limited for patients on a diet that limits sodium to 2000 mg daily. The other foods listed have minimal levels of sodium and can be eaten without restriction.

The nurse is caring for a patient who is receiving IV furosemide (Lasix) and morphine for the treatment of acute decompensated heart failure (ADHF) with severe orthopnea. Which clinical finding is the best indicator that the treatment has been effective? a. Weight loss of 2 lb in 24 hours b. Hourly urine output greater than 60 mL c. Reduced dyspnea with the HOB at 30 degrees. d. Patient denies experiencing chest pain or chest pressure

a Because the patient's major clinical manifestation of ADHF is orthopnea (caused by the presence of fluid in the alveoli), the best indicator that the medications are effective is a decrease in dyspnea with the head of the bed at 30 degrees. The other assessment data may also indicate that diuresis or improvement in cardiac output has occurred but are not as specific to evaluating this patient's response.

A patient's morning lab work shows a potassium level of 6.3. The patient's potassium level yesterday was 4.0 The patient was recently started on new medications for treatment of myocardial infarction. What medication below can cause an increased potassium level? A. Losartan B. Norvasc C. Aspirin D. Cardizem

a Losartan is an ARB. ARBs (angiotensin receptor blockers) and ACE inhibitors (angiotension converting enzyme inhibitors) can cause an INCREASE potassium level because of it affects of decreasing aldosterone. A normal potassium level is 3.5-5.1.

Which of the following patients are MOST at risk for developing heart failure? Select-all-that-apply: A. A 69 year old male with a history of alcohol abuse and is recovering from a myocardial infarction. B. A 55 year old female with a health history of asthma and hypoparathyroidism. C. A 30 year old male with a history of endocarditis and has severe mitral stenosis. D. A 45 year old female with lung cancer stage 2. E. A 58 year old female with uncontrolled hypertension and is being treated for influenza.

ace These patients are at most risk for heart failure. Remember risks factor for developing heart failure include: remember the mnemonic FAILURE: Faulty heart valves ( Option C mitral stenosis in this case), Arrhythmias, Infarction (Option A), Lineage, Uncontrolled hypertension (Option E), Recreational drug usage, Evaders (Option E with influenza)


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