Cardiac NCLEX style; N-200

The intensive care department nurse is assessing the client who is 12 hours post-myocardial infarction. The nurse assesses an S3 heart sound. Which intervention should the nurse implement?1. Notify the health-care provider immediately 2. Elevate the head of the client's bed 3. Document this as a normal and expected finding 4.Administer morphine intravenously

1. An S3 indicates left ventricular failure and should be reported to the healthcare provider. It is a potentially life threatening complication of a myocardial infarction

The client comes into the emergency department saying, "I am having a heart attack" Which question is most pertinent when assessing the client? 1. "Can you describe the chest pain" 2. "What were you doing when the pain started" 3. "Did you have a high-fat meal today" 4. "Does the pain get worse when you lie down"

1. The chest pain for MI is usually described as an elephant sitting on the chest or a belt squeezing the substernal midchest, often radiating to the jaw or left arm.

2. Medical treatment of coronary artery disease includes which of the following procedures? 1. Cardiac catheterization 2. Coronary artery bypass surgery 3. Oral medication therapy 4. Percutaneous transluminal coronary angioplasty

2. Answer: 3. Oral medication therapy Oral medication administration is a noninvasive, medical treatment for coronary artery disease.•Option A: Cardiac catheterization isn't a treatment, but a diagnostic tool.•Options B and D: Coronary artery bypass surgery and percutaneous transluminal coronary angioplasty are invasive, surgical treatments

The client is admitted to the emergency department, and the nurse suspects a cardiac problem. Which assessment interventions should the nurse implement? Select All that Apply 1. Obtain a midstream urine specimen 2. Attach telemetry monitor to the client 3. Start a saline lock in the right arm 4. Draw a baseline metabolic panel (BMP) 5. Request an order for a STAT 12-lead ECG

2. Anytime a nurse suspects cardiac problems, the electrical conductivity of the heart should be assessed. 3. Emergency medications for heart problems are primarily administered intravenously, so starting a saline lock in the right arm is appropriate. 5. A 12-lead ECG evaluates the electrical conductivity of the heart from all planes.

Along with persistent, crushing chest pain, which signs/symptoms would make the nurse suspect that the client is experiencing a myocardial infarction? 1. Midepigastric pain and pyrosis 2. Diaphoresis and cool clammy skin 3. Intermittent claudication and pallor 4. Jugular vein distention and dependent edema

2. Diaphoresis is a systemic reaction to the MI. The body vasoconstricts to shunt blood from the periphery to the trunk of the body; this in turn, leads to cold, clammy skin

The client is one day postoperative coronary artery bypass surgery. The client complains of chest pain. Which intervention should the nurse implement first? 1. Medicate the client with intravenous morphine 2. Assess the client's chest dressing and vital signs 3. Encourage the client to turn from side to side 4. Check the client's telemetry monitor

2. The nurse must always assess the client to determine if the chest pain that is occurring is expected post-operatively or if it is a complication of surgery.

3. Which of the following is the most common symptom of myocardial infarction (MI)? 1. Chest pain 2. Dyspnea 3. Edema 4. Palpitations

3. Answer: 1. Chest pain The most common symptom of an MI is chest pain, resulting from deprivation of oxygen to the heart.•Option B: Dyspnea is the second most common symptom, related to an increase in the metabolic needs of the body during an MI.•Option C: Edema is a later sign of heart failure, often seen after an MI.•Option D: Palpitations may result from reduced cardiac output, producing arrhythmias.

The client diagnosed with a myocardial infarction is six hours post-right femoral percutanous transluminal coronary angioplasty (PTCA), also known as balloon surgery. Which assessment data would require immediate intervention by the nurse? 1. The client is keeping the affected extremity straight 2. The pressure dressing to the right femoral area is intact 3.The client is complaining of numbness in the right foot 4. The client's right pedal pulse is +3 and bounding

3. Any neurovascular assessment data that is abnormal requires intervention by the nurse; numbness may indicate decreased blood flow to the right foot

The client who has had a myocardial infarction is admitted to the telementry unit from intensive care. Which referral would be most appropriate for the client? 1. Social worker 2. Physical therapy 3. Cardiac rehabilitation 4.Occupation therapy

3. Cardiac rehabilitation is the most appropriate referral. The client can start rehabilitation in the hospital and then attend an outpatient cardiac rehabilitation clinic, which includes progressive exercises, diet teaching, and classes on modifying risk factors.

The client diagnosed with rule-out myocardial infarction is experiencing chest pain while walking to the bathroom. Which action should the nurse implement first? 1. Administer sublingual nitroglycerin 2. Obtain a stat 12 Lead ECG 3. Have the client sit down immediately 4. Assess the client's vital signs

3. Stopping all activity will decrease the need of the myocardium for oxygen and may help decrease the chest pain.

The client is 3 hours post myocardial infarction. Which data would warrant immediate intervention by the nurse? 1. Bilateral peripheral pulses 2+ 2. The pulse oximeter reading is 96% 3. The urine output is 240 mL in the last 4 hours 4. Cool, clammy, diaphoretic skin

4. Cold, clammy skin is an indicator of cardiogenic shock, which is a complication of MI and warrants immediate intervention.

The nurse is administering a calcium channel blocker to the client diagnosed with a myocardial infarction. Which assessment data would cause the nurse to question administering this medication? 1. The client's apical pulse is 64 2. The client's calcium level is elevated 3. The client's telemetry shows occasional PVCs 4. The client's blood pressure is 90/62

4. The client's blood pressure is low, and a calcium channel blocker could cause the blood pressure to bottom out.

5. Which of the following blood tests is most indicative of cardiac damage? 1. Lactate dehydrogenase 2. Complete blood count (CBC) 3. Troponin I 4. Creatine kinase (CK)

5. Answer: 3. Troponin IT roponin I levels rise rapidly and are detectable within 1 hour of myocardial injury. Troponin I levels aren't detectable in people without cardiac injury.•Option A: Lactate dehydrogenase (LDH) is present in almost all body tissues and not specific to heart muscle. LDH isoenzymes are useful in diagnosing a cardiac injury.•Option B: CBC is obtained to review blood counts, and a complete chemistry is obtained to review electrolytes.•Option D: Because CK levels may rise with a skeletal muscle injury, CK isoenzymes are required to detect cardiac injury.

6. What is the primary reason for administering morphine to a client with an MI? 1. To sedate the client 2. To decrease the client's pain 3. To decrease the client's anxiety 4. To decrease oxygen demand on the client's heart

6. Answer: 4. To decrease oxygen demand on the client's heart Morphine is administered because it decreases myocardial oxygen demand.•Options A, B, and C: Morphine will also decrease pain and anxiety while causing sedation, but it isn't primarily given for those reasons.

A client admitted with angina compains of severe chest pain and suddenly becomes unresponsive. After establishing unresponsiveness, which of the following actions should the nurse take first? A) Activate the resuscitation team B) Open the client's airway C) Check for breathing D) Check for signs of circulation

A) Activate the resuscitation team Immediately after establishing unresponsiveness, the nurse should activate the resuscitation team. The next step is to open the airway using the head-tilt, chin-lift maneuver and check for breathing (looking, listening, and feeling for no more than 10-seconds). If the client isn't breathing, give two slow breaths using a bag mask or pocket mask. Next, check for signs of circulation by palpating the carotid pulse.

Which of the following terms describes the force against which the ventricle must expel blood? A) Afterload B) Cardiac output C) Overload D) Preload

A) Afterload Afterload refers to the resistance normally maintained by the aortic and pulmonic valves, the condition and tone of the aorta, and the resistance offered by the systemic and pulmonary arterioles. Cardiac output is the amount of blood expelled by the heart per minute. Overload refers to an abundance of circulating volume. Preload is the volume of blood in the ventricle at the end of diastole.

The nurse teaches the client that the major difference between angina and pain associated with myocardial infarction (MI) is that: A) Angina is relieved with nitroglycerin and rest .B) Angina can be fatal. C) MI pain always radiates to the left arm or jaw. D) MI pain cannot be treated.

A) Angina is relieved with nitroglycerin and rest.

Toxicity from which of the following medications may cause a client to see a green-yellow halo around lights? A) Digoxin B) Furosemide (Lasix) C) Metoprolol (Lopressor) D) Enalapril (Vasotec)

A) Digoxin One of the most common signs of digoxin toxicity is the visual disturbance known as the "green-yellow halo sign." The other medications aren't associated with such an effect.

The physician orders continuous intravenous nitroglycerin infusion for the client with MI. Essential nursing actions include which of the following? A) Obtaining an infusion pump for the medication B) Monitoring BP q4h C) Monitoring urine output hourly D) Obtaining serum potassium levels daily

A) Obtaining an infusion pump for the medication IV nitro infusion requires an infusion pump for precise control of the medication. BP monitoring would be done with a continuous system, and more frequently than every 4 hours. Hourly urine outputs are not always required. Obtaining serum potassium levels is not associated with nitroglycerin infusion.

Which of the following results is the primary treatment goal for angina? A) Reversal of ischemia B) Reversal of infarction C) Reduction of stress and anxiety D) Reduction of associated risk factors

A) Reversal of ischemia Reversal of the ischemia is the primary goal, achieved by reducing oxygen consumption and increasing oxygen supply. An infarction is permanent and can't be reversed.

A patient admitted with heart failure appears very anxious and complains of shortness of breath. Which nursing actions would be appropriate to alleviate this patient's anxiety (select all that apply)? A. Administer ordered morphine sulfate. B. Position patient in a semi-Fowler's position. C. Position patient on left side with head of bed flat. D. Instruct patient on the use of relaxation techniques. E. Use a calm, reassuring approach while talking to patient.

A, B, D, E. Morphine sulfate reduces anxiety and may assist in reducing dyspnea. The patient should be positioned in semi-Fowler's position to improve ventilation that will reduce anxiety. Relaxation techniques and a calm reassuring approach will also serve to reduce anxiety.

The patient has heart failure (HF) with an ejection fraction of less than 40%. What core measures should the nurse expect to include in the plan of care for this patient (select all that apply)? A. Left ventricular function is documented. B. Controlling dysrhythmias will eliminate HF. C. Prescription for digoxin (Lanoxin) at discharge D. Prescription for angiotensin-converting enzyme (ACE) inhibitor at discharge E. Education materials about activity, medications, weight monitoring, and what to do if symptoms worsen

A, D, E. The Joint Commission has identified these three core measures for heart failure patients. Although controlling dysrhythmias will improve CO and workload, it will not eliminate HF. Prescribing digoxin for all HF patients is no longer done because there are newer effective drugs and digoxin toxicity occurs easily related to electrolyte levels and the therapeutic range must be maintained.

A patient with a recent diagnosis of heart failure has been prescribed furosemide (Lasix) in an effort to physiologically do what for the patient?A. Reduce preload. B. Decrease afterload. C. Increase contractility. D. Promote vasodilation.

A. Reduce preload. Diuretics such as furosemide are used in the treatment of HF to mobilize edematous fluid, reduce pulmonary venous pressure, and reduce preload. They do not directly influence afterload, contractility, or vessel tone.

The patient with chronic heart failure is being discharged from the hospital. What information should the nurse emphasize in the patient's discharge teaching to prevent progression of the disease to ADHF? A. Take medications as prescribed. B. Use oxygen when feeling short of breath .C. Only ask the physician's office questions. D. Encourage most activity in the morning when rested.

A. Take medications as prescribed. The goal for the patient with chronic HF is to avoid exacerbations and hospitalization. Taking the medications as prescribed along with nondrug therapies such as alternating activity with rest will help the patient meet this goal. If the patient needs to use oxygen at home, it will probably be used all the time or with activity to prevent respiratory acidosis. Many HF patients are monitored by a care manager or in a transitional program to assess the patient for medication effectiveness and monitor for patient deterioration and encourage the patient. This nurse manager can be asked questions or can contact the health care provider if there is evidence of worsening HF.

A pulsating abdominal mass usually indicates which of the following conditions? a. Abdominal aortic aneurysm b. Enlarged spleen c. Gastic distention d. Gastritis

AAA

What is the most common symptom in a client with AAA?

Abdominal pain

Nurse is assisting with admission of a client who has possible dissecting AAA. What is the priority nursing intervention?

Administer IV fluids

What is the first intervention for a client experiencing MI?

Administer oxygen

A 76 year old man enters the ER with complaints of back pain and feeling fatigued. Upon examination, his blood pressure is 190/100, pulse is 118, and hematocrit and hemoglobin are both low. The nurse palpates the abdomen which is soft, non-tender and auscultates an abdominal pulse. The most likely diagnosis is: A. Buerger's disease B. CHF C. Secondary hypertension D. Aneurysm

Aneurysm

1. Which of the following actions is the first priority of care for a client exhibiting signs and symptoms of coronary artery disease? 1. Decrease anxiety 2. Enhance myocardial oxygenation 3. Administer sublingual nitroglycerin 4. Educate the client about his symptoms

Answer: 2. Enhance myocardial oxygenation Enhancing myocardial oxygenation is always the first priority when a client exhibits signs or symptoms of cardiac compromise. Without adequate oxygenation, the myocardium suffers damage.•Options A and D: Although educating the client and decreasing anxiety are important in care delivery, neither are priorities when a client is compromised.•Option C: Sublingual nitroglycerin is administered to treat acute angina, but the administration isn't the first priority.

What is the most common complication of MI?

Arrhythmias

What is the most common cause of abdominal aortic aneurysm? a. Atherosclerosis b. DM c. HPN d. Syphilis

Atherosclerosis Plaque builds up on the wall of the vessel and weakens it causing an aneurysm

Which of the following groups of symptoms indicates a rupture AAA? a. Lower back pain, increased BP, decreased RBC, increased WBC b. Severe lower back pain, decreased BP, decreased RBC, increased WBC c. Severe lower back pain, decreased BP, decreased RBC, decreased WBC d. Intermittent lower back pain, decreased BP, decreased RBC, increased WBC

B Severe lower back pain indicates an aneurysm rupture, secondary to pressure being applied within the abdominal cavity. When rupture occurs, the pain is constant because it can't be alleviated until the aneurysm is repaired. Blood pressure decreases due to the loss of blood. After the aneurysm ruptures, the vasculature is interrupted and blood volume is lost, so blood pressure wouldn't increase. For the same reason, the RBC count is decreased - not increase. The WBC count increases as cells migrate to the site of injury.

Aspirin is administered to the client experiencing an MI because of its: A) Antipyrectic action B) Antithrombotic action C) Antiplatelet action D) Analgesic action

B) Antithrombotic action Aspirin does have antipyretic, antiplatelet, and analgesic actions, but the primary reason ASA is administered to the client experiencing an MI is its antithrombotic action.

Which of the following classes of drugs is most widely used in the treatment of cardiomyopathy? A) Antihypertensives B) Beta-adrenergic blockers C) Calcium channel blockers D) Nitrates

B) Beta-adrenergic blockers By decreasing the heart rate and contractility, beta-blockers improve myocardial filling and cardiac output, which are primary goals in the treatment of cardiomyopathy. Antihypertensives aren't usually indicated because they would decrease cardiac output in clients who are already hypotensive. Calcium channel blockers are sometimes used for the same reasons as beta-blockers; however, they aren't as effective as beta-blockers and cause increased hypotension. Nitrates aren't used because of their dilating effects, which would further compromise the myocardium.

A 55-year-old client is admitted with an acute inferior-wall myocardial infarction. During the admission interview, he says he stopped taking his metoprolol (Lopressor) 5 days ago because he was feeling better. Which of the following nursing diagnoses takes priority for this client? A) Anxiety B) Ineffective tissue perfusion; cardiopulmonary C) Acute pain D) Ineffective therapeutic regimen management

B) Ineffective tissue perfusion; cardiopulmonary MI results from prolonged myocardial ischemia caused by reduced blood flow through the coronary arteries. Therefore, the priority nursing diagnosis for this client is Ineffective tissue perfusion (cardiopulmonary). Anxiety, acute pain, and ineffective therapeutic regimen management are appropriate but don't take priority

What should the nurse recognize as an indication for the use of dopamine (Intropin) in the care of a patient with heart failure? A. Acute anxiety B. Hypotension and tachycardia C. Peripheral edema and weight gain D. Paroxysmal nocturnal dyspnea (PND)

B. Hypotension and tachycardia Dopamine is a β-adrenergic agonist whose inotropic action is used for treatment of severe heart failure accompanied by hemodynamic instability. Such a state may be indicated by tachycardia accompanied by hypotension. PND, anxiety, edema, and weight gain are common signs and symptoms of heart failure, but these do not necessarily warrant the use of dopamine.

The home care nurse visits a 73-year-old Hispanic woman with chronic heart failure. Which clinical manifestations, if assessed by the nurse, would indicate acute decompensated heart failure (pulmonary edema)? A. Fatigue, orthopnea, and dependent edema B. Severe dyspnea and blood-streaked, frothy sputum C. Temperature is 100.4o F and pulse is 102 beats/minute D. Respirations 26 breaths/minute despite oxygen by nasal cannula

B. Severe dyspnea and blood-streaked, frothy sputum Clinical manifestations of pulmonary edema include anxiety, pallor, cyanosis, clammy and cold skin, severe dyspnea, use of accessory muscles of respiration, a respiratory rate > 30 breaths per minute, orthopnea, wheezing, and coughing with the production of frothy, blood-tinged sputum. Auscultation of the lungs may reveal crackles, wheezes, and rhonchi throughout the lungs. The heart rate is rapid, and blood pressure may be elevated or decreased.

Med that reduces heart rate

Beta Blocker

Which of the following classes of medication protects the ischemic myocardium by blocking catecholamines and sympathetic nerve stimulation?

Beta-blockers

Client with valvular heart disease is at risk for develop left side HF. Nurse knows to monitor what to determine if client has developed this?

Breath Sounds (crackles is associated with left side HF)

Which of the following sounds is distinctly heard on auscultation over the abdominal region of an AAA. client?

Bruit

The nurse determines that treatment of a client with a beta-adrenergic blocker for myocardial infarction has been effective when: A) Tachycardia occurs. B) Blood pressure is 90/50. C) Decreased dysrhythmias occur. D) Decreased urinary output occurs

C) Decreased dysrhythmias occur. Rationale: Beta blockers have the ability to decrease heart rate, decrease contractility, and decrease blood pressure, leading to decreased oxygen demand. They also slow conduction, which suppresses dysrhythmias. Tachycardia would not be desired with an MI. A low BP alone would not indicate effective treatment of the MI

If medical treatments fail, which of the following invasive procedures is necessary for treating cariomyopathy? A) Cardiac catherization B) Coronary artery bypass graft (CABG) C) Heart transplantation D) Intra-aortic balloon pump (IABP)

C) Heart transplantation The only definitive treatment for cardiomyopathy that can't be controlled medically is a heart transplant because the damage to the heart muscle is irreversible.

A client with a myocardial infarction is admitted to the cardiac unit. The nurse can best determine the effectiveness of the client's ventricular contractions by: A) OBSERVING ANXIETY LEVELS B) EVALUATING ENZYME RESULTS C) MONITORING URINARY OUTPUT HOURLY D) ASSESSING BREATH SOUNDS FREQUENTLY

C) MONITORING URINARY OUTPUT HOURLY

A 54-year-old male patient who had bladder surgery 2 days ago develops acute decompensated heart failure (ADHF) with severe dyspnea. Which action by the nurse would be indicated first? A. Perform a bladder scan to assess for urinary retention. B. Restrict the patient's oral fluid intake to 500 mL per day. C. Assist the patient to a sitting position with arms on the overbed table. D. Instruct the patient to use pursed-lip breathing until the dyspnea subsides.

C. Assist the patient to a sitting position with arms on the overbed table. The nurse should place the patient with ADHF in a high Fowler's position with the feet horizontal in the bed or dangling at the bedside. This position helps decrease venous return because of the pooling of blood in the extremities. This position also increases the thoracic capacity, allowing for improved ventilation. Pursed-lip breathing helps with obstructive air trapping but not with acute pulmonary edema. Restricting fluids takes considerable time to have an effect.

Which of the following conditions is most commonly responsible for myocardial infarction?

Coronary artery thrombosis

Which of the following tests is used most often to diagnose angina? A) Chest x-ray B) Echocardiogram C) Cardiac catherization D) 12-lead electrocardiogram (ECG)

D) 12-lead electrocardiogram (ECG) The 12-lead ECG will indicate ischemia, showing T-wave inversion. In addition, with variant angina, the ECG shows ST-segment elevation. A chest x-ray will show heart enlargement or signs of heart failure, but isn't used to diagnose angina.

Which of the following is an expected outcome for a client on the second day of hospitalization after an MI? A) Has severe chest pain B) Can identify risks factors for MI C) Agrees to participate in a cardiac rehabilitation walking program D) Can perform personal self-care activities without pain

D) Can perform personal self-care activities without pain By day 2 of hospitalization after an MI, clients are expected to be able to perform personal care without chest pain. Day 2 hospitalization may be too soon for clients to be able to identify risk factors for MI or begin a walking program; however, the client may be sitting up in a chair as part of the cardiac rehabilitation program. Severe chest pain should not be present.

The teaching plan for a client being started on long-acting nitroglycerin includes the action of this drug. The nurse teaches that this drug relieves chest pain by which action? A) Dilating just the coronary arteries B) Decreasing the blood pressure C) Increasing contractility of the heart D) Dilating arteries and veins

D) Dilating arteries and veins

Which diagnostic tool is used to determine the location of myocardial damage for a patient with a myocardial infarction (MI) ? A) CARDIAC CATHETERIZATION B) CARDIAC ENZYMES C) ECHOCARDIAGRAM D) ELECTROCARDIOGRAM (ECG)

D) ELECTROCARDIOGRAM (ECG)ELECTROCARDIOGRAM (ECG) IS THE QUICKEST, MOST ACCURATE AND MOST WIDELY USED TOOL TO DETERMINE THE LOCATION OF A MYOCARDIAL INFARCTION (MI)

A client has frequent bursts of ventricular tachycardia on the cardiac monitor. A nurse is most concerned with this dysrhythmia because: A) It is uncomfortable for the client, giving a sense of impending doom. B) It produces a high cardiac output that quickly leads to cerebral and myocardial ischemia. C) It is almost impossible to convert to a normal sinus rhythm. D) It can develop into ventricular fibrillation at any time.

D) It can develop into ventricular fibrillation at any time. Ventricular tachycardia is a life-threatening dysrhythmia that results from an irritable ectopic focus that takes over as the pacemaker for the heart. The low cardiac output that results can lead quickly to cerebral and myocardial ischemia. Client's frequently experience a feeling of impending death. Ventricular tachycardia is treated with antidysrhythmic medications or magnesium sulfate, cardioversion (client awake), or defibrillation (loss of consciousness), Ventricular tachycardia can deteriorate into ventricular defibrillation at any time.

A stable patient with acute decompensated heart failure (ADHF) suddenly becomes dyspneic. Before positioning the patient on the bedside, what should the nurse assess first? A. Urine output B. Heart rhythm C. Breath sounds D. Blood pressure

D. Blood pressure The nurse should evaluate the blood pressure before dangling the patient on the bedside because the blood pressure can decrease as blood pools in the periphery and preload decreases. If the patient's blood pressure is low or marginal, the nurse should put the patient in the semi-Fowler's position and use other measures to improve gas exchange.

After having an MI, the nurse notes the patient has jugular venous distention, gained weight, developed peripheral edema, and has a heart rate of 108/minute. What should the nurse suspect is happening? A. ADHF B. Chronic HF C. Left-sided HF D. Right-sided HF

D. Right-sided HF An MI is a primary cause of heart failure. The jugular venous distention, weight gain, peripheral edema, and increased heart rate are manifestations of right-sided heart failure.

In which of the following areas is an abdominal aortic aneurysm most commonly located? a. Distal to the iliac arteries b. Distal to the renal arteries c. Adjacent to the aortic branch d. Proximal to the renal arteries`

Distal to the renal arteries

What causes aneurysm to rupture

HTN (high blood pressure)

Dyspnea, cough, expectoration, weakness, and edema are classified signs and symptoms of which of the following conditions?

Heart Failure

Which of the following disorders is jugular vein distention most prominent?

Heart Failure

After an anterior wall myocardial infarction, which of the following problems is indicated by auscultation of crackles in the lungs?

Left sided heart failure

Which of the following symptoms usually signifies rapid expansion and impending rupture of an AAA?

Lower back pain

When assessinga client for an AAA which area of the abdomen is most commonly palpated?

Middle lower abdomen to the left of the midline

A client is admitted with suspected abdominal aortic aneurysm (AAA). A common complaint of the client with an abdominal aortic aneurysm is: A. Loss of sensation in the lower extremities B. Back pain that lessens when standing C. Decreased urinary output D. Pulsations in the periumbilical area

Pulsations in the periumbilical area

Which of the following conditions is most closely associated with weight gain, nausea, and a decreased in urine output?

Right sided heart failure

Which cardiac enzyme would the nurse expect to elevate first in a client diagnosed with a myocardial infarction?

Troponin (elevates within 1-2 hrs)

Which of the following complications is of greatest concern when caring for a preoperative abdominal aneurysm client?

aneurysm rupture

Ms. Sy undergoes surgery and the abdominal aortic aneurysm is resected and replaced with a graft. When she arrives in the RR she is still in shock. The nurse's priority should be : A. placing her in a trendeleburg position B. putting several warm blankets on her C. monitoring her hourly urine output D. assessing her VS especially her RR

assessing her VS espescially her RR Shock is characterized by reduced tissue and organ perfusion and eventual organ dysfunction and failure. Checking on the VS especially the RR, which detects need for oxygenation, is a priority to help detect its progress and provide for prompt management before the occurrence of complications

Med that reduced preload and afterload

diuretics

Client has anterior septal myocardial infarction. Client is on Dobutamine drip. Rationale for client's dobutamine drip is

improve cardiac output (it increases heart rate and improves hypertension)